Chantal T. Nguyen, MD

All Publications

• Effects of Supplementation in Masters Athletes and Older Adults: A Narrative Review. Current sports medicine reports Nguyen, C., Allen, M. R., Hornburg, K., Fredericson, M. 2026; 25 (7): 216-223

  Abstract

  Supplementation use in athletes is common and increasing in popularity, especially for adults seeking improvements in athletic performance. However, the effects of supplementation for older adults or Masters athletes in improving athletic performance or musculoskeletal health are less well explored. The aim of this narrative review is to explore common supplements, namely protein, caffeine, creatine, beta-alanine, nitrates, and peptides, including collagen, body protection compound-157, and thymosin-beta 4 and 500, in improving performance or musculoskeletal health in Masters athletes and adults over 55 years of age.

  View details for DOI 10.1249/JSR.0000000000001353

  View details for PubMedID 42385164

• Investigating the effectiveness of an artificial intelligence-enhanced physical therapy and home exercise program on knee pain: a pilot study JOURNAL OF MEDICAL ARTIFICIAL INTELLIGENCE Roh, E. Y., Kaufman, M. W., Nguyen, C., Clark, H., Kwon, S. 2026

  View details for DOI 10.21037/jmai-2025-1-166

  View details for Web of Science ID 001779292600001

• International Analysis of Para Versus Able-Bodied Sport Medical and Executive Governing Boards: Exploring the Impact of Physiatry. American journal of physical medicine & rehabilitation Nguyen, C., Kim, K., Kaufman, M., Agaibi, M., Kathardekar, V., Johnson, F., Luu, S., Tinney, M. 2026; 105 (5): 439-447

  Abstract

  The goal of this paper is to analyze the composition of all 2024 Olympic and Paralympic international sport federations (medical and executive governing boards) and to assess the involvement of physical medicine & rehabilitation physicians (physiatry) on these boards.A comprehensive Google search was performed in December 2024 to analyze all Olympic and Paralympic 2024 sport medical and executive governing boards. Differences in gender, geography, and medical training were assessed.There were more able-bodied medical (29) and executive (43) boards than para medical (4) and executive (29) boards. The majority of able-bodied and para medical board members were physicians specializing in sports medicine. There were significantly more physical medicine & rehabilitation physicians on para medical boards than able-bodied medical boards (odds ratio = 11.2, P  = 0.005). The odds of a physician being a physiatrist was eight times higher in a para medical board than in an able-bodied medical board.International sport federations include medical and/or executive boards which govern safety and logistics of sport participation. There are more physical medicine & rehabilitation physicians involved at the para medical board level, which is in line with an inherent physiatric training background focused on optimizing function and managing medical/sport-related considerations for individuals with disabilities.

  View details for DOI 10.1097/PHM.0000000000002854

  View details for PubMedID 41066091

• Pickleball-related injuries treated at a tertiary academic center over five years: a cross-sectional study. Injury epidemiology Meng, Y., Chen, A., Nguyen, C., Kaufman, M., Li, D., Pham, N., Chou, R., Roh, E. 2026

  Abstract

  Pickleball has grown rapidly in popularity in recent years, accompanied by an increasing number of reported injuries among players. Our aim is to determine the epidemiology of pickleball-related injuries at a single academic center and evaluate patient-specific factors such as incidence and type of injury, mechanisms of injury, and treatment outcomes.This is a cross-sectional study at a tertiary academic outpatient orthopedic and physical medicine and rehabilitation clinic. We reviewed 164 cases of patients presenting with pickleball-related injuries from 2019 to 2023 involving the shoulder (n = 23), elbow (n = 8), wrist/hand (n = 30), hip/thigh (n = 9), knee (n = 52), foot/ankle (n = 32), and spine (n = 10). Independent variables included age, gender, and hand dominance. Outcome measures included injury type, laterality, treatment modality, and follow-up duration. Demographic and epidemiologic data were analyzed, and comparisons between injury characteristics were performed using appropriate statistical tests (Fisher's exact tests and Kruskal-Wallis tests).The most common pickleball-related injuries included lateral epicondylitis at the elbow (75%), rotator cuff tears at the shoulder (70%), distal radius fractures after a fall at the hand/wrist (60%), Achilles tendon tears at the foot/ankle (50%), radicular pain and spinal stenosis at the spine (50% each), medial meniscus tears at the knee (48%), and hamstring strain or rupture and iliopsoas tendinitis at the hip/thigh (33% each).Rates of injury were similar between male and female players except in the hand/wrist, which was higher among female players (77%). Non-paddle side injuries in the upper extremity occur disproportionally higher in the hand/wrist (52%) when compared to the shoulder (7%) or elbow (17%) (p < 0.01). There was no significant difference in laterality for lower extremity and spine injuries.As pickleball has become the fastest growing sport in America, the incidence of pickleball-related injuries has risen dramatically. Characterizing the wide spectrum of musculoskeletal injuries unique to pickleball may inform athletes on injury prevention considerations and allows for targeting modifiable risk factors.

