117 results match your criteria: "Shiley Center for Orthopaedic Research and Education at Scripps Clinic[Affiliation]"

Purpose: This study aimed to investigate the sequential changes in patient-reported outcome measures (PROMs) and the satisfaction rate during long-term follow-up after total knee arthroplasty (TKA).

Methods: Studies published until December 2023 were searched in MEDLINE, EMBASE, SCOPUS and Cochrane Library. The inclusion criteria were TKA as the primary procedure, a final post-operative follow-up period of at least seven years and reporting of PROMs data.

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The clinical application of collagen-based biomaterials is expanding rapidly, especially in tissue engineering and cosmetics. While oral supplements and injectable skin boosters are popular for enhancing skin health, clinical evidence supporting their effectiveness remains limited. Injectable products show potential in revitalizing skin, but safety concerns persist due to challenges in sterilization and the risk of biological contamination.

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Is Magnetic Resonance Imaging Overused Among Patients Undergoing Total Knee Arthroplasty?

J Am Acad Orthop Surg Glob Res Rev

October 2024

From the Shiley Center for Orthopaedic Research and Education at Scripps Clinic, La Jolla, CA (Ms. Mukkamala and Ms. Schaffer), and the Department of Orthopaedic Surgery, Scripps Clinic, La Jolla, CA (Dr. Weber, Dr. Wilde, and Dr. Rosen).

Introduction: With increasing healthcare costs, it is important to quantify the number of total knee arthroplasty (TKA) patients who have MRIs that are not considered clinically necessary. The purpose of this study was to determine the number of unnecessary preconsultation MRIs done among TKA patients at our institution.

Methods: Eight hundred and sixty-nine patients who underwent a primary TKA were identified.

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Article Synopsis
  • The study aimed to determine how different durations of intraoperative radiofrequency ablation affect the health and characteristics of bursal cells collected during rotator cuff surgery in patients.
  • Six healthy patients participated, and bursal tissue was subjected to varying levels of ablation to assess cell viability, growth potential, and phenotypes.
  • Findings showed that longer ablation times led to reduced viability of the cells, but the overall characteristics of the cells remained consistent across different treatment groups, indicating that while ablation affects cell survival, it does not significantly alter cell properties.
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Introduction: We aimed to investigate the anatomical and clinical advantages of an Asian-specific femoral component design with a high femoral aspect ratio, compared with the conventional femoral component design.

Materials And Methods: A retrospective analysis of the operation and outpatient clinic records of 239 knees operated on using an anatomically modified femoral component design (MFCD, Group A) and 153 knees operated on using a conventional femoral component design (CFCD, Group B) in Korean patients was performed. Three subgroups were created based on the mediolateral size of the two different femoral component designs.

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Background: Large osteochondral lesions of the humeral head can result from locked posterior dislocations, avascular necrosis, and osteochondritis dissecans. Fresh osteochondral allograft (OCA) transplantation is a treatment option for young patients with focal osteochondral defects of the humeral head. The purpose of this case series was to assess graft survivorship, subjective patient-reported outcomes, and satisfaction among 7 patients who underwent OCA transplantation of the humeral head.

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Hybrid lateral closed-wedge high tibial osteotomy (HBHTO) carries certain advantages over medial open-wedge high tibial osteotomy (OWHTO). We investigated the potential difference in the required correction angle between HBHTO and OWHTO to achieve an equal amount of whole lower-extremity alignment correction, retrospectively analyzing the preoperative plain radiographic images of 100 patients. The medial proximal tibial angle (MPTA), joint line convergence angle (JLCA), mechanical lateral distal femoral angle (mLDFA), hip-knee-ankle axis (HKA), length of the tibia, width of the tibial plateau, length of the lower limb (leg length), and location of the center of deformity (CD) were measured.

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Article Synopsis
  • - The article reviews various surgical reconstruction methods for acromioclavicular (AC) joint injuries, noting a lack of agreement on the best techniques due to varying failure rates.
  • - It provides an in-depth look at current surgical principles and methods favored by experts for managing AC shoulder injuries.
  • - The article stresses the importance of addressing both horizontal and rotational instability in AC injuries and suggests that these insights can guide future research to enhance treatment outcomes.
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Background: Various arthroscopic rotator cuff repair techniques are being used for the treatment of rotator cuff tears with the development of surgical instruments. However, retears after repair are not completely avoidable, and efforts to reduce retears remain a challenge.

