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    University - Student Department: School of Medicine Position: Graduate, Medicine

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All Publications

  • 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