  View details for DOI 10.1186/s40621-026-00673-6

  View details for PubMedID 41981700

• Clinical Recommendations for Female Para and Adaptive Athletes: Perspectives from Current Literature. Physical medicine and rehabilitation clinics of North America Nguyen, C., Tinney, M. J. 2026; 37 (1): 117-136

  Abstract

  Female Para and adaptive athletes face health disparities affecting sport performance, clinical health, and well-being unique to the intersection between sex and disability. A guideline to comprehensive clinical care for female Para and adaptive athletes, including discussion regarding concussion, mental health, cardiorespiratory, body composition/nutrition, endocrinologic, gynecologic/urologic, and musculoskeletal factors, are summarized in this article. Data from large epidemiologic studies investigating the role of gender in injury/illness outcomes are additionally summarized, thus providing context on trends disproportionately facing this population.

  View details for DOI 10.1016/j.pmr.2025.08.016

  View details for PubMedID 41207720

• A Rock Climber's Encounter With Gravity Causing a Real Pain in the Butt. American journal of physical medicine & rehabilitation Nguyen, C., Dykowski, S., Fredericson, M. 2026; 105 (2): 184-187

  View details for DOI 10.1097/PHM.0000000000002866

  View details for PubMedID 41082266

• Domains, Trends, and Uptake of Common Data Elements in Intervention Studies Focused on Recovery of Consciousness in Severe Brain Injury From 1986 to 2020: A Scoping Review. Archives of physical medicine and rehabilitation Weaver, J. A., Cogan, A. M., Pertsovskaya, V., Bhandari, P., Awan, B. Z., Lewis, S., Hartman, A., Maisano, K., Harrod, T., Pape, T. L., Mallinson, T. 2026; 107 (1): 105-122

  Abstract

  To evaluate the range and typology of primary clinical outcome assessments used in intervention studies promoting recovery of consciousness for patients with disorders of consciousness. A secondary aim was to examine the extent to which the introduction of common data elements (CDE) has reduced the heterogeneity of primary clinical outcome assessments in studies that include participants with disorders of consciousness.We searched for articles across 5 databases including Cochrane, Embase, PsycInfo, PubMed, and Scopus.We selected articles that focused on facilitating recovery of consciousness among adults with disorders of consciousness after severe traumatic brain injury.We extracted the study year, primary clinical outcome assessment, and funding source.We classified the primary clinical outcome by International Classification of Functioning, Disability, and Health domain and CDE status. A total of 75 primary clinical outcome assessments were extracted from 306 included articles representing 307 studies; 45 primary clinical outcome assessments (60%) aligned with the International Classification of Functioning, Disability, and Health Body Function domain. The proportion of articles with US federal funding that reported a CDE as the clinical outcome assessment did not differ by year published.Implementation of CDEs in 2010 did not substantively change the utilization of clinical outcome assessments that are CDEs because these were already more likely to be reported than non-CDEs. Overall, the wide variation in primary clinical outcome assessments used in intervention studies facilitating recovery of consciousness limits the ability to conduct meta-analyses, which are needed to increase the strength of evidence for disorders of consciousness interventions.

  View details for DOI 10.1016/j.apmr.2025.07.021

  View details for PubMedID 40835083

• Increasing Access to Physical Activity Opportunities for Patients: A Review. American journal of lifestyle medicine Nguyen, C., Abbott-Frey, A., Anaya Gallegos, A. D., Kaufman, M., Noordsy, D., Oppezzo, M., Fredericson, M. 2025: 15598276251348174

  Abstract

  Physical activity has been shown to improve health outcomes, decrease risk of medical comorbidities, and improve longevity. Despite these known benefits, most individuals do not meet the recommended national exercise guidelines for physical activity. This paper identifies individual and community-level factors impacting engagement in physical activity, thus focusing on solutions to address common barriers to exercise and optimize diversity, equity, and inclusion initiatives for physical activity. Afterward, several cases within one large academic institution and its affiliates illustrate recent endeavors to improve access to physical activity and highlight future opportunities for growth in all communities.

