المؤلفون: Gottreich, Julia R., Katz, Jeffrey N., Jones, Morgan H.

المصدر: Orthopaedic Journal of Sports Medicine ; volume 12, issue 3 ; ISSN 2325-9671 2325-9671

مصطلحات موضوعية: Orthopedics and Sports Medicine

الوصف: Background: Biomarkers collected in synovial tissue and fluid have been identified as potential predictors of outcomes after arthroscopy. Purpose: To provide a narrative review of the current literature that assesses the associations between preoperative biomarkers in the synovial fluid or synovial tissue and patient outcomes after knee arthroscopy. Study Design: Narrative review. Methods: We searched the PubMed database with keywords, “biomarkers AND arthroscopy,” “biomarkers AND anterior cruciate ligament reconstruction,” and “biomarkers AND meniscectomy.” To be included, studies must have collected synovial fluid or synovial tissue from patients before or during arthroscopic knee surgery and analyzed the relationship of biomarkers to postoperative patient outcomes. Biomarkers were classified into 4 main categories: metabolism of aggrecan in cartilage, metabolism of collagen in cartilage (type II collagen), noncollagenous proteins in the knee, and other. When biomarker levels and outcomes were expressed with continuous variables, we abstracted the Pearson or Spearman correlation coefficients as the effect measure. If the biomarker values were continuous and the outcomes binary, we abstracted the mean or median biomarker values in those with favorable versus unfavorable outcomes. We calculated effect sizes as the difference between means of both groups divided by the standard deviation from the mean in the group with better outcomes. Results: Eight studies were included in the review. Each study reported different patient outcomes. Biomarkers associated with metabolism of aggrecan, type II collagen metabolism, and noncollagenous proteins as well as inflammatory biomarkers had statistically significant associations with a range of patient outcomes after knee arthroscopy. Difference across studies in sample size and outcome measures precluded choosing a single biomarker that best predicted patient outcomes. Conclusion: The findings suggest that biomarkers associated with metabolism of aggrecan, type II collagen ...

الإتاحة: https://doi.org/10.1177/23259671231193370Test

المؤلفون: Lowenstein, Natalie A., Chang, Yuchiao, Mass, Hanna, Mercurio, Angela M., Ukogu, Chierika, Katz, Jeffrey N., Matzkin, Elizabeth G.

المصدر: The American Journal of Sports Medicine ; volume 52, issue 1, page 116-123 ; ISSN 0363-5465 1552-3365

الوصف: Background: Preoperative risk factors contributing to poor outcomes after arthroscopic partial meniscectomy (APM) have not yet been consolidated and codified into an index scoring system used to predict APM success. Purpose: To create an index score using available preoperative factors to predict the likelihood of favorable postoperative outcomes after APM. Study Design: Case-control study; Level of evidence, 3. Methods: A consecutive cohort of patients undergoing primary APM were enrolled in this study. Patients completed pre- and postoperative patient-reported outcome measure (PROM) questionnaires that included the Knee injury and Osteoarthritis Outcome Score (KOOS), visual analog scale (VAS) for pain, Veterans RAND 12-Item Health Survey (VR-12 Physical and Mental), and Marx Activity Rating Scale (MARS). Multivariable logistic regression models were performed to evaluate independent predictors of KOOS Pain, Symptoms, and Activities of Daily Living scores and achievement of the minimal clinically important difference (MCID) and substantial clinical benefit (SCB). The authors assigned points to each variable proportional to its odds ratio, rounded to the nearest integer, to generate the index score. Results: In total, 468 patients (mean age, 49 years [SD, 10.4 years; range, 19-81 years]) were included in this study. In the univariate analysis, shorter symptom duration, lower Kellgren-Lawrence (KL) grade, lower preoperative KOOS Pain value, and lower VR-12 Physical score were associated with a higher likelihood of clinical improvement at 1 year. In the multivariable model for clinical improvement with MCID, symptom duration (<3 months: OR, 3.00 [95% CI, 1.45-6.19]; 3-6 months: OR, 2.03 [95% CI, 1.10-3.72], compared with >6 months), KL grade (grade 0: OR, 3.54 [95% CI, 1.66-7.54]; grade 1: OR, 3.04 [95% CI, 1.48-6.26]; grade 2: OR, 2.31 [95% CI, 1.02-5.27], compared with grade 3), and preoperative KOOS Pain value (score <45: OR, 3.00 [95% CI, 1.57-5.76]; score of 45-60: OR, 2.80 [95% CI, 1.47-5.35], ...

