Publications by authors named "Jourdan Cancienne"
Introduction: The popularity of platelet-rich plasma (PRP) injections for the treatment of orthopaedic conditions has grown markedly. We sought to better define the trends in the usage of orthopaedic PRP injections across an insured US population over the past decade.
Methods: The PearlDiver M91Ortho commercial administrative claims database was queried for all patients receiving PRP injections for orthopaedic conditions from 2010 through the first quarter of 2020 (Q1.
Labral tears resulting in 270° near-circumferential pathology predispose patients to recurrent instability and are technically challenging to repair. Furthermore, when such lesions are associated with Hill-Sachs lesions, recurrent instability risk is significantly increased and can result in substantially lower clinical outcomes. When determining a surgical treatment algorithm for shoulder stabilization, it is important to consider both humeral- and glenoid-sided pathology because subtle defects can have significant influence on recurrence and patient reported outcomes.
View Article and Find Full Text PDFBackground: The application of orthobiologics at the time of arthroscopic rotator cuff repair (RCR) has received an increasing amount of clinical interest despite a relative scarcity of human clinical studies on their efficacy.
Purpose: To utilize a national administrative database to determine the association of bone marrow aspirate concentrate (BMAC) and platelet-rich plasma (PRP) applied at the time of RCR with revision surgery rates.
Study Design: Cohort study; Level of evidence, 3.
Medial collateral ligament (MCL) injuries are typically managed non-operatively, with high rates of clinical success. However, patients who present with medial knee laxity with valgus stress testing of a fully extended knee, anteromedial rotatory instability, associated tibial plateau fracture, or multiligament injury or those who continue to be symptomatic after non-operative treatment may benefit from surgical intervention. Patients with a history of total knee arthroplasty who suffer MCL and posterior oblique ligament (POL) injuries represent a challenging patient population and often require surgical attention.
View Article and Find Full Text PDFAnterior cruciate ligament (ACL) reconstruction is one of the most commonly performed orthopaedic sports procedures. Two main techniques are used for accomplishing an ACL reconstruction: transtibial and anteromedial portal techniques. The transtibial technique has been criticized for its inability to create an anatomic femoral tunnel given the intrinsic constraint of the tibial tunnel during drilling.
View Article and Find Full Text PDFBackground: There is little literature examining the association of corticosteroid injections into shoulders with a pre-existing arthroplasty. The aim of the current study was to determine the risk of early infection following intra-articular corticosteroid injection into a pre-existing shoulder arthroplasty.
Methods: The PearlDiver database was retrospectively reviewed to identify patients with a pre-existing shoulder arthroplasty from 2007 to 2017.
Background: The goals of this study were to determine the incidence in the United States of preoperative three-dimensional imaging prior to anatomic total shoulder arthroplasty for osteoarthritis and to determine if preoperative imaging is associated with decreased complication rates.
Methods: Using a Medicare insurance database, we identified all patients who underwent computed tomography (n = 9380) and/or magnetic resonance imaging (n = 15,653) prior to anatomic total shoulder arthroplasty for a diagnosis of osteoarthritis from 2005 to 2014. The incidence of imaging over time was analyzed and complication rates compared between patients with imaging to matched controls.
Background: Although previous studies have reported acceptable clinical outcomes after simultaneous, single-stage bilateral and staged bilateral rotator cuff repair (RCR), few studies have been adequately powered to compare postoperative complication rates at various time intervals between procedures.
Purpose: To examine the relationship between the timing of bilateral arthroscopic RCR and complications.
Study Design: Descriptive epidemiology study.
Introduction: The primary objective of this study was to examine the relationship between vitamin D deficiency and implant-related and medical complications following total shoulder arthroplasty.
Methods: Using the PearlDiver database, patients who underwent total shoulder arthroplasty from 2005 to 2016 with vitamin D deficiency were identified. These were compared to a 3:1 control group matched by age, sex, and presence of a concomitant osteoporosis diagnosis.
Background: To curb costs at the state level, improve care quality, and promote access to care, certificate-of-need (CON) laws were established in many states in 1974. It is not known how CON regulations have affected the provision of knee arthroscopy, one of the most common orthopedic procedures performed in the USA.
Questions/purposes: We sought to characterize the effects of CON regulations on knee arthroscopy in the national Medicare population by examining trends in procedure volumes, comparing trends in procedure charges, evaluating distribution of procedure volumes between high-, mid-, and low-volume facilities, and comparing adverse event and complication rates after knee arthroscopy between states with and without CON regulations.
Background: Return to play after anterior cruciate ligament (ACL) reconstruction can increase risk for both ipsilateral graft rupture and contralateral ACL rupture. The risk for injury of the contralateral knee after ACL reconstruction could be nearly double that of ipsilateral graft rupture.
Questions/purposes: We sought to identify independent, patient-related risk factors for contralateral ACL rupture following primary ACL reconstruction.
Background And Hypothesis: Although the literature on the association of workers' compensation (WC) status with negative outcomes after orthopedic surgery is extensive, there is a paucity of evidence on outcomes in WC recipients undergoing biceps tenodesis. We hypothesized that WC patients would report significantly worse outcomes postoperatively on patient-reported outcome measures (PROMs).
Methods: Functional and health-related quality-of-life PROMs and a visual analog scale score for pain were administered preoperatively and at 12 months postoperatively to consecutive patients undergoing isolated biceps tenodesis between 2014 and 2018 at our institution.
