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  1. Article: Femoral interference screw divergence as a result of anteromedial portal insertion and outside-in FlipCutter femoral tunnel drilling: A cadaveric study.

    Gardner, Carson / Wu, Samuel / Zahir, Jamal / Dong, Oliver / Raji, Oluwatodimu / Leasure, Jeremi / McGahan, Patrick

    Journal of orthopaedics

    2024  Volume 52, Page(s) 138–142

    Abstract: ... significantly less than those reported using a cannulated reamer (p = 0.001).: Conclusions: The flip cutter ...

    Abstract Aims and objectives: To investigate whether interference screw fixation through an anteromedial portal into an outside-in drilled femoral tunnel via a flip cutter results in acceptable hardware position.
    Materials & methods: 10 cadaveric knees underwent ACL-reconstruction with patellar BTB autograft. Femoral tunnel drilling was performed utilizing an outside-in flip cutter drill and interference screws for femoral fixation. Lateral and anterior-posterior (AP) fluoroscopic images were taken to measure screw divergence within the femoral tunnel. The means of AP and lateral divergence angles were compared using two-tailed t-tests.
    Results: Using the flip cutter, the AP and lateral divergence angles were 7.3° ± 4.5° and 9.3° ± 9.3°, respectively, while the total divergence angles were 16.6° ± 11.8°. Divergence angles using a cannulated reamer were found to be 14.4° ± 2.5° and 6.8° ± 2.8° for AP and lateral, respectively and 21.1° ± 5.2° for the total divergence. The AP divergence angles using the flip cutter were significantly less than those reported using a cannulated reamer (p = 0.001).
    Conclusions: The flip cutter method resulted in significantly reduced divergence angle between the screw and graft when compared to previous cadaveric studies in the coronal plane. There was no significant difference in divergence angle in the sagittal plane. Both methods appear to result in divergence angles below the threshold which would be considered to significantly decrease pull-out strength. Large standard deviations also reflect limited sample size but may also suggest more variability in divergence when compared to historical control set. This study clearly establishes the outside-in technique using a retrograde reamer as a viable independent femoral drilling solution for ACL reconstruction when using a BTB autograft with a femoral interference screw.
    Language English
    Publishing date 2024-03-31
    Publishing country India
    Document type Journal Article
    ZDB-ID 2240839-3
    ISSN 0972-978X
    ISSN 0972-978X
    DOI 10.1016/j.jor.2024.03.035
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Tommy John Ligament Repair with Ulnar Collateral Ligament Internal Brace.

    Guzman, Alvarho / Williams, Nicholas / Francisco, Raia / Reed, Lena / Cheng, Samantha J / Waldron, Patrick / Vallelanes, Ethan / McGahan, Patrick / Chen, James L

    Arthroscopy techniques

    2023  Volume 13, Issue 1, Page(s) 102830

    Abstract: Ulnar collateral ligament (UCL) injuries commonly occur in overhead athletes as a result of excess valgus stress on the elbow and can be functionally debilitating, requiring surgical intervention. Since the advent of the first initial UCL reconstruction ... ...

    Abstract Ulnar collateral ligament (UCL) injuries commonly occur in overhead athletes as a result of excess valgus stress on the elbow and can be functionally debilitating, requiring surgical intervention. Since the advent of the first initial UCL reconstruction technique pioneered by Dr. Frank Jobe performed on professional baseball player Tommy John, UCL, or Tommy John Ligament reconstruction has successfully returned athletes to sport following injury and shown enhanced clinical outcomes with minimal complication rates. Tommy John surgery continues to evolve with the development of various techniques over recent years. This technical note describes a UCL repair with an internal brace using knotless suture anchors and aims to contribute to the current literature a technique that is efficacious and reproducible and offers satisfactory stability, functionality, and return to play.
    Language English
    Publishing date 2023-12-25
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2653101-X
    ISSN 2212-6287
    ISSN 2212-6287
    DOI 10.1016/j.eats.2023.09.006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Glenoid Avulsion of the Glenohumeral Ligament Repair Through a Single Working Portal.

    Shin, Caleb / Guzman, Alvarho / Haratian, Aryan / Borovinsky, Jenna / Youn, Erin / McGahan, Patrick / Chen, James

    Arthroscopy techniques

    2023  Volume 12, Issue 2, Page(s) e285–e289

    Abstract: Glenoid avulsion of the glenohumeral ligament (GAGL) is a traumatic cause of shoulder instability. GAGL lesions are a rare shoulder pathology most commonly reported as a source of anterior shoulder instability, with no current reports implicating this ... ...

    Abstract Glenoid avulsion of the glenohumeral ligament (GAGL) is a traumatic cause of shoulder instability. GAGL lesions are a rare shoulder pathology most commonly reported as a source of anterior shoulder instability, with no current reports implicating this pathology as a cause of posterior instability. Satisfactory surgical repairs of GAGL lesions with anterior shoulder instability have been well documented; however, this Technical Note highlights the successful repair of a posterior GAGL lesion through a single working portal with suture anchor fixation of the posterior capsule.
    Language English
    Publishing date 2023-01-18
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2653101-X
    ISSN 2212-6287
    ISSN 2212-6287
    DOI 10.1016/j.eats.2022.11.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Income and Insurance Status Impact Access to Health Care for Hip Osteoarthritis.

    Youn, Erin J / Shin, Caleb / Haratian, Ryan / Guzman, Alvarho / Kim, Joo Yeon / McGahan, Patrick / Chen, James L

    Arthroscopy, sports medicine, and rehabilitation

    2023  Volume 5, Issue 4, Page(s) 100747

    Abstract: Purpose: To explore differences in the affordability of and accessibility to health care among adults with hip osteoarthritis with respect to race/ethnicity, income, and insurance status.: Methods: This cross-sectional retrospective study was ... ...

    Abstract Purpose: To explore differences in the affordability of and accessibility to health care among adults with hip osteoarthritis with respect to race/ethnicity, income, and insurance status.
    Methods: This cross-sectional retrospective study was conducted using 2016 National Health Interview Survey (NHIS) data. NHIS data collection occurred continuously from January to December 2016. Individuals belonging to households and noninstitutionalized groups were included in the study. Because NHIS randomized surveys are conducted face-to-face on an annual basis, follow-up data are not collected.
    Results: Answers from 38,158,634 weighted respondents with a mean age of 58.33 ± 0.33 years were assessed. Among adults with hip osteoarthritis, those with public insurance had increased odds of delaying care owing to lack of transportation and had decreased odds of delaying care and follow-up care owing to cost. Individuals who were uninsured or who belonged to lower income brackets were associated with increased odds of being unable to afford or utilize health care.
    Conclusions: In this study, we found that income bracket and insurance status affect the accessibility to health care among adults with hip osteoarthritis in the United States.
    Level of evidence: Level IV, prognostic case series.
    Language English
    Publishing date 2023-06-27
    Publishing country United States
    Document type Journal Article
    ISSN 2666-061X
    ISSN (online) 2666-061X
    DOI 10.1016/j.asmr.2023.05.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Impact of the COVID-19 Pandemic on Access to Cancer Surgery: Analysis of Surgical Wait Times in British Columbia, Canada.

    Shojaei, Delaram / Bakos, Brendan / Loree, Jonathan / Mah, Allison / So, Alan / McGahan, Colleen / Phang, Terry P / Brown, Carl James

    Disaster medicine and public health preparedness

    2023  Volume 17, Page(s) e565

    Abstract: Objective: As coronavirus disease 2019 (COVID-19) spread, efforts were made to preserve resources for the anticipated surge of COVID-19 patients in British Columbia, Canada. However, the relationship between COVID-19 hospitalizations and access to ... ...

    Abstract Objective: As coronavirus disease 2019 (COVID-19) spread, efforts were made to preserve resources for the anticipated surge of COVID-19 patients in British Columbia, Canada. However, the relationship between COVID-19 hospitalizations and access to cancer surgery is unclear. In this project, we analyze the impact of COVID-19 patient volumes on wait time for cancer surgery.
    Methods: We conducted a retrospective study using population-based datasets of regional surgical wait times and COVID-19 patient volumes. Weekly median wait times for urgent, nonurgent, cancer, and noncancer surgeries, and maximum volumes of hospitalized patients with COVID-19 were studied. The results were qualitatively analyzed.
    Results: A sustained association between weekly median wait time for priority and other cancer surgeries and increase hospital COVID-19 patient volumes was not qualitatively discernable. In response to the first phase of COVID-19 patient volumes, relative to pre-COVID-19 pandemic levels, wait time were shortened for urgent cancer surgery but increased for nonurgent surgeries. During the second phase, for all diagnostic groups, wait times returned to pre-COVID-19 pandemic levels. During the third phase, wait times for all surgeries increased.
    Conclusion: Cancer surgery access may have been influenced by other factors, such as policy directives and local resource issues, independent of hospitalized COVID-19 patient volumes. The initial access limitations gradually improved with provincial