الإتاحة: https://doi.org/10.1177/03635465231210303Test

المؤلفون: Spindler, Kurt P., Imrey, Peter B., Yalcin, Sercan, Beck, Gerald J., Calbrese, Gary, Cox, Charles L., Fadale, Paul D., Farrow, Lutul, Fitch, Robert, Flanigan, David, Fleming, Braden C., Hulstyn, Michael J., Jones, Morgan H., Kaeding, Christopher, Katz, Jeffrey N., Kriz, Peter, Magnussen, Robert, McErlean, Ellen, Melgaard, Carrie, Owens, Brett D., Saluan, Paul, Strnad, Greg, Winalski, Carl S., Wright, Rick

المصدر: Orthopaedic Journal of Sports Medicine ; volume 10, issue 1, page 232596712110654 ; ISSN 2325-9671 2325-9671

مصطلحات موضوعية: Orthopedics and Sports Medicine

الوصف: Background: BEAR (bridge-enhanced anterior cruciate ligament [ACL] restoration), a paradigm-shifting technology to heal midsubstance ACL tears, has been demonstrated to be effective in a single-center 2:1 randomized controlled trial (RCT) versus hamstring ACL reconstruction. Widespread dissemination of BEAR into clinical practice should also be informed by a multicenter RCT to demonstrate exportability and compare efficacy with bone--patellar tendon–bone (BPTB) ACL reconstruction, another clinically standard treatment. Purpose: To present the design and initial preparation of a multicenter RCT of BEAR versus BPTB ACL reconstruction (the BEAR: Multicenter Orthopaedic Outcomes Network [BEAR-MOON] trial). Design and analytic issues in planning the complex BEAR-MOON trial, involving the US National Institute of Arthritis and Musculoskeletal and Skin Diseases, the US Food and Drug Administration, the BEAR implant manufacturer, a data and safety monitoring board, and institutional review boards, can usefully inform both clinicians on the trial’s strengths and limitations and future investigators on planning of complex orthopaedic studies. Study Design: Clinical trial. Methods: We describe the distinctive clinical, methodological, and operational challenges of comparing the innovative BEAR procedure with the well-established BPTB operation, and we outline the clinical motivation, experimental setting, study design, surgical challenges, rehabilitation, outcome measures, and planned analysis of the BEAR-MOON trial. Results: BEAR-MOON is a 6-center, 12-surgeon, 200-patient randomized, partially blinded, noninferiority RCT comparing BEAR with BPTB ACL reconstruction for treating first-time midsubstance ACL tears. Noninferiority of BEAR relative to BPTB will be claimed if the total score on the International Knee Documentation Committee (IKDC) subjective knee evaluation form and the knee arthrometer 30-lb (13.61-kg) side-to-side laxity difference are both within respective margins of 16 points for the IKDC and 2.5 mm for ...

الإتاحة: https://doi.org/10.1177/23259671211065447Test

المؤلفون: Santana, Daniel C., Oak, Sameer R., Jin, Yuxuan, Rothy, Alex, Lee, Ling-Ling, Katz, Jeffrey N., Winalski, Carl S., Duryea, Jeff, Jones, Morgan H.

المساهمون: national institute of arthritis and musculoskeletal and skin diseases

المصدر: The American Journal of Sports Medicine ; volume 50, issue 8, page 2075-2082 ; ISSN 0363-5465 1552-3365