  View details for DOI 10.1177/15598276251348174

  View details for PubMedID 40485746

  View details for PubMedCentralID PMC12141265

• Focused Review of Sleep Wearable Technology and Its Application in Sports Performance. Current sports medicine reports Kaufman, M. W., Shetty, M., Nguyen, C., Abas, J., Fredericson, M., Zeitzer, J. 2025; 24 (6): 171-176

  Abstract

  Sleep is a critical component of quality of life, recovery, and performance both physically and cognitively. Tracking sleep with wearables is increasingly prevalent among individuals; the data that are retrieved from these wearables, however, is of unclear relevance. To update this space, literature was reviewed to examine the implications for good and bad sleepers, the current shortcomings of wearables, their current status usage and literature reports in sports medicine, and the future benefits that these devices may have for athletes and nonathletes alike. Wearables have good performance in detecting sleep but have greater difficulty in discerning between quiet wakefulness and early stages of sleep. The use of summative scores in consumer wearables is opaque, which should make sports medicine providers skeptical of their clinical utility. There is ample opportunity for wearables to be clinically useful and research opportunities to better explore the bidirectional relationship between daytime athletic performance and sleep.

  View details for DOI 10.1249/JSR.0000000000001258

  View details for PubMedID 40472156

• Chronic Low Back Pain in a Trapeze Artist-No More "Mousing" Around. American journal of physical medicine & rehabilitation Nguyen, C., Oh, R. C. 2025; 104 (4): e61-e62

  View details for DOI 10.1097/PHM.0000000000002615

  View details for PubMedID 39120978

• Diagnostic ultrasonography of upper extremity dynamic compressive neuropathies in athletes: A narrative review. International orthopaedics Nguyen, C., Chou, R. 2025

  Abstract

  This narrative review identifies and summarizes current evidence for diagnostic ultrasonographic evaluation of upper extremity dynamic compressive neuropathies affecting athletes.Relevant literature was identified using the PubMed database and then summarized.The compressive neuropathies affecting athletes we identified included: neurogenic thoracic outlet syndrome, pectoralis minor syndrome, quadrilateral space syndrome, suprascapular nerve entrapment, proximal median nerve entrapment or bicipital aponeurosis/lacertus fibrosus (lacertus syndrome), radial tunnel syndrome, and cubital tunnel syndrome. Symptoms may develop only during specific sport activity, after specific sport-related trauma, or in setting of overuse during sport. Diagnostic ultrasound strategies assessing compressive neuropathies focus on static evaluation of nerves and surrounding structures, as well as dynamic evaluation of these structures in certain degrees of shoulder abduction, elbow flexion, or forearm pronation.Ultrasonography can be used as a diagnostic tool in assessing upper extremity dynamic compressive neuropathies. Ultrasound allows for dynamic evaluation of these rare conditions, especially for athletes who primarily develop symptoms during movement or participation in sport.

  View details for DOI 10.1007/s00264-025-06417-3

  View details for PubMedID 39883178

  View details for PubMedCentralID 2890065

• Minimally invasive needle tenotomy vs. platelet rich plasma injection in the treatment of chronic elbow epicondylitis. JSES international Nguyen, C. T., Lee, M. H., Kaufman, M. W., Meng, Y., Koduri, J. A., Abrams, G., Cheung, E. V., Freehill, M. T., Roh, E. Y. 2025; 9 (1): 231-236

  Abstract

  Medial and lateral epicondylitis, characterized by repetitive microtraumas to common flexor and extensor tendons, respectively, are common causes of elbow pain in adults. Though symptoms are generally self-limiting, 10% of cases are refractory to conservative management, persisting for greater than 18 months, and leading to surgery, which can have increased risk of complications. There is minimal data on sustained pain relief and functional benefit for newer nonsurgical management options, such as minimally invasive needle tenotomy (MINT), and platelet-rich plasma (PRP) for chronic elbow epicondylitis. Additionally, no previously established correlation exists between magnetic resonance imaging (MRI) severity of chronic epicondylitis with pain and functional improvement in MINT- and PRP-treated patients.A retrospective review of 51 adults (n = 23 for MINT; n = 28 for PRP) was conducted to investigate long-term outcomes in pain relief (via visual analog scale or VAS) and improvements in upper extremity function (via quick disability of the arm, shoulder, and hand questionnaire or qDASH). These outcomes were correlated with radiographic evidence of epicondylitis severity, assessed by the grade of epicondylitis and percentage thickness of tendon tears.There were significant improvements in pain (VAS), but no significant differences in function (qDASH) following MINT and PRP. On average, VAS score improved by 2.6 (P < .001) post-MINT and by 3.8 (P < .001) post-PRP combined for all follow-up time points. No adverse events were reported over the entire study. A significantly higher percentage of patient-reported pain relief was noted post-MINT at all follow-up time points. VAS and qDASH outcomes post-MINT and post-PRP were not correlated with the initial MRI severity of epicondylitis.There are multifactorial benefits of both MINT and PRP as safe, nonopen surgical modalities that can be used, despite MRI severity, to provide sustained pain relief for patients with refractory elbow epicondylitis.