A massive, irreparable rotator cuff tear represents a challenging treatment scenario with respect to surgical intervention. Traditionally, surgical options have included reverse total shoulder arthroplasty, hemiarthroplasty, or rotator cuff repair; however, these techniques may not necessarily restore proper anatomy to the superior capsule, a structure implicated in the maintenance of subacromial contact pressures and the prevention of superior glenohumeral translation. Indications for arthroscopic superior capsular reconstruction include massive, irreparable supraspinatus and/or infraspinatus tears and failure of conservative treatment beyond subjective pain thresholds and dysfunction tolerability.
View Article and Find Full Text PDFA national database in the United States was used to identify increasing age, male sex, smoking, obesity, hyperlipidemia, and vitamin D deficiency as significant independent patient-specific risk factors for rotator cuff repair failure requiring revision repair. Understanding risks for repair failure can help counsel patients, inform treatment strategies, and consider treatment alternatives for patients with symptomatic rotator cuff tears.
View Article and Find Full Text PDFIntroduction: The practice of identifying trends in surgical decision-making through large-scale patient databases is commonplace. We hypothesize that notable differences exist between claims-based and prospectively collected clinical registries.
Methods: We queried the American College of Surgeons National Surgical Quality Improvement Program (NSQIP), a prospective surgical outcomes database, and PearlDiver (PD), a claims-based private insurance database, for patients undergoing primary total shoulder arthroplasties from 2007 to 2016.
Purpose: To evaluate the relationship between preoperative mental health measured by the Short-Form 12 health survey mental component score and outcomes after isolated biceps tenodesis.
Methods: The American Shoulder and Elbow Surgeons form (ASES), Single Assessment Numeric Evaluation (SANE), Constant-Murley score (CMS), and visual analog scale (VAS) for pain were administered preoperatively and at 6 and 12 months postoperatively to consecutive patients undergoing isolated biceps tenodesis between 2014 and 2018. Minimal clinically important difference, substantial clinical benefit (SCB), patient-acceptable symptom state (PASS), and rates of achievement were calculated.
Background: Reverse total shoulder arthroplasty (RTSA) as a revision procedure for failed anatomic total shoulder arthroplasty (TSA) is increasing in incidence. The purpose of this study was to analyze the results of RTSA as a revision salvage procedure for failed TSA and identify factors that influenced those outcomes.
Methods: All anatomic TSAs that were revised to RTSAs in adult patients, under the care of 2 senior surgeons at a single academic center from 2006 to 2018, were queried and reviewed.
Purpose: The purpose of this study is to define the impact of preoperative opioid use on postoperative opioid use, patient-reported outcomes, and revision rates in a cohort of patients receiving arthroscopic shoulder surgery.
Methods: Patients who underwent shoulder arthroscopy were identified from an institutional database. Inclusion criteria were completion of preoperative and postoperative patient-reported outcome measures (PROMs) at 1-year follow-up and completion of a questionnaire on use of opioids and number of pills per day.
Purpose: To biomechanically compare the suction seal, contact area, contact pressures, and peak forces of the intact native labrum, torn labrum, 12- to 3-o'clock labral repair, and 270° labral reconstruction in the hip.
Methods: A cadaveric study was performed using 8 fresh-frozen hemipelvises with intact labra and without osteoarthritis. Intra-articular pressure maps were produced for each specimen using an electromechanical testing system under the following conditions: (1) intact labrum, (2) labral tear, (3) labral repair between the 12- and 3-o'clock positions, and (4) 270° labral reconstruction using iliotibial band allograft.
Purpose: To compare the biomechanical properties of the hip joint with an intact femoral cam lesion, partial cam resection, and complete cam resection.
Methods: A cadaveric study was performed using 8 hemipelvises with cam-type morphology (alpha angle > 55°) and intact labra. Intra-articular pressure maps were produced for each specimen under the following conditions: (1) native cam morphology (intact), (2) cam morphology with incomplete resection (partial), and (3) cam morphology with complete resection (complete).
Purpose: To determine the biomechanical effect of limited lateral retinacular and capsular release on lateral patellar translation as a function of constant force at various knee flexion angles.
Methods: Six pairs of bilateral cadaveric knee specimens (12 knees) were obtained from a tissue bank, dissected, and potted in a perfect lateral position based on fluoroscopy. A direct lateral force was applied to the patella through an eye screw in the midpoint of the lateral patella, and each knee underwent testing in the intact state and after lateral retinacular and capsular release.
Background: The purpose of the present study was to examine the relationship between postoperative therapeutic anticoagulation, wound complications, infection, and revision.
Methods: Using a national insurance database from 2007 to 2016, patients who underwent shoulder arthroplasty with an indication for postoperative therapeutic anticoagulation in the case of atrial fibrillation or acute postoperative venous thromboembolism were identified. Those with a prescription for a therapeutic anticoagulant within 2 weeks of surgery were identified and compared with controls without postoperative therapeutic anticoagulant prescriptions.
Background: The use of platelet-rich plasma (PRP) in the Medicare population is not well described.
Purpose: To investigate the national use of PRP among Medicare beneficiaries, including the incidence and conditions for which it was used in both operative and nonoperative settings, and determine charges to Medicare.
Study Design: Descriptive epidemiology study.
Purpose: To define the contributions of the of the medial patellofemoral ligament (MPFL) and medial quadriceps tendon femoral ligament (MQTFL) to lateral patellar translation as the knee moves through a 90° arc of motion.
Methods: Six pairs of bilateral cadaveric knee specimens (12 knees) were dissected and potted in perfect lateral position using fluoroscopy. An eye screw was placed in the midpoint on the lateral aspect of the patella.