273 results match your criteria: "Atrium Health - Musculoskeletal Institute[Affiliation]"

Objectives: Patients with dental pain seek treatment in Urgent and Emergency Care settings by physicians and advanced practice practitioners (APPs) unable to provide definitive care, often relying on prescriptions for pain management including opioids. In the face of an opioid epidemic, this study assessed the impact of an electronic health record (EHR) clinical decision support tool to identify patients at high risk for opioid misuse using objective, evidence-based criteria, and guide safer prescribing.

Methods: Dental pain encounters occurring between January 2016 and June 2018 within our healthcare system were identified and linked to the database supporting a real-time clinical decision support intervention, Prescription Reporting with Immediate Medication Utilization Mapping (PRIMUM), to characterize opioid prescribing patterns and prescribers' response to alert.

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Purpose: We sought to determine the rate of intraoperative and early postoperative (90-day) complications of multiligamentous knee reconstruction surgeries, both medical and surgical, and associated variables from the 15-year experience of a single academic institution.

Methods: Patients treated at a single academic institution between 2005 and 2019 who underwent multiligament knee surgery were identified. Inclusion criteria included intervention with 2+ ligament reconstructions performed concurrently, and more than 90 days postoperative follow-up.

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Objectives: To quantify radiographic outcomes and to identify predictors of late displacement in the nonoperative treatment of lateral compression type II (LC-2) pelvic ring injuries.

Design: Retrospective review.

Setting: Two Level 1 trauma centers.

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Purpose: To quantify the prevalence of opioid and benzodiazepine prescriptions for patients with rotator cuff disease across a large health care system and to describe evidence-based risk factors for opioid use within this population.

Methods: We conducted a retrospective cohort study at a major health care system of all patients with qualifying diagnostic codes. Emergency department, urgent care, and outpatient encounters between January and December 2016 for an acute rotator cuff tear, listed as the primary diagnosis, were included.

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Does sex affect second ACL injury risk? A systematic review with meta-analysis.

Br J Sports Med

August 2021

Faculty of Medicine, Department of Physical Therapy, The University of British Columbia, Vancouver, British Columbia, Canada

Objective: To determine sex-based differences in risk of a second ACL injury (overall and by laterality) following primary ACL reconstruction in athletes who are attempting to return to sport.

Design: Systematic review with meta-analysis.

Data Sources: Systematic search of five databases conducted in August 2019.

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Potential Benefits of Limited Clinical and Radiographic Follow-up After Surgical Treatment of Ankle Fractures.

J Am Acad Orthop Surg Glob Res Rev

May 2021

From the Geisinger Medical Center, Department of Orthopaedics, MSK Institute, Danville, PA (Dr. Friedman and Dr. Horwitz); the Universidad del Rosario, School of Medicine and Health Sciences, Bogota, Colombia (Dr. Sanchez); the Department of Orthopaedic Surgery, University of California Davis Health System, Sacramento, CA (Dr. Zachos); Department of Orthopedic Surgery, Lahey Hospital and Medical Center, Burlington, MA (Dr. Marcantonio); Department of Orthopaedic Surgery, Beaumont Health, Royal Oak, MI (Dr. Audet); Department of Orthopaedic Surgery, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH (Dr. Vallier); Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN (Dr. Mullis); University of Miami, Department of Anesthesiology, Jackson Memorial Hospital, Miami, FL (Dr. Myers-White); Department of Orthopaedic Surgery, Carolinas Medical Center, Atrium Health Musculoskeletal Institute, Charlotte, NC (Dr. Kempton); and Department of Orthopedic Surgery, Cleveland Clinic Akron General Hospital, Akron, OH (Dr. Watts).

Introduction: Ankle fractures are one of the most prevalent musculoskeletal injuries, with a significant number requiring surgical treatment. Postoperative complications requiring additional interventions frequently occur during the early postoperative period. We hypothesize that there is a limited need for routine clinical and radiographic follow-up once the fracture is deemed healed.

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Knee Arthrodesis With an Intramedullary Antegrade Rod as a Salvage Procedure for the Chronically Infected Total Knee Arthroplasty.