  View details for DOI 10.1016/j.jseint.2024.08.183

  View details for PubMedID 39898191

  View details for PubMedCentralID PMC11784263

• It’s Cold Sports Medicine: It's Environmental Nguyen, C., Sherman, S., Fredericson, M. 2025
• Supporting a lifetime of fitness for the military veteran athlete: a narrative review. Frontiers in sports and active living Tinney, M. J., Nguyen, C. 2024; 6: 1510422

  Abstract

  The military veteran starts their career at peak physical fitness. Once injured or retired, physical activity for the veteran is integral to rehabilitation, recovery, and ongoing wellness. This may require adaptation for continued participation in physical activity. The military veteran, in the United States, has access to resources which can facilitate ongoing physical activity, engagement in competitive and recreational sports, no matter what age or ability. Reviewing the current literature will help understand the scope of programs available, their outcomes, and strategies employed to support a lifetime of fitness that may be applied to other populations and health care systems.

  View details for DOI 10.3389/fspor.2024.1510422

  View details for PubMedID 39726773

  View details for PubMedCentralID PMC11669501

• Accuracy of ultrasound-guided iliopsoas tendon injection after total hip arthroplasty: a retrospective observational study. Journal of ultrasound Kaufman, M. W., Nguyen, C., Meng, Y., Roh, E. 2024

  Abstract

  To describe and characterize the accuracy and benefit of a technique for performing ultrasound-guided needle placement for iliopsoas peritendon or bursa injections as an alternative method to fluoroscopic guidance.Patients with a history of total hip arthroplasty who were referred by their orthopedic surgeon for iliopsoas peritendon or bursa corticosteroid injection for iliopsoas impingement syndrome between June 2017 and December 2019 were eligible for inclusion. Of these patients, 19 received a total of 26 ultrasound-guided needle placement followed by confirmatory fluoroscopic guidance prior to injection. Pre-injection and post-injection VAS scores were collected to monitor pain. Additionally, the patients were followed for 6 months via chart review after their injection to assess for complications, need for repeat injections, and progression to surgical intervention. The accuracy of a longitudinal in-plane distal to proximal approach to ultrasound guided needle placement was then evaluated.Ultrasound guided needle placement using a longitudinal in-plane distal to proximal approach demonstrated spread of contrast material in the intended anatomic location with fluoroscopic confirmation in patients who underwent iliopsoas peritendon or bursa injection post total hip arthroplasty.Ultrasound guided needle placement using a longitudinal in-plane distal to proximal approach can be an effective alternative technique for diagnostic or therapeutic iliopsoas peritendon injection in patients with total hip arthroplasty.

  View details for DOI 10.1007/s40477-024-00904-w

  View details for PubMedID 39107567

• Analysis of Common Exercise Modalities in Improving Athletic Performance in Older Adults: A Narrative Review. Current sports medicine reports Nguyen, C., Kaufman, M., Vallejo, A., DeParis, S., Friedlander, A., Frehlich, L., Fredericson, M. 2024; 23 (6): 245-252

  Abstract

  Exercise leads to robust cardiovascular, musculoskeletal, and psychological benefits that improve quality of life and longevity for older adults, but accompanying improvements in athletic parameters are less well explored. The aim of this review is to summarize some of the most common exercise modalities, namely, Pilates, martial arts (tai chi, Japanese-style karate, hard martial arts), locomotion (brisk walking/jogging and running), Masters sports, resistance training, and high-intensity interval training, in improving athletic performance for older adults. Regular participation in these activities can have robust yet unique impacts on physical performance that prolong exercise participation. In particular, this review will explore benefits in cardiorespiratory fitness, power, strength, flexibility, and balance, thereby hopefully improving endurance, exercise adherence, and overall fall risk. A narrative literature review was performed to explore benefits, pitfalls, and recommendations for some of the most popular exercise modalities for older adults.

