A5071993433- Total Knee Arthroplasty Outcomes
- Orthopaedic implants and arthroplasty
- Orthopedic Infections and Treatments
- Anesthesia and Pain Management
- Pain Management and Opioid Use
- Shoulder and Clavicle Injuries
- Shoulder Injury and Treatment
- Hip and Femur Fractures
- Cardiac, Anesthesia and Surgical Outcomes
- Opioid Use Disorder Treatment
- Hip disorders and treatments
- Bone Metabolism and Diseases
- Health Systems, Economic Evaluations, Quality of Life
- Bone health and treatments
- scientometrics and bibliometrics research
- Diversity and Career in Medicine
- Musculoskeletal pain and rehabilitation
- Nerve Injury and Rehabilitation
- Health and Medical Research Impacts
- Meta-analysis and systematic reviews
- Innovations in Medical Education
- Bone fractures and treatments
- Cardiovascular Syncope and Autonomic Disorders
- Osteoarthritis Treatment and Mechanisms
- Sports injuries and prevention
Florida Orthopaedic Institute
2023-2025
Orthopedic Institute
2024-2025
University of Florida
2017-2023
Florida College
2018-2023
Pain and Rehabilitation Medicine
2021
Prince Charles Hospital
2020
Clinical Orthopaedics and Related Research
2020
Institute for Orthopaedic Surgery & Sports Medicine
2019
University of Pennsylvania
2011-2017
University of California, San Francisco
2015
Interest in outpatient total hip arthroplasty (THA) and knee (TKA) has increased recently as part of value-based care early recovery protocols. Outpatient pathways require significant paradigm shifts, are not used widely, mostly implemented at surgery centers or orthopedic specialty hospitals. In this article, we report on the outcomes implementation an protocol a tertiary academic medical center.We performed retrospective review series 105 consecutive patients who underwent THA TKA...
Poor fracture healing in geriatric populations is a significant source of morbidity, mortality, and cost to individuals society; however, fundamental biologic understanding age-dependent remains elusive. The development an aged-based model system would allow for mechanistic that could guide future treatments.
Diagnosing periprosthetic joint infection after total arthroplasty is often challenging. The alpha defensin test has been recently reported as a promising diagnostic for infection. goal of this study was to determine the accuracy testing.One hundred and eighty-three synovial fluid C-reactive protein (CRP) tests performed in 183 patients undergoing evaluation were reviewed. Results compared with Musculoskeletal Infection Society (MSIS) criteria infection.Alpha prior surgical treatment...
Total joint arthroplasty (TJA) remains the highest expenditure in Centers for Medicare and Medicaid Services (CMS) budget. One model to control cost is Comprehensive Care Joint Replacement (CJR) model. There has been no published literature date examining efficacy of CJR on value-based outcomes. The purpose this study was determine sustainability a multidisciplinary care redesign total under paradigm at an academic tertiary center.We implemented system-wide redesign, affecting all patients...
With modern advancements in surgical techniques and rapid recovery protocols, incidence of outpatient total joint arthroplasty (TJA) is increasing. Previous literature has historically focused on cost, safety, clinical outcomes, with few studies investigating patient expectations experiences. The aim this study was to survey preoperative related TJA surgery compared perioperative perceptions experience. Prospective patients undergoing hip or knee at a single Tertiary Academic center....
ABSTRACT The rotator cuff assists in shoulder movement and provides dynamic stability to the glenohumeral joint. Specifically, anterior–posterior (AP) force balance, provided by subscapularis anteriorly infraspinatus teres minor posteriorly, is critical for joint concentric rotation of humeral head on glenoid. However, limited understanding exists consequences associated with disruption AP balance (due tears both supraspinatus tendons) function damage. We investigated effect disrupting...
Attention to the collection of patient-reported outcomes measures (PROMs) associated with total hip arthroplasty (THA) is growing. The aim this study was preoperatively predict failure achieve minimal clinically important difference (MCID) and substantial clinical benefit (SCB) between pre- postoperative PROMs. In addition, we sought identify factors predictive MCID SCB in patients undergoing a THA. A retrospective query electronic health record data performed at single institution. Outcomes...
Opioid prescribing for postoperative pain management is challenging because of inter-patient variability in opioid response and concern about addiction. Tramadol, hydrocodone, codeine depend on the cytochrome P450 2D6 (CYP2D6) enzyme formation highly potent metabolites. Individuals with reduced or absent CYP2D6 activity (i.e., intermediate metabolizers [IMs] poor [PMs], respectively) have lower concentrations metabolites potentially inadequate control. The primary objective this prospective,...
Objectives: Morbidity associated with geriatric fractures may be attributed, in part, to compromised mesenchymal stem cell (MSC) function within the fracture callus. The Notch signaling pathway is important for healing of nonskeletal tissues an age-dependent manner, but effect on and MSC dysfunction has not been substantiated. objective this study was examine MSCs obtained from young mice. Methods: Marrow-derived were harvested femora 5- 25-month-old C57BL/6 We assessed vivo number using...
Background: Dissociation of the polyethylene liner from acetabular shell is an uncommon event. Offset, face-changing liners theoretically increase femoral head coverage, allow for larger heads with smaller cup diameters, and offer improved stability without risk impingement. However, we present four cases dissociations that necessitated revision hip surgery. Methods: Four patients spontaneous offset, underwent arthroplasty between January 2007 June 2010. All were women average age...
With the removal of total knee arthroplasty (TKA) from Medicare inpatient-only list, outpatient TKA can now be offered, irrespective payer, in multiple sites. We compared time- and cost-effectiveness performed a hospital department (HOPD) to that at an inpatient academic medical center (AMC).We reviewed all TKAs our AMC HOPD August 2018 July 2019. Time efficiency by phase care was determined, cost data were obtained financial department. Patient selection for surgery identical each site...
The Centers for Medicare & Medicaid Services currently incentivizes hospitals to reduce postdischarge adverse events such as unplanned hospital readmissions patients who underwent total joint arthroplasty (TJA). This study aimed predict 90-day TJA from our comprehensive electronic health record data and routinely collected patient-reported outcome measures.
Abstract Rotator cuff tears are common conditions that can alter shoulder mechanics and may lead to damage of intact joint tissues. These injuries particular concern in populations who perform tasks requiring repetitive overhead activity (e.g., athletes laborers) likely return aggressive pre‐injury levels despite limited understanding the potentially damaging effects on remaining Therefore, we investigated effect returning overuse following a supraspinatus tear function mechanical properties...
Osteopontin (OPN) is a secreted acidic phosphoprotein that involved in many inflammatory and immune-modulating disorders. We previously demonstrated OPN novel islet protein pro survival factor may serve as an intrinsic feedback regulator of nitric oxide signaling β-cells. Here, we investigated the endogenous expression pancreatic non obese diabetic (NOD) mice explored its regulation islets b-cells. High levels mRNA were seen prediabetic NOD pancreata. The temporal pattern inversely...