Purpose/hypothesis: To introduce a new repair technique, the double-row modified Mason-Allen technique with a single knot, and to compare clinical outcomes and retear rates with the single-row modified Mason-Allen technique.

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Article Synopsis
  • Medial opening-wedge high tibial osteotomy (MOWHTO) is a surgical procedure aimed at treating young adults with knee osteoarthritis due to varus deformity, but the impact of different types of medial meniscal tears on joint space width (JSW) has not been fully understood.* -
  • This cohort study followed 134 patients for over two years post-MOWHTO, categorizing them based on their medial meniscal status (intact, nonroot tear, root tear) and measuring changes in JSW at multiple intervals, while also assessing clinical function using the IKDC scores.* -
  • Results indicated that while JSW increased for all groups after surgery, the timing and extent of the
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High accuracy of intra-articular needle position during anterior landmark guided glenohumeral injections.

J ISAKOS

August 2024

Department of Orthopaedic Surgery, Sports Medicine, Scripps Clinic Medical Group, Shiley Center for Orthopaedic Research and Education at Scripps Clinic, 10666 N. Torrey Pines Rd. MS116 La Jolla, CA 92037, USA.

Objectives: Image-guided ultrasound or fluoroscopic glenohumeral injections have high accuracy rates but require training, equipment, cost, and radiation exposure (fluoroscopy). In contrast, landmark-guided glenohumeral injections do not require additional subspecialist referrals or equipment. An optimal technique would be safe and accurate and have few barriers to implementation.

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Background: Fresh osteochondral allograft (OCA) transplantation is a viable treatment option for osteochondral defects of the talus. However, sufficient data are not available on patients' participation in sports or recreational activities after the procedure.

Purpose: To assess whether patients undergoing OCA transplantation of the talus participated in sports or recreational activities postoperatively.

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Purpose: This study aimed to determine whether the repair of a medial meniscus posterior root tear (MMPRT) is effective for MMPRT healing, cartilage regeneration, and clinical outcomes in opening wedge high tibial osteotomy (OWHTO).

Methods: This retrospective study included 80 patients who underwent OWHTO and subsequent second-look arthroscopy. The patients were divided into OWHTO-with-MMPRT-repair (n = 40) and OWHTO alone (n = 40) groups, and the healing rates (complete/partial/failure) were compared.

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Correlations between elastic modulus and ultrashort echo time (UTE) adiabatic T1ρ relaxation time (UTE-Adiab-T1ρ) in Achilles tendons and entheses.

J Biomech

November 2023

Department of Radiology, University of California, San Diego, La Jolla, CA, USA; Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, La Jolla, CA, USA. Electronic address:

Patients with psoriatic arthritis commonly have abnormalities of their entheses, which are the connections between tendons and bone. There are shortcomings with the use of conventional magnetic resonance imaging (MRI) sequences for the evaluation of entheses and tendons, whereas ultrashort echo time (UTE) sequences are superior for the detection of high signals, and can also be used for non-invasive quantitative assessments of these structures. The combination of UTE-MRI with an adiabatic-T preparation (UTE-Adiab-T) allows for reliable assessment of entheses and tendons with decreased susceptibility to detrimental magic angle effects.

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To determine whether the mechanical properties of joint soft tissues such as cartilage can be calculated from quantitative magnetic resonance imaging (MRI) data, we investigated whether the mechanical properties of articular cartilage and meniscus scheduled to be resected during arthroplasty are correlated with the T2 relaxation time on quantitative MRI at the same location. Six patients who had undergone knee arthroplasty and seven who had undergone hip arthroplasty were examined. For the knee joint, the articular cartilage and lateral meniscus of the distal lateral condyle of the femur and proximal lateral tibia were examined, while for the hip joint, the articular cartilage above the femoral head was studied.

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Background: The minipig has been used for research in various fields of medicine, even in orthopedics. Though previous studies have already suggested other methods to create osteoporotic bone, those methods had some disadvantages for taking time and efforts. Therefore, we aimed to generate osteoporotic proximal humerus and proximal femur of minipig using EDTA solution and validate their properties through dual energy X-ray absorptiometry (DEXA), micro-CT study, histological and biomechanical ways.

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Objectives: Single-cell level analysis of articular cartilage and meniscus tissues from human healthy and osteoarthritis (OA) knees.