الوصف: Background: Arthroscopic partial meniscectomy (APM) is widely performed and remains an important therapeutic option for patients with a meniscal tear. However, it is debated whether or not APM accelerates the progression of osteoarthritis (OA) in the long term. Purpose/Hypothesis: The purpose was to compare the progression of OA measured by the change in tibiofemoral joint space width (JSW)—a quantitative measure of OA radiographic severity—across 3 groups with a midterm follow-up: (1) patients undergoing APM; (2) those with a meniscal tear treated nonoperatively; and (3) those without a tear. We hypothesized that the reduction in JSW would be greatest in patients undergoing APM and least in those patients without a tear. Study Design: Cohort study; Level of evidence, 3. Methods: Using the Osteoarthritis Initiative cohort, a total of 144 patients were identified that underwent APM with at least 12 months of follow up and without previous knee surgery. Those with a meniscal tear who did not have APM (n = 144) and those without a tear (n = 144) were matched to patients who had APM by sex, age, Kellgren-Lawrence (KL) grade, and follow up time. Participants underwent magnetic resonance imaging at baseline. Knee radiographs to assess JSW were collected annually or biannually. The change in minimum medial compartment JSW was calculated using a validated automated method. A piecewise linear mixed effects model was constructed to examine the relationship between JSW decline over time and treatment group—adjusting for age, body mass index, smoking status, KL grade, and baseline JSW. Results: All groups had comparable baseline JSW—ranging from 4.33 mm to 4.38 mm. The APM group had a rate of JSW decline of −0.083 mm/mo in the first 12 months and −0.014 mm/mo between 12 and 72 months. The rate of JSW decline in the APM group was approximately 27 times greater in the first 12 months than that in the nonsurgical group (−0.003 mm/mo) and 5 times greater than that in the no tear group (−0.015 mm/mo); however, there was no ...

الإتاحة: https://doi.org/10.1177/03635465221096790Test

المؤلفون: Curry, Emily J., Matzkin, Elizabeth E., Dong, Yan, Higgins, Laurence D., Katz, Jeffrey N., Jain, Nitin B.

المصدر: Orthopaedic Journal of Sports Medicine ; volume 3, issue 5, page 232596711558459 ; ISSN 2325-9671 2325-9671

مصطلحات موضوعية: Orthopedics and Sports Medicine

الوصف: Background: Structural characteristics of rotator cuff tears are used in surgical decision making. However, data on the association of tear size with patient-reported pain and function are sparse. Purpose: To assess the association of tear size, fatty infiltration, and muscle atrophy with shoulder pain/function in patients with cuff tears undergoing operative and nonoperative treatment. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 67 patients with rotator cuff tears were recruited for this longitudinal cohort study. Patients were determined to have a cuff tear using clinical assessment and blinded magnetic resonance imaging review. The Shoulder Pain and Disability Index (SPADI) was used as a measure of shoulder pain and function. Results: Tear size and thickness were not significantly associated with pain (SPADI pain score, 60.6 [95% CI, 49.8-71.5] for partial-thickness tear; 56.8 [95% CI, 42.8-70.7] for <2 cm full-thickness tear; 60.4 [95% CI, 51.7-69.0] for ≥2 cm full-thickness tear). Tear size and thickness were not associated with function (SPADI disability score, 42.7 [95% CI, 29.8-55.6] for partial-thickness tear; 37.6 [95% CI, 23.9-51.4] for <2 cm full-thickness tear; 45.1 [95% CI, 35.4-54.8] for ≥2 cm full-thickness tear). Fatty infiltration, muscle atrophy, and tendon retraction were also not significantly associated with SPADI pain and disability scores. A Mental Health Index score of <68 as well as age ≥60 years were significantly associated with a higher SPADI pain score. Female sex, increased number of comorbidities, Mental Health Index score of <68, and age <60 years were significantly associated with a higher SPADI disability score. Conclusion: In patients with rotator cuff tears undergoing operative and nonoperative treatment, pain and functional status were not associated with tear size and thickness, fatty infiltration, and muscle atrophy. Conversely, factors unrelated to cuff anatomy such as mental health, comorbidities, age, and sex were ...

