All Publications
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Clinical Efficacy of Pulsed Electromagnetic Field Therapy on Thumb Carpometacarpal Joint Pain: A Double-Blind, Randomized, Controlled Trial.
Hand (New York, N.Y.)
2025: 15589447251371088
Abstract
Thumb carpometacarpal (CMC) osteoarthritis (OA) is a common source of hand pain with limited nonoperative treatment options. Pulsed electromagnetic field (PEMF) therapy has been recently shown in studies to be effective in providing sustained pain relief in knee osteoarthritis. This study aimed to assess the efficacy of PEMF therapy for treating thumb CMC OA pain.This single-center, double-blind, randomized controlled trial included adults with radiographically and/or clinically diagnosed CMC OA who reported an average Numeric Pain Rating Scale (NPRS) score between 3 and 8. Participants were randomized to either a PEMF device or an identical sham device that was used for 8 hours each night for 4 weeks. The primary outcome measure was the change in average daily NPRS from baseline to 4 weeks. Secondary outcome measures included Patient-Rated Wrist/Hand Evaluation (PRWHE) and Single Assessment Numeric Evaluation at 4 and 6 weeks.Sixty-one participants were recruited, and 51 participants completed the study at 4 weeks. Both the PEMF therapy and sham device groups showed improvements in average NPRS and PRWHE at 4 weeks, but there was not a significant improvement between groups. At 6 weeks, there was a significantly greater change in average NPRS from baseline in the PEMF therapy group compared with the sham device group (P = .02).Pulsed electromagnetic field therapy may improve thumb CMC OA pain with sustained relief beyond the treatment period. Future studies will need to assess if adjusting treatment duration or other factors can enhance its efficacy.
View details for DOI 10.1177/15589447251371088
View details for PubMedID 41015912
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Incidence and outcomes of radial nerve palsy in distal third diaphyseal humerus fractures after surgical fixation.
European journal of orthopaedic surgery & traumatology : orthopedie traumatologie
2025; 35 (1): 330
Abstract
Radial nerve palsy (RNP) is a common complication of diaphyseal humerus fractures, with primary RNP rates varying by fracture location. However, the relationship between fracture location and the risk of secondary RNP following surgical fixation remains unclear. This study aimed to evaluate the incidence of postoperative RNP based on fracture location within the middle and distal thirds of the humeral diaphysis and to describe the outcomes of RNP over time.A retrospective cohort study was conducted of patients undergoing open reduction and internal fixation for middle and distal third diaphyseal humerus fractures at two Level 1 trauma centers from 2011 to 2023. Patients with proximal third fractures, pathologic fractures, or intramedullary nailing were excluded. Fracture location, surgical approach, and neurovascular outcomes were recorded. Differences between groups were analyzed using ANOVA and Fisher's exact tests.A total of 164 fractures met inclusion criteria. Postoperative RNP occurred in 8% of middle third fractures, 14% of distal third fractures, and 23% of middle-distal third fractures (p = 0.18). Preoperative RNP was significantly more common in middle-distal third fractures (38%) compared to middle third (21%) or distal third fractures (16%) (p = 0.02). At final follow-up, 49% of preoperative RNPs and 78% of postoperative RNPs had resolved, with postoperative RNPs significantly more likely to recover (p = 0.048). No significant differences in RNP resolution were observed based on fracture location.Fracture location within the middle or distal third of the humeral diaphysis was not associated with a significant difference in the incidence of postoperative radial nerve palsy following surgical fixation. Postoperative RNP demonstrated a high rate of recovery, supporting conservative management in most cases.Level III, Retrospective Cohort Study.
View details for DOI 10.1007/s00590-025-04462-7
View details for PubMedID 40736753
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Liver Function Test Results Correlate With Spleen Size in Patients With Infectious Mononucleosis.
Cureus
2024; 16 (9): e70041
Abstract
We aimed to evaluate the efficacy of measuring transaminase levels to determine the resolution of splenomegaly in athletes diagnosed with infectious mononucleosis (IM).We collected serial aspartate aminotransferase (AST) and alanine transaminase (ALT) levels and ultrasound-measured spleen sizes in university athletes who had been diagnosed with IM. Our study included seven university-aged athletes from a single institution. Patients received serial liver function tests (LFT) and splenic ultrasound testing until resolution of symptoms and full return to sport. The effects of AST, ALT, and days from symptom onset were analyzed using multivariable mixed-effects linear regression models.Levels of AST and ALT were significantly correlated with spleen size. For each 10-unit increase in AST and ALT values, spleen size increased by 0.1 cm (p = 0.007) and 0.09 cm (p = 0.008), respectively. Decreasing levels of ALT and AST correlated with a decrease in spleen size. Normalization of AST/ALT values correlated with return of spleen size to baseline.Liver function testing may be useful in the return-to-play decision-making process for athletes with IM.
View details for DOI 10.7759/cureus.70041
View details for PubMedID 39449903
View details for PubMedCentralID PMC11499307
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Training Background and Demographic Characteristics of Primary Care Team Physicians in Professional Sports.