Methods: Single-cell RNA sequencing (scRNA-seq) analyses were performed on articular cartilage and meniscus tissues from healthy (n=6, n=7) and OA (n=6, n=6) knees. Expression of genes of interest was validated using immunohistochemistry and RNA-seq and function was analysed by gene overexpression and depletion.

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Successful tissue regeneration requires a clinically viable source of mesenchymal stem cells (MSCs). We explored activin receptor-like kinase (ALK)-5 inhibitors to rapidly derive an MSC-like phenotype with high cartilage forming capacity from a xeno-free human embryonic cell line. Embryonic stem cell (ESC) lines (H9 and HADC100) were treated with the ALK-5 inhibitor SB431542; HADC100 cells were additionally treated with ALK-5 inhibitors SB525334 or GW788388.

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Hip and Knee Arthroplasty Outcomes for Nonagenarian Patients.

J Am Acad Orthop Surg

November 2022

From the Department of Orthopaedic Surgery, Scripps Clinic, La Jolla, CA (Sizer, Bugbee, Copp, Ezzet, Walker, and Rosen), and Shiley Center for Orthopaedic Research and Education at Scripps Clinic, La Jolla, CA (McCauley, Luu, and Densley).

Introduction: Studies have previously reported higher complication rates in elective total joint arthroplasty (TJA) for nonagenarians compared with younger cohorts. The purpose of this study was to assess whether nonagenarians were still at increased risk of complications and hospital readmissions by answering three questions: (1) Do nonagenarians have an increased risk of medical complications after TJA compared with octogenarians and septuagenarians? (2) Do nonagenarians have an increased risk of surgical complications after TJA compared with octogenarians and septuagenarians? (3) Do nonagenarians have an increased risk of hospital readmission after TJA compared with octogenarians and septuagenarians?

Methods: A total of 174 patients undergoing primary TJA between 2010 and 2017 were included; 58 nonagenarians (older than 90 years) were matched with 58 octogenarians (age 80 to 84 years) and 58 septuagenarians (age 70 to 74). Groups were matched by sex, diagnosis, surgeon, surgical joint, and year of surgery.

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Purpose: This study aimed to investigate the complications of primary total hip arthroplasty based on immediate postoperative X-rays. The overall quality and cost of X-rays were assessed.

Methods: The institutional database was queried to identify all patients who underwent total hip arthroplasty in a single institution between January 1, 2018, and December 31, 2018.

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Patellofemoral joint complications remain an important issue in total knee arthroplasty. We compared the patellofemoral contact status between cruciate-retaining and posterior-stabilized designs with varying degrees of tibial sagittal and rotational alignment using a computer simulation to ensure proper alignments in total knee arthroplasty. Knee kinematics, patellofemoral contact force and quadriceps force were computed using a musculoskeletal modeling program (LifeMOD/KneeSIM 2010; LifeModeler, Inc.

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Background: Tranexamic acid (TXA) is often used to prevent excessive blood loss during bilateral TKA. Although it diminishes blood loss, TXA may have a potentially elevated thrombogenic risk with extra, unnecessary doses of TXA in this high-risk population. To date, the most efficacious dosing protocol in this setting has not yet been ascertained.

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Background: The relative impact of soft tissue balance and knee laxity on clinical outcomes after total knee arthroplasty (TKA) is not fully understood. We analyzed associations among knee laxity, kinematics, and patient-reported outcomes.

Methods: Knee Society Scores were recorded in 67 patients before and after primary TKA for osteoarthritis with varus deformity (N = 78).

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There are various methods for reconstructing the anterior cruciate ligament (ACL) from other muscles or tendons. Initial tension of the reconstructed ACL is one of the key elements affecting postoperative outcomes. However, tension cannot be measured after graft fixation.

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To mimic the ultrastructural morphology of the meniscus with nanofiber scaffolds coupled with controlled growth factor delivery to modulate cellular performance for tissue engineering of menisci. The authors functionalized collagen nanofibers by conjugating heparin to the following growth factors for sustained release: PDGF-BB, TGF-β1 and CTGF. Incorporating growth factors increased human meniscal and synovial cell viability, proliferation and infiltration , and ; upregulated key genes involved in meniscal extracellular matrix synthesis and enhanced generation of meniscus-like tissue.

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