J Am Acad Orthop Surg Glob Res Rev

September 2020

From the Department of Orthopaedic Surgery, Loyola University Medical Center, Maywood, IL (Dr. Brown); the Department of Orthopaedic Surgery, University of Rochester Medical Center, Orthopaedics & Rehabilitation, Rochester, NY (Dr. Balkissoon); OrthoCarolina, Sports Medicine Center, Atrium Health Musculoskeletal Institute (MSKI), Charlotte, NC (Dr. Saltzman); Anchorage Fracture & Orthopedic Clinic, Anchorage, AK (Dr. Haughom); UCSF Fresno, Fresno, CA (Dr. Li); the Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL (Dr. Levine); and the Department of Orthopaedic Surgery, Cadence Health, Winfield, IL (Dr. Sporer).

Introduction: Infection is a challenging complication after total knee arthroplasty (TKA) that is often treatable. However, recurrent infection may require resection, amputation, or arthrodesis. The purpose of this study was to evaluate the results of antegrade nailing with an intramedullary rod for the treatment of a chronically infected TKA.

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Background: Obese patients have increased complications after total knee arthroplasty (TKA). A body mass index (BMI) cutoff of 40 is frequently used to determine eligibility for TKA. Patients with a BMI <40 and extremely large legs which may predispose them to complications are approved for surgery because they fall below this cutoff.

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Background: The identification of risk factors for injury is a key step for musculoskeletal injury prevention in youth sports. Not identifying and correcting for injury risk factors may result in lost opportunity for athletic development. Physical maturation and sex affect these characteristics, which may indicate the need for both age and sex-based injury prevention programs.

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Nonsurgical Management of Ulnar Collateral Ligament Injuries.

J Am Acad Orthop Surg Glob Res Rev

April 2021

From the Department of Orthopedics, New York Presbyterian, Columbia University Medical Center, New York, NY (Dr. Swindell, Dr. Trofa, Dr. Alexander, and Dr. Ahmad); the OrthoCarolina Sports Medicine Center, Charlotte, NC (Dr. Sonnenfeld and Dr. Saltzman); and the Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, Charlotte, NC (Dr. Saltzman).

Ulnar collateral ligament (UCL) injuries are a common source of pain and disability in the overhead athlete and often result in notable loss of time from competition. Over the past 10 to 15 years, the prevalence of UCL injury and reconstruction has undergone a dramatic increase, making it imperative to determine which patients may benefit from a nonsurgical regimen. Nonsurgical treatment involves a multidisciplinary approach of rehabilitation with tailored physical therapy programs and, in certain cases, biologic adjuncts.

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Overuse Elbow Injuries in Youth Gymnasts.

Am J Sports Med

February 2022

OrthoCarolina, Charlotte, North Carolina, USA.

Background: Gymnastics is a unique sport that places significant loads across the growing elbow, resulting in unique overuse injuries, some of which are poorly described in the current literature.

Purpose: To provide a comprehensive review of the unique overuse elbow injuries seen in youth gymnasts and to provide an up-to-date synthesis of the available literature and clinical expertise guiding treatment decisions in this population.

Study Design: Narrative review.

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Article Synopsis
  • Despite the common use of antibiotics, surgical site infections remain prevalent in patients with fractures, prompting the need to explore better prevention methods.
  • An open-label randomized clinical trial tested the impact of intrawound vancomycin powder on reducing deep surgical site infections in high-risk patients undergoing tibial plateau or pilon fracture surgeries across multiple US trauma centers.
  • Results showed that the treatment group had a lower incidence of deep infections (6.4%) compared to the control group (9.8%), with the vancomycin specifically showing a significant effect on gram-positive infections, indicating its potential as an effective intervention in surgical settings.
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Background: Ulnar collateral ligament reconstruction (UCLR) is the gold standard for treating ulnar collateral ligament injuries in throwing athletes who have failed conservative treatment. There are several described techniques that produce successful and reproducible outcomes. In addition, there is biomechanical evidence that supports hybrid fixation of the graft with a docking technique on the humeral side and suspensory fixation on the ulnar side.

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Background: Complications after total knee arthroplasty (TKA) are devastating for patients, and surgeons are held accountable in alternative payment models. Optimization of modifiable risk factors has become a mainstay in the preoperative period. We sought to evaluate the consequence of failure to optimize key risk factors in a modern cohort of patients who underwent TKA.

