Olivia Okoli

All Publications

• Dental Composite Offers Comparable or Greater Pullout and Shear Strength to Lateral Mass Screw Fixation in a Human Cadaveric Model. International journal of spine surgery Wadhwa, H., Castro, J., Okoli, O., Chan, C., Ahmad, S. H., Karnowska, A., Hu, S. S., Koltsov, J. C., Bruckman, K. C., Mok, J. M. 2026

  Abstract

  Lateral mass screw fixation is the common method of fixation for an instrumented posterior fusion of the subaxial cervical spine. While screws have established efficacy, adhesive material that can be applied to the bony surface may be a promising alternative strategy owing to ease of application, size, and avoidance of screw loosening, malposition, or fracture.Eighteen fresh frozen human cadaveric subaxial cervical vertebrae were prepared for biomechanical testing. In each vertebra, 1 side underwent lateral mass screw fixation, and the contralateral side underwent composite fixation. On the screw side, a 12 × 3.5-mm lateral mass screw was inserted using a standard free-hand technique by a spine surgeon. For the dental composite side, the lamina was treated with etching acid solution and a dental bonding agent over a 10-mm diameter area before an orthodontic metal bracket was attached using dental composite. Nine specimens in each group were subjected to an axial load to failure (pullout) test, where the load was perpendicular to the vertebral surface. The remaining specimens were subjected to cyclical testing, where the load was applied cranially (shear) relative to each vertebra and gradually increased with each cycle until failure occurred. Differences were assessed with paired t tests with a 2-sided level of significance of α = 0.05.Under axial load (pullout), the dental composite (203.4 ± 43.4 N) showed higher ultimate load than the screws (127.7 ± 21.2 N; P < 0.001). The predominant failure mode under axial load was the composite pulling off the cortical bone surface, whereas the screw pulled through the cancellous and cortical bone. In cyclical testing, the ultimate shear load of dental composite (163.7 ± 48.4 N) did not differ from lateral mass screws (173.6 ± 65.5 N; P = 0.7). The composite failure mechanism under shear loading for half of the specimens was composite separation from bone, whereas the rest failed due to fractures distant from the composite site, indicating robust fixation integrity of composite to bone.Dental composite displayed similar shear strength and greater pullout strength compared with lateral mass screws.An adhesion-based fixation strategy may serve as a viable alternative to traditional screws in specific clinical scenarios that are worthy of further investigation.

  View details for DOI 10.14444/8871

  View details for PubMedID 41932832

• Articular Length Better Predicts Talar Dome Radius of Curvature Than Articular Width or Age in Pediatric Osteochondral Allograft Planning. Foot & ankle international Tuyishime, H., Okoli, O., Sueyoshi, T., Obilo, C., Shea, K. G., Chan, C. M. 2026: 10711007251405243

  Abstract

  Osteochondral lesions (OCLs) of the talus involve damage to both the articular cartilage and underlying subchondral bone, which may range from compression injury to complete fragment separation. Treating large lesions may necessitate osteochondral allograft transplantation (OCA) to ensure cartilage congruence and minimize articular step-off. However, current allograft selection techniques rely largely on gross size estimation rather than precise contour matching, which may increase the risk of graft incongruity and suboptimal clinical outcomes. This study evaluates the correlations between the talar dome posteromedial (PM) and central lateral (CL) radii of curvature (ROC) with age, articular width (AW), and articular length (AL) in a young patient group to optimize graft selection and matching.Twenty-nine patients, aged 9-18 years, and 30 ankles were included. Magnetic resonance imaging was used to measure talar dome ROC, AW, and AL. The ROC was measured on sagittal images at the PM and CL regions, whereas AW and AL were measured on coronal and sagittal planes, respectively. Three independent reviewers assessed all measurements using Sectra PACS software. Reliability was evaluated using intraclass correlation coefficients (<0.50, poor; 0.50-0.75, moderate; 0.75-0.90, good; >0.90, excellent). Correlations (R2) between ROC with age, AW, and AL were assessed.The mean PM ROC was 20.55 mm and CL ROC 17.20 mm. The mean AW and AL were 27.84 mm and 36.25 mm, respectively. Intraobserver reliability was good to excellent for PM ROC and AW, and moderate to excellent for CL ROC and AL. Interobserver reliability was good to excellent for PM ROC and AW, and moderate to good for CL ROC and AL. For PM ROC, R² values were 0.29 (age), 0.18 (AW), and 0.62 (AL); for CL ROC, R² values were 0.06 (age), 0.54 (AW), and 0.78 (AL).Articular length demonstrated stronger correlations with talar dome PM and CL ROCs compared with AW and age. AL may be a useful parameter for optimizing graft selection, particularly contour and size matching, in OCA.

  View details for DOI 10.1177/10711007251405243

  View details for PubMedID 41618523

• Bedside Aspiration for Workup of the Pediatric Septic Hip: Avoid Trips to the OR and Expedited Time to Diagnosis. Journal of pediatric orthopedics Skaggs, K. F., Okoli, O., Naz, H., Pham, N. S., Vorhies, J. S., Tileston, K. R. 2025

  Abstract

  Septic arthritis of the hip is a pediatric orthopaedic emergency. Joint synovial fluid aspiration is a critical step of diagnosis, which may be delayed due to limited personnel or operating room (OR) availability. To expedite diagnosis, orthopaedic residents perform ultrasound-guided bedside arthrocentesis in the emergency department (ED). This study aims to evaluate the impact of this practice on time to diagnosis and definitive treatment of septic arthritis of the hip and minimizing trips to the operating room.This is a retrospective study of patients presenting to our pediatric orthopaedic tertiary care emergency room requiring a hip aspiration to rule out septic arthritis between 2003 and 2023. We identified all patients who had resulted hip synovial fluid nucleated cell count during the above time period. Chart review was performed to determine how synovial fluid was collected via interventional radiology (IR), in the OR with an orthopaedic surgeon, or via bedside aspiration with the on-call resident. Clinical outcomes were primarily defined as time points in clinical care. Patient demographics, Kocher criteria values, time to aspiration, and final treatment are presented. Kruskal-Wallis and Fisher exact tests were used to compare demographic and clinical differences in RStudio using a two-sided level of significance of 0.05.Hip aspiration was performed in the workup of septic arthritis in 57 patients (median age 5.1 y; 58% female). Aspiration occurred in the ED for 28 patients, interventional radiology (IR) for 11, and in the OR for 18 patients. Bedside aspiration avoided a trip to the OR for 15 patients (54%). Median time to obtaining joint fluid was significantly shorter for patients undergoing bedside or IR-guided aspiration compared with OR aspiration (7.4 vs. 5.3 vs. 15.7 h, respectively; bedside vs. OR P=0.007, IR vs. OR P=0.013). Time from presentation to OR for open surgical debridement, total operative time, and the percentage of patients requiring open surgical debridement did not significantly differ between groups.Bedside aspiration decreases the time to diagnosis of septic arthritis and can prevent ~50% of children from going to the OR. This is beneficial for the patient as it may allow for earlier antibiotic administration, provide pain relief, and avoid possible complications of general anesthesia.Level III-retrospective chart review.

  View details for DOI 10.1097/BPO.0000000000002996

  View details for PubMedID 40391565