الإتاحة: https://doi.org/10.1177/2325967115584596Test

المؤلفون: McDonnell, Anne M., Barra, Megan E., Abreu, Luis Alcantara, Thornhill, Thomas S., Katz, Jeffrey N., Ghazinouri, Roya

المصدر: Journal of Pharmacy Practice ; volume 34, issue 6, page 838-843 ; ISSN 0897-1900 1531-1937

مصطلحات موضوعية: Pharmacology (medical)

الوصف: Health care professionals often participate in short-term surgical missions in underserved areas of the world. Surgical missions often rely on the use of medications to provide health care to these underserved areas in patients with multiple comorbid conditions. The direct role a pharmacist may have in surgical missions is not well described in the literature; however, numerous opportunities exist for pharmacist involvement to improve patient care and operational processes throughout medication planning and delivery of surgical missions. Pharmacists have specialized knowledge in medication acquisition, preparation, and distribution that result in a unique position to contribute positively to the mission’s clinical and operational dynamics. Pharmacists may assist in various activities such as medication ordering, accrual, purchasing and preparing during the surgical mission. Pharmacists may also provide clinical support and offer alternative medications in the setting of drug intolerance or allergies. In 2008, Operation Walk Boston, a short-term surgical mission was established to provide hip and knee joint replacements to patients in the Dominican Republic. Pharmacists and pharmacy residents play a crucial role as members of this surgical mission. Based on our experience, this article aims to describe the evolving role of pharmacists as a member of a surgical mission.

الإتاحة: https://doi.org/10.1177/0897190020934296Test

المؤلفون: MacFarlane, Lindsey A., Yang, Heidi, Collins, Jamie E., Guermazi, Ali, Jones, Morgan H., Spindler, Kurt P., Winter, Amelia R., Losina, Elena, Katz, Jeffrey N., Brophy, Robert H., Cole, Brian J., Levy, Bruce A., Mandl, Lisa A., Martin, Scott, Marx, Robert G., Matava, Mathew, Safran-Norton, Clare, Stuart, Michael, Wright, Rick

المصدر: The American Journal of Sports Medicine ; volume 47, issue 3, page 612-619 ; ISSN 0363-5465 1552-3365

مصطلحات موضوعية: Physical Therapy, Sports Therapy and Rehabilitation, Orthopedics and Sports Medicine

الوصف: Background: Arthroscopic partial meniscectomy (APM) is used to treat meniscal tears, although its efficacy is controversial. Purpose: This study used magnetic resonance imaging (MRI) to determine characteristics that lead to greater benefit from APM and physical therapy (PT) than from PT alone among patients with meniscal tear and knee osteoarthritis. Study Design: Cohort study; Level of evidence, 2. Methods: Using data from the Meniscal Tear in Osteoarthritis Research (MeTeOR) trial, the authors first assessed whether the effect of treatment on pain scores at 6 months differed according to baseline MRI features (bone marrow lesions, cartilage and meniscal damage). Second, the authors summed MRI features associated with differential pain relief between APM and PT to create a “damage score,” which included bone marrow lesion number and cartilage damage size with possible values of 0 (least damage), 1 (moderate), and 2 (greatest). The authors used linear models to determine whether the association between damage score and pain relief at 6 months differed for APM versus PT. Results: The study included 220 participants: 13%, had the least damage; 52%, moderate; and 34%, greatest. Although treatment type did not significantly modify the association of damage score and change in pain ( P interaction = .13), those with the least damage and moderate damage had greater improvement with APM than with PT in Knee injury and Osteoarthritis Outcome Score pain subscale—by 15 and 7 points, respectively. Those with the greatest damage had a similar improvement with APM and PT. Conclusion: Among patients with osteoarthritis and meniscal tear, those with less intra-articular damage on MRI may have greater improvement in pain with APM and PT than with PT alone. However, these results should be interpreted cautiously owing to the limited sample size.

الإتاحة: https://doi.org/10.1177/0363546518819444Test

المؤلفون: Meints, Samantha M., Yang, Heidi Y., Collins, Jamie E., Katz, Jeffrey N., Losina, Elena

المساهمون: National Institute of Arthritis and Musculoskeletal and Skin Diseases

المصدر: American Journal of Health Promotion ; volume 33, issue 6, page 886-893 ; ISSN 0890-1171 2168-6602

مصطلحات موضوعية: Public Health, Environmental and Occupational Health, Health (social science)