  View details for DOI 10.1249/JSR.0000000000001175

  View details for PubMedID 38838688

• Analysis of Common Exercise Modalities in Improving Athletic Performance in Older Adults: A Narrative Review CURRENT SPORTS MEDICINE REPORTS Nguyen, C., Kaufman, M., Vallejo, A., DeParis, S., Friedlander, A., Frehlich, L., Fredericson, M. 2024; 23 (6): 245-252

  Abstract

  Exercise leads to robust cardiovascular, musculoskeletal, and psychological benefits that improve quality of life and longevity for older adults, but accompanying improvements in athletic parameters are less well explored. The aim of this review is to summarize some of the most common exercise modalities, namely, Pilates, martial arts (tai chi, Japanese-style karate, hard martial arts), locomotion (brisk walking/jogging and running), Masters sports, resistance training, and high-intensity interval training, in improving athletic performance for older adults. Regular participation in these activities can have robust yet unique impacts on physical performance that prolong exercise participation. In particular, this review will explore benefits in cardiorespiratory fitness, power, strength, flexibility, and balance, thereby hopefully improving endurance, exercise adherence, and overall fall risk. A narrative literature review was performed to explore benefits, pitfalls, and recommendations for some of the most popular exercise modalities for older adults.

  View details for Web of Science ID 001706576000001

  View details for PubMedID 38838688

• Subscapularis Recess Ganglion Cyst: An Uncommon Cause for Anterior Shoulder Pain in a Recreational Tennis Player. American journal of physical medicine & rehabilitation Nguyen, C., Lumetta, K., Chou, R. 2024

  View details for DOI 10.1097/PHM.0000000000002546

  View details for PubMedID 38726962

• Evaluation of range of motion using vision artificial intelligence (AI) in musculoskeletal medicine JOURNAL OF MEDICAL ARTIFICIAL INTELLIGENCE Meng, Y., Lee, M., Clark, H., Nguyen, C., Kwon, S., Schultz, S., Pham, N., Schirmer, D., Roh, E. Y. 2024; 7

  View details for DOI 10.21037/jmai-24-58

  View details for Web of Science ID 001538057400040

• Posterior intra-articular hip injections: a pilot study investigating a new approach. Journal of ultrasound Kaufman, M. W., Nguyen, C., Meng, Y., Roh, E. 2024

  Abstract

  The purpose of this study was to investigate a novel posterior intra-articular hip injection approach while discussing the clinical pearls for methodology, accuracy, and associated adverse events. The goal was to investigate if this approach could potentially be used in those where the typical anterior access would be challenging.10 adults (age > 18 years) who were referred to a tertiary outpatient clinic for hip injection due to hip osteoarthritis or femoral acetabular impingement with labral tearing to a single academic sports medicine clinic. Patients were placed in prone position. Posterior structures were identified using a curvilinear transducer. A 22 gauge 3.5-6-inch spinal needle was advanced in-plane to the transducer towards the hip capsule at the head-neck junction of the femur from inferolateral to superomedial. A fluoroscopic arthrogram was obtained to evaluate needle placement accuracy. Location of the needle, direction of contrast flow, the rate of conversion to an anterior portal, and adverse events were analyzed.A fluoroscopic arthrogram was obtained after the first attempt in nine patients (90%). One patient (10%) was converted to the anterior approach due to inability to obtain the expected arthrogram. Two patients (20%) demonstrated mild adverse events.Ultrasound-guided posterior approach hip injection is accurate and without serious adverse events in our study. The posterior approach can be considered as an alternative approach for patients who cannot tolerate or may have technical difficulty with an anterior approach.

  View details for DOI 10.1007/s40477-023-00863-8

  View details for PubMedID 38311662

  View details for PubMedCentralID 3789916

• Risk Factors for Injury and Injury Prevention in Female Athletes Essentials for the Female Athlete Nguyen, C., Kaufman, M., Kraus, E. 2024
• Popular Dietary Trends' Impact on Athletic Performance: A Critical Analysis Review. Nutrients Kaufman, M., Nguyen, C., Shetty, M., Oppezzo, M., Barrack, M., Fredericson, M. 2023; 15 (16)

  Abstract

  BACKGROUND: Nutrition fuels optimal performance for athletes. With increased research developments, numerous diets available, and publicity from professional athletes, a review of dietary patterns impact on athletic performance is warranted.RESULTS: The Mediterranean diet is a low inflammatory diet linked to improved power and muscle endurance and body composition. Ketogenic diets are restrictive of carbohydrates and proteins. Though both show no decrements in weight loss, ketogenic diets, which is a more restrictive form of low-carbohydrate diets, can be more difficult to follow. High-protein and protein-paced versions of low-carbohydrate diets have also shown to benefit athletic performance. Plant-based diets have many variations. Vegans are at risk of micronutrient deficiencies and decreased leucine content, and therefore, decreased muscle protein synthesis. However, the literature has not shown decreases in performance compared to omnivores. Intermittent fasting has many different versions, which may not suit those with comorbidities or specific needs as well as lead to decreases in sprint speed and worsening time to exhaustion.CONCLUSIONS: This paper critically evaluates the research on diets in relation to athletic performance and details some of the potential risks that should be monitored. No one diet is universally recommend for athletes; however, this article provides the information for athletes to analyze, in conjunction with medical professional counsel, their own diet and consider sustainable changes that can help achieve performance and body habitus goals.

  View details for DOI 10.3390/nu15163511

  View details for PubMedID 37630702

• Sternomanubrial Joint Pain Secondary to Ulcerative Colitis Treated with Ultrasound-Guided Injection. PM & R : the journal of injury, function, and rehabilitation Nguyen, C., Stanek, J. L. 2023

  View details for DOI 10.1002/pmrj.13031

  View details for PubMedID 37376805

• Artificial Intelligence System for Automatic Quantitative Analysis and Radiology Reporting of Leg Length Radiographs. Journal of digital imaging Larson, N., Nguyen, C., Do, B., Kaul, A., Larson, A., Wang, S., Wang, E., Bultman, E., Stevens, K., Pai, J., Ha, A., Boutin, R., Fredericson, M., Do, L., Fang, C. 2022

  Abstract

  Leg length discrepancies are common orthopedic problems with the potential for poor functional outcomes. These are frequently assessed using bilateral leg length radiographs. The objective was to determine whether an artificial intelligence (AI)-based image analysis system can accurately interpret long leg length radiographic images. We built an end-to-end system to analyze leg length radiographs and generate reports like radiologists, which involves measurement of lengths (femur, tibia, entire leg) and angles (mechanical axis and pelvic tilt), describes presence and location of orthopedic hardware, and reports laterality discrepancies. After IRB approval, a dataset of 1,726 extremities (863 images) from consecutive examinations at a tertiary referral center was retrospectively acquired and partitioned into train/validation and test sets. The training set was annotated and used to train a fasterRCNN-ResNet101 object detection convolutional neural network. A second-stage classifier using a EfficientNet-D0 model was trained to recognize the presence or absence of hardware within extracted joint image patches. The system was deployed in a custom web application that generated a preliminary radiology report. Performance of the system was evaluated using a holdout 220 image test set, annotated by 3 musculoskeletal fellowship trained radiologists. At the object detection level, the system demonstrated a recall of 0.98 and precision of 0.96 in detecting anatomic landmarks. Correlation coefficients between radiologist and AI-generated measurements for femur, tibia, and whole-leg lengths were>0.99, with mean error of<1%. Correlation coefficients for mechanical axis angle and pelvic tilt were 0.98 and 0.86, respectively, with mean absolute error of<1°. AI hardware detection demonstrated an accuracy of 99.8%. Automatic quantitative and qualitative analysis of leg length radiographs using deep learning is feasible and holds potential in improving radiologist workflow.

  View details for DOI 10.1007/s10278-022-00671-2

  View details for PubMedID 35794502

• Mapping outcomes for recovery of consciousness in studies from 1986 to 2020: a scoping review protocol. BMJ open Weaver, J., Cogan, A., Bhandari, P., Zainab, B. A., Jacobs, E., Pape, A., Nguyen, C., Guernon, A., Harrod, T., Bender Pape, T., Mallinson, T. 2022; 12 (6): e056538

  Abstract

  Historically, heterogeneous outcome assessments have been used to measure recovery of consciousness in patients with disorders of consciousness (DoC) following traumatic brain injury (TBI), making it difficult to compare across studies. To date, however, there is no comprehensive review of clinical outcome assessments that are used in intervention studies of adults with DoC. The objective of this scoping review is to develop a comprehensive inventory of clinical outcome assessments for recovery of consciousness that have been used in clinical studies of adults with DoC following TBI.The methodological framework for this review is: (1) identify the research questions, (2) identify relevant studies, (3) select studies, (4) chart the data, (5) collate, summarise and report results and (6) consult stakeholders to drive knowledge translation. We will identify relevant studies by searching the following electronic bibliographic databases: PubMed, Scopus, EMBASE, PsycINFO and The Cochrane Library (including Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials and Cochrane Methodology Register). Criteria for article inclusion are published in the English-language, peer-reviewed studies of interventions aimed at facilitating recovery of consciousness among adults (> 18 years) with DoC following a severe TBI, published from January 1986 to December 2020. Articles meeting inclusion criteria at this stage will undergo a full text review. We will chart the data by applying the WHO International Classification of Functioning, Disability and Health Framework to identify the content areas of clinical outcome assessments. To support knowledge translation efforts, we will involve clinicians and researchers experienced in TBI care throughout the project from conceptualisation of the study through dissemination of results.No ethical approval is required for this study as it is not determined to be human subjects research. Results will be presented at national conferences and published in peer-reviewed journals.CRD42017058383.

  View details for DOI 10.1136/bmjopen-2021-056538

  View details for PubMedID 35772816

  View details for PubMedCentralID PMC9247663

• Risk Factors for Readmissions After Total Joint Replacement: A Meta-Analysis. JBJS reviews Mahajan, S. M., Mahajan, A. S., Nguyen, C., Bui, J., Abbott, B. T., Osborne, T. 2021; 9 (6)

  Abstract

  We performed a systematic review and meta-analysis of predictive modeling studies examining the risk of readmission after total hip arthroplasty (THA) and total knee arthroplasty (TKA) in order to synthesize key risk factors and evaluate their pooled effects. Our analysis entailed 15 compliant studies for qualitative review and 17 compliant studies for quantitative meta-analysis.A qualitative review of 15 predictive modeling studies highlighted 5 key risk factors for risk of readmission after THA and/or TKA: age, length of stay, readmission reduction policy, use of peripheral nerve block, and type of joint replacement procedure.A meta-analysis of 17 studies unveiled 3 significant risk factors: discharge to a skilled nursing facility rather than to home (approximately 61% higher risk), surgery at a low- or medium-procedure-volume hospital (approximately 26% higher risk), and the presence of patient obesity (approximately 34% higher risk). We demonstrated clinically meaningful relationships between these factors and moderator variables of procedure type, source of data used for model-building, and the proportion of male patients in the cohort.We found that many studies did not adhere to gold-standard criteria for reporting and study construction based on the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) and NOS (Newcastle-Ottawa Scale) methodologies.We recommend that these risk factors be considered in clinical practice and future work alike as they relate to surgical, discharge, and care decision-making. Future work should also prioritize greater observance of gold-standard reporting criteria for predictive models.

  View details for DOI 10.2106/JBJS.RVW.20.00122

  View details for PubMedID 34125720

• Brown/Beige Fat Activation after Skeletal Muscle Ischemia-Reperfusion Injury MLTJ-MUSCLES LIGAMENTS AND TENDONS JOURNAL Liu, M., Wang, Z., Lee, C. S., Nguyen, C., Lee, L., Kim, H. T., Feeley, B. T., Liu, X. 2020; 10 (4): 579-588

  View details for DOI 10.32098/mltj.04.2020.05

  View details for Web of Science ID 000983424600005

• Risk Factors for Readmission After Knee Arthroplasty Based on Predictive Models: A Systematic Review. Arthroplasty today Mahajan, S. M., Nguyen, C., Bui, J., Kunde, E., Abbott, B. T., Mahajan, A. S. 2020; 6 (3): 390-404

  Abstract

  An increase in the aging yet active US population will continue to make total knee arthroplasty (TKA) procedures routine in the coming decades. For such joint procedures, the Centers for Medicare and Medicaid Services introduced programs such as the Comprehensive Care for Joint Replacement to emphasize accountable and efficient transitions of care. Accordingly, many studies have proposed models using risk factors for predicting readmissions after the procedure. We performed a systematic review of TKA literature to identify such models and risk factors therein using a reliable appraisal tool for their quality assessment.Five databases were searched to identify studies that examined correlations between post-TKA readmission and risk factors using multivariate models. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis methodology and Transparent Reporting of a multivariate prediction model for Individual Prognosis Or Diagnosis criteria established for quality assessment of prognostic studies.Of 29 models in the final selection, 6 models reported performance using a C-statistic, ranging from 0.51 to 0.76, and 2 studies used a validation cohort for assessment. The average 30-day and 90-day readmission rates across the studies were 5.33% and 7.12%, respectively. Three new significant risk factors were discovered.Current models for TKA readmissions lack in performance measurement and reporting when assessed with established criteria. In addition to using new techniques for better performance, work is needed to build models that follow the systematic process of calibration, external validation, and reporting for pursuing their deployment in clinical settings.

  View details for DOI 10.1016/j.artd.2020.04.017

  View details for PubMedID 32577484

  View details for PubMedCentralID PMC7303919

• Predictive models for identifying risk of readmission after index hospitalization for hip arthroplasty: A systematic review. Journal of orthopaedics Mahajan, S. M., Mahajan, A., Nguyen, C., Bui, J., Abbott, B. T., Osborne, T. F. 2020; 22: 73-85

  Abstract

  An aging United States population profoundly impacts healthcare from both a medical and financial standpoint, especially with an increase in related procedures such as Total Hip Arthroplasty (THA). The Hospital Readmission Reduction Program and Comprehensive Care for Joint Replacement Program incentivize hospitals to decrease post-operative readmissions by correlating reimbursements with smoother care transitions, thereby decreasing hospital burden and improving quantifiable patient outcomes. Many studies have proposed predictive models built upon risk factors for predicting 30-day THA readmissions.(1) Are there validated statistical models that predict 30-day readmissions for THA patients when appraised with a standards-based, reliable assessment tool?. (2) Which evidence-based factors are significant and have support across models for predicting risk of 30-day readmissions post-THA?Five major electronic databases were searched to identify studies that examined correlations between post-THA readmission and risk factors using multivariate models. We rigorously applied the PRISMA methodology and TRIPOD criteria for assessment of the prognostic studies.We found 26 studies that offered predictive models, of which two presented models tested with validation cohorts. In addition to the many factors grouped into demographic, administrative, and clinical categories, bleeding disorder, higher ASA status, discharge disposition, and functional status appeared to have broad and significant support across the studies.Reporting of recent predictive models establishing risk factors for 30-day THA readmissions against the current standard could be improved. Aside from building better performing models, more work is needed to follow the thorough process of undergoing calibration, external validation, and integration with existing EHR systems for pursuing their use in clinical settings. There are several risk factors that are significant in multiple models; these factors should be closely examined clinically and leveraged in future risk modeling efforts.

  View details for DOI 10.1016/j.jor.2020.03.045

  View details for PubMedID 32280173

  View details for PubMedCentralID PMC7139132

• Functional workspace and patient-reported outcomes improve after reverse and total shoulder arthroplasty. Journal of shoulder and elbow surgery Ngan, A., Xiao, W., Curran, P. F., Tseng, W. J., Hung, L. W., Nguyen, C., Matthew, R., Ma, B., Lotz, J., Feeley, B. T. 2019; 28 (11): 2121-2127

  Abstract

  Low-cost motion analysis systems (LCMASs) have emerged as easy and practical methods to measure the functional workspace (FWS). Thus, we ventured to apply an LCMAS, the Kinect2 gaming camera, to evaluate the FWS in patients with shoulder osteoarthritis (OA) and patients who underwent total shoulder arthroplasty (TSA) or reverse total shoulder arthroplasty (RTSA).A cross-sectional study of participants with OA (n = 53), TSA (n = 70), and RTSA (n = 34) was performed. The FWS as measured by an LCMAS, the American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment Form score, and the Patient-Reported Outcomes Measurement Information System (PROMIS) score were collected. For participants who underwent TSA or RTSA, the FWS was evaluated at 6, 12, and 24 months postoperatively. The correlation of the FWS with the ASES score and PROMIS score was determined. Significance was set at P < .05.Patients who underwent TSA or RTSA had a significantly higher FWS than patients with shoulder OA at almost all time points. Patients who underwent TSA had a significantly higher FWS than patients who underwent RTSA at 24 months after surgery. PROMIS and ASES scores showed strong correlations with the FWS in patients who underwent TSA (R = 0.75 [P < .001] and R = 0.83 [P < .001], respectively) and RTSA (R = 0.84 [P < .001] and R = 0.73 [P < .001], respectively).The FWS measured by an LCMAS is an easy and low-cost method to quantify the reachable space of the hand in patients and shows strong correlations with patient-reported outcome measures. This may be a useful tool to assess upper-extremity range of motion before and after shoulder arthroplasty.

  View details for DOI 10.1016/j.jse.2019.03.029

  View details for PubMedID 31281000