Chiamaka Nneka Obilo

All Publications

• National Agenda for Disparities Research in Hand Surgery: Validation of Social Determinant of Health Domains and Measurement Constructs. Hand (New York, N.Y.) Obilo, C., Kamal, R. N., Shapiro, L. M. 2025: 15589447251336401

  Abstract

  Social determinants of health (SDOH) encompass various factors of one's environment and have been shown to strongly influence patient health. The effect of SDOH has been evaluated in various medical specialties; however, a paucity of literature exists investigating the effects of SDOH on outcomes in hand surgery. As such, we completed a RAND/University of California Los Angeles (UCLA) Delphi Appropriateness process for the purpose of guiding the inclusion of SDOH domains and measurement constructs in hand surgery clinical research.A consortium of 9 academic upper-limb surgeons completed a RAND/UCLA Delphi Appropriateness process to evaluate the importance, feasibility, usability, and scientific acceptability of collecting SDOH domains and measurement constructs in hand surgery clinical research. The domains and measurement constructs were collated from frameworks and tools from the U.S. Department of Health and Human Services, the Centers for Medicare and Medicaid Services, and Cochrane. Panelists rated each domain/measurement construct on an ordinal scale between 1 (definitely not important/feasible/usable/supported) and 9 (definitely important/feasible/usable/supported) in 2 rounds with an intervening face-to-face discussion. Agreement and validity were determined according to previously validated and pre-defined criteria.The consortium achieved agreement on the inclusion of 5 SDOH domains (Education Access and Quality, Health care Access and Quality, Neighborhood and Built Environment, Social and Community Context, and Economic Stability) and 21 measurement constructs.As there is growing evidence that SDOH can differentially impact patient health, these validated domains and constructs can help prioritize and guide hand surgery research to evaluate and better inform interventions related to SDOH and outcomes.

  View details for DOI 10.1177/15589447251336401

  View details for PubMedID 40310679

• Retrospective Analysis and Characterization of Avascular Necrosis By Bone Location in Pediatric Leukemia/Lymphoma Patients. Journal of pediatric orthopedics Alayleh, A., Naz, H., Taylor, V., Johnson, T. R., Farook, S., Hofmann, G., Obilo, C., Pham, N. S., Harbacheck, K., Laureano, T., Smith, S. M., Chao, K., Goodman, S. B., Shea, K. G. 2025

  Abstract

  Avascular necrosis (AVN) is a serious complication of high-dose steroid therapy for pediatric patients with leukemia/lymphoma. AVN affects multiple bones and joints, leading to significant pain in different bone regions, early-onset osteoarthritis, and early joint replacement. Early detection and intervention for AVN may prevent pain and progressive joint collapse. The purpose of this study is to evaluate and characterize the specific AVN locations in a cohort of pediatric and adolescent patients with leukemia/lymphoma using the newly developed Bone Location for AVN from STeroids (BLAST) classification system that considers epiphyseal, metaphyseal, and diaphyseal locations in long bones.An imaging database was queried for patients 25 years old and younger with a diagnosis of AVN and leukemia/lymphoma who required steroid treatment. Patient MRIs were reviewed, and AVN sites were classified using the BLAST system. AVN locations were described using descriptive statistics. Multivariable logistic regression analysis was used to assess the odds of AVN bilaterality based on location.A total of 84 patients (49/35 males/females) with acute lymphoblastic leukemia (ALL) (B-cell 74%, T-cell 21%) or acute myeloid leukemia (5%) were included in this cohort. The median age was 14.8 years at leukemia diagnosis and 16.5 years at AVN diagnosis. Most AVN locations include the femur (87%), tibia (68%), and humerus (25%). On the basis of the BLAST classification, the most common sites of AVN overall include the proximal tibial metaphysis (61%), distal femoral metaphysis (60%) and epiphysis (60%), and femoral head epiphysis (50%). The most common sites of AVN in the tibia, humerus, and femur are proximal tibial metaphysis (89%), humeral head epiphysis (86%), and distal femoral metaphysis (68%) and epiphysis (68%), respectively.This analysis demonstrates that AVN in leukemia/lymphoma patients on steroid therapy has a clear predilection for specific locations in long bones. Using the BLAST classification, practitioners are better equipped to characterize the location of AVN, monitor high-risk locations for joint collapse, and track early outcomes of preventative treatment. The development of prospective multicenter AVN study groups and screening protocols for early detection will be critical to improve functional outcomes and joint preservation for leukemia/lymphoma survivors and all other patients taking high-dose steroids.Level II-retrospective cohort study.

  View details for DOI 10.1097/BPO.0000000000002963

  View details for PubMedID 40214168

• A Cadaveric Study of the Sagittal Patellar Insertion of the Medial Patellofemoral Ligament in Children: Implications for Reconstruction. The American journal of sports medicine Alayleh, A., Hollyer, I., Johnstone, T., Khoo, B., Obilo, C., McFarlane, K., Baird, W., Chan, C., Tompkins, M., Ellis, H., Schmitz, M., Yen, Y. M., Ganley, T., Sherman, S. L., Shea, K. G. 2025: 3635465241313239

  Abstract

  Patellofemoral instability is a common problem, and medial patellofemoral ligament (MPFL) reconstruction is a standard treatment approach for recurrent instability. The accurate restoration of anatomy in MPFL reconstruction is essential. While coronal-plane anatomy of the MPFL patellar insertion has been previously reported, sagittal-plane anatomy has not been widely studied.To evaluate the sagittal patellar insertion of the MPFL in pediatric specimens to guide future anatomic reconstruction.Descriptive laboratory study.A total of 11 pediatric cadaveric knee specimens were dissected. The patella and sagittal MPFL insertion were evaluated. The maximal anterior-posterior patellar width, distance from the posterior patella to the posterior MPFL insertion, distance from the medial patellar articular cartilage edge to the MPFL insertion, maximal MPFL thickness, and distance from the anterior MPFL insertion to the anterior patella were measured. The proportion of patellar coverage by the sagittal MPFL insertion footprint was calculated.The pediatric knee specimens had a mean age of 9.3 ± 1.4 years (range, 6-11 years). The mean maximal transverse patellar width was 19.0 ± 2.7 mm (range, 13.7-22.7 mm). The mean posterior patella-to-posterior MPFL distance was 10.5 ± 1.6 mm (range, 7.7-12.6 mm). The mean patellar articular cartilage edge-to-MPFL distance was 2.3 ± 0.6 mm (range, 1.5-3.5 mm). The mean maximal MPFL thickness was 4.0 ± 0.9 mm (range, 2.6-5.5 mm). The mean anterior MPFL-to-anterior patella distance was 4.4 ± 1.1 mm (range, 2.6-5.8 mm). The sagittal MPFL insertion footprint spanned a mean of 21.0% (range, 16.1%-29.7%) of the medial patella.This study, utilizing skeletally immature cadaveric specimens, demonstrated that the sagittal MPFL insertion consistently resided in the anterior third of the patella, averaging 21% of the total sagittal patellar width. Additionally, the distance from the MPFL insertion to the medial patellar articular cartilage edge showed minimal variation, representing a consistent intraoperative landmark for MPFL graft placement.This research characterized MPFL insertion anatomy on the medial patella in the sagittal plane. This knowledge provides a clear target area for anatomic graft placement during MPFL reconstruction.

  View details for DOI 10.1177/03635465241313239

  View details for PubMedID 39912699