الوصف: Purpose: To examine differences in physical activity (PA) uptake between black and white employees during a financial incentive-based workplace intervention. Design: Prospective cohort study from July 2014 to June 2015 (NCT02850094). Setting: Tertiary academic medical center. Participants: Forty-three black and 182 white nonclinical employees. Intervention: Participants self-selected or were assigned to teams. Participants completed a 24-week intervention receiving rewards for meeting weekly PA goals (increasing moderate-to-vigorous PA [MVPA] by 10% from previous week or meeting Guidelines threshold of 150 minutes of MVPA). Measures: Outcomes included weekly MVPA in minutes, average daily step counts, number of weeks meeting personal goals and the Guidelines, and Fitbit adherence in days and weeks. Analysis: We performed an analysis of covariance for each outcome, with race as the primary independent variable of interest, adjusting for demographic and health-related covariates. Results: During the intervention, blacks walked 9128 steps per day while whites walked 7826 steps per day, a difference of approximately 1300 steps ( P < .05). Blacks also demonstrated a greater uptake in both steps and MVPA from baseline than did whites, resulting in similar MVPA throughout the intervention. Conclusions: Findings suggest that workplace PA interventions using financial incentives may result in similar engagement in MVPA among white and black employees, while black employees walk more steps during the intervention. Limitations include a primarily white female sample which may not generalize.

الإتاحة: https://doi.org/10.1177/0890117119833341Test

المؤلفون: Teeple, Erin, Dennerlein, Jack T., Hashimoto, Dean, Soto, Luis A., Losina, Elena, Katz, Jeffrey N.

المصدر: NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy ; volume 27, issue 2, page 210-224 ; ISSN 1048-2911 1541-3772

مصطلحات موضوعية: General Medicine

الوصف: The Joint Commission provides accreditation standards for staging hospital waste, but there are no federal lifting safety standards for linen bags. We evaluated hospital laundry bag lifting using the Revised National Institute for Occupational Safety and Health (NIOSH) Lifting Equation. We hypothesized that the permitted 32-gallon linen container capacity might allow filling to weights above our calculated Recommended Weight Limit (RWL) for some lifting positions and contents. We found that 30- and 40-gallon bags filled with loose dry linen had predicted weights within estimated RWLs only for lifts close to the body. Thirty- and 40-gallon bags filled more than halfway with dry compact linen had predicted weights above estimated RWLs for all lifting positions. Thirty- and 40-gallon bags filled with wet compact linen exceeded estimated RWLs for all positions when less than one-quarter full. Bag volume and filling controls may be considered to ensure linen bags are not excessively heavy.

الإتاحة: https://doi.org/10.1177/1048291117710783Test

المؤلفون: Ramirez-Avila, Lynn, Regan, Susan, Chetty, Senica, Giddy, Janet, Ross, Douglas, Katz, Jeffrey N, Freedberg, Kenneth A, Losina, Elena, Walensky, Rochelle P, Bassett, Ingrid V

المصدر: International Journal of STD & AIDS ; volume 26, issue 10, page 704-709 ; ISSN 0956-4624 1758-1052

مصطلحات موضوعية: Infectious Diseases, Pharmacology (medical), Public Health, Environmental and Occupational Health, Dermatology

الوصف: The HIV public health messages in South Africa have increased. Our objective was to evaluate changes over time in HIV testing behaviour, prevalence and knowledge. We prospectively enrolled adults (≥18 years) prior to HIV testing at one urban and one peri-urban outpatient department in Durban, South Africa. A baseline questionnaire administered before testing included the number of prior HIV tests and four knowledge items. We used test results to estimate previously undiagnosed HIV prevalence among those tested. We assessed linear trends over enrollment. From November 2006 to August 2010, 5229 subjects enrolled and 4877 (93%) were HIV tested and had results available. Subjects reporting prior testing over time increased, from 13% in study year 1 to 42% in year 4 (linear trend p < 0.001). The HIV prevalence among those tested declined steadily and significantly over time, from 64% of enrollees in study year 1 to 39% in the final year (linear trend p < 0.001). The percentage of subjects who recognised that medicine can help people with HIV live longer increased from 80% in study year 1 to 96% in study year 4. Rates of HIV testing have increased and prevalence among those tested has decreased in outpatients in Durban, South Africa.

الإتاحة: https://doi.org/10.1177/0956462414551234Test