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Upper limb amputations, ranging from transhumeral to partial hand, can be devastating for patients, their families, and society. Modern paradigm shifts have focused on reconstructive options after upper extremity limb loss, rather than considering the amputation an ablative procedure. Surgical advancements such as targeted muscle reinnervation and regenerative peripheral nerve interface, in combination with technological development of modern prosthetics, have expanded options for patients after amputation.

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Introduction: Pragmatic trials in comparative effectiveness research assess the effects of different treatment, therapeutic, or healthcare options in clinical practice. They are characterized by broad eligibility criteria and large sample sizes, which can lead to an unmanageable number of participants, increasing the risk of bias and affecting the integrity of the trial. We describe the development of a sampling strategy tool and its use in the PREPARE trial to circumvent the challenge of unmanageable work flow.

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Quality and Content of Internet-Based Information for Osteoporosis and Fragility Fracture Diagnoses.

J Am Acad Orthop Surg Glob Res Rev

February 2021

From the Department of Orthopaedic Surgery, Atrium Health Musculoskeletal Institute, Charlotte, NC (Dr. Wally, Dr. Bemenderfer, Dr. McKnight, Dr. Gorbaty, Dr. Seymour, and Dr. Karunakar); the Department of Orthopedic Surgery, Prisma Health-Upstate; Greenville, SC (Dr. Jeray); and the University of South Carolina School of Medicine Greenville, Greenville, SC (Dr. Jeray).

Introduction: We aimed to assess the quality and content of websites addressing orthopaedic conditions affecting older adults, emphasizing osteoporosis and fragility fracture.

Methods: Ten diagnoses were chosen. The transparency of information was assessed via the Health On the Net (HON) score; information content was assessed via diagnosis-specific grading templates.

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Recognition of Failure Modes of Lateral Ankle Ligament Reconstruction: Revision and Salvage Options.

Foot Ankle Clin

March 2021

OrthoCarolina Foot and Ankle Institute, Atrium Health Musculoskeletal Institute, 2001 Vail Avenue, Suite 200B, Charlotte, NC 28207, USA. Electronic address:

Primary lateral ankle ligament reconstruction has a high success rate, but failures may lead to recurrent instability. In patients with recurrent lateral ankle instability, it is important to determine the mode of failure. Underlying cavovarus deformity and joint hypermobility must be identified and addressed at the time of revision surgical stabilization.

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Background: The medical community is beginning to recognize the contribution of prescription opioids in the growing national opioid crisis. Many studies have compared the safety and efficacy of alternative analgesics to opioids, but none utilizing a completely opioid-free perioperative protocol in orthopedics.

Methods: We developed and tested an opioid-free perioperative analgesic pathway (from preoperative to postoperative period) among patients undergoing common elective orthopedic procedures.

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Background: Pelvic fractures represent a small percent of all skeletal injuries but are associated with significant morbidity and mortality secondary to hemodynamic instability from bleeding bone surfaces and disrupted pelvic vasculature. Stabilization of the pelvis prior to arrival at a treatment facility may mitigate the hemodynamic consequences of pelvic ring injuries and improve morbidity and mortality. Whether pelvic compression devices such as pelvic binders or sheets can be safely applied in the prehospital setting has not been well-studied.

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Cells of the nucleus pulposus (NP) are essential contributors to extracellular matrix synthesis and function of the intervertebral disc. With age and degeneration, the NP becomes stiffer and more dehydrated, which is associated with a loss of phenotype and biosynthetic function for its resident NP cells. Also, with aging, the NP cell undergoes substantial morphological changes from a rounded shape with pronounced vacuoles in the neonate and juvenile, to one that is more flattened and spread with a loss of vacuoles.

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Background: Osteoporotic hip fractures typically occur in frail elderly patients with multiple comorbidities, and repair of the fracture within 48 h is recommended. Pre-operative evaluation sometimes involves transthoracic echocardiography (TTE) to screen for heart disease that would alter peri-operative management, yet TTE can delay surgery and is resource intensive. Evidence suggests that the use of clinical practice guidelines (CPGs) can improve care.

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Background: Research has become a key pillar of academic medicine and a cornerstone of residency training; however, there continues to be significant barriers to ensuring research productivity for residents. We implemented a novel tiered team approach which aimed to increase research productivity and promote collaboration during residency training.

Methods: This was a retrospective study that evaluated the implementation of a novel tiered team research approach at a single institution between 2009 and 2013.

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