Orthopaedic journal of sports medicine
2024; 12 (4): 23259671241242412
Abstract
Previous studies have shown that most professional head and orthopaedic team physicians are men, and most orthopaedic team physicians are fellowship-trained. It is unknown whether this holds true for primary care team physicians.To evaluate the residency and fellowship training background as well as the demographic characteristics of primary care team physicians in professional sports.Cross-sectional study.Publicly available information was used to determine the lead and supporting primary care team physicians for every US-based team in Major League Baseball, Major League Soccer, National Basketball Association, National Football League, National Hockey League, National Women's Soccer League, and Women's National Basketball Association. Data regarding training background and sex were obtained using internet-based sources.We identified 310 primary care team physicians from all 165 US-based teams in the 7 leagues included in the study. Female physicians comprised 11.5% (19/165) of the lead primary care team physicians and 14.2% (44/310) of all primary care team physicians. Overall, 66.7% (110/165) of lead primary care team physicians and 75.5% (234/310) of all primary care team physicians were sports medicine fellowship-trained. There was a higher proportion of female (37.5%) and fellowship-trained (93.8%) physicians in women's professional sports leagues. Most primary care team physicians (244/310 [78.7%]) were trained in family medicine or internal medicine.Women constituted a small minority of primary care team physicians in professional sports. Most primary care team physicians were residency trained in family medicine or internal medicine and were sports medicine fellowship-trained. The proportion of female and fellowship-trained primary care team physicians was highest in the National Women's Soccer League and the Women's National Basketball Association.
View details for DOI 10.1177/23259671241242412
View details for PubMedID 38680217
View details for PubMedCentralID PMC11047226
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Optimizing Tissue Engineering for Clinical Relevance in Rotator Cuff Repair.
Tissue engineering. Part B, Reviews
2024
Abstract
Rotator cuff tear (RCT) is the most common cause of disability in the upper-extremity.1 It results in 4.5 million physician visits in the United States every year and is the most common etiology of shoulder conditions evaluated by orthopedic surgeons.2,3 Over 460,000 RCT repair surgeries are performed in the United States annually.4 Rotator cuff (RC) retear and failure to heal remain significant post-operative complications.5 Literature suggests that the retear rates can range from 29.5% to as high as 94%.6,7 Weakened and irregular enthesis regeneration is a crucial factor in post-surgical failure.8 Although commercially available RC repair grafts have been introduced to augment RC enthesis repair, they have been associated with mixed clinical outcomes.9,10 These grafts lack appropriate biological cues such as stem cells and signaling molecules at the bone-tendon interface. Additionally, they do little to prevent fibrovascular scar tissue formation, which causes the RC to be susceptible to retear. Advances in tissue engineering have demonstrated that mesenchymal stem cells (MSCs) and growth factors (GFs) enhance RC enthesis regeneration in animal models. These models show that delivering MSCs and GFs to the site of RC tear enhances native enthesis repair and leads to greater mechanical strength. Additionally, these models demonstrate that MSCs and GFs may be delivered through a variety of methods including direct injection, saturation of repair materials, and loaded microspheres. Grafts that incorporate MSCs and GFs enhance anti-inflammation, osteogenesis, angiogenesis, and chondrogenesis in the RC repair process. It is crucial that the techniques which have shown success in animal models are incorporated into the clinincal setting. A gap currently exists between the promising biological factors which have been investigated in animal models and the RC repair grafts that can be used in the clinical setting. Future RC repair grafts must allow for stable implantation and fixation, be compatible with current arthroscopic techniques, and have the capability to deliver MSCs and/or GF. References (Full citations include in manuscript) 1.Kovacevic (2020) 2. Moran (2023) 3. Piper (2018) 4. IData (2018) 5. Yamaura (2023) 6. Park (2021) 7. Davey (2023) 8. Smietana (2017) 9. Walton (2007) 10. Soler (2007).
View details for DOI 10.1089/ten.TEB.2023.0320
View details for PubMedID 38411502
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Stereovision-updated image guidance in multi-level open spine surgery: short vs long exposure
edited by Fei, B., Linte, C. A.
SPIE-INT SOC OPTICAL ENGINEERING. 2021
View details for DOI 10.1117/12.2549646
View details for Web of Science ID 000672559200077
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Hand-Held Stereovision System for Image Updating in Open Spine Surgery
OPERATIVE NEUROSURGERY
2020; 19 (4): 461-470
Abstract
Image guidance in open spinal surgery is compromised by changes in spinal alignment between preoperative images and surgical positioning. We evaluated registration of stereo-views of the surgical field to compensate for vertebral alignment changes.To assess accuracy and efficiency of an optically tracked hand-held stereovision (HHS) system to acquire images of the exposed spine during surgery.Standard midline posterior approach exposed L1 to L6 in 6 cadaver porcine spines. Fiducial markers were placed on each vertebra as "ground truth" locations. Spines were positioned supine with accentuated lordosis, and preoperative computed tomography (pCT) was acquired. Spines were re-positioned in a neutral prone posture, and locations of fiducials were acquired with a tracked stylus. Intraoperative stereovision (iSV) images were acquired and 3-dimensional (3D) surfaces of the exposed spine were reconstructed. HHS accuracy was assessed in terms of distances between reconstructed fiducial marker locations and their tracked counterparts. Level-wise registrations aligned pCT with iSV to account for changes in spine posture. Accuracy of updated computed tomography (uCT) was assessed using fiducial markers and other landmarks.Acquisition time for each image pair was <1 s. Mean reconstruction time was <1 s for each image pair using batch processing, and mean accuracy was 1.2 ± 0.6 mm across 6 cases. Mean errors of uCT were 3.1 ± 0.7 and 2.0 ± 0.5 mm on the dorsal and ventral sides, respectively.Results suggest that a portable HHS system offers potential to acquire accurate image data from the surgical field to facilitate surgical navigation during open spine surgery.
View details for DOI 10.1093/ons/opaa057
View details for Web of Science ID 000593128100077
View details for PubMedID 32365204
View details for PubMedCentralID PMC7490214
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Calibration of a Hand-held Stereovision System for Image-guided Spinal Surgery
edited by Fei, B., Linte, C. A.
SPIE-INT SOC OPTICAL ENGINEERING. 2019
View details for DOI 10.1117/12.2512861
View details for Web of Science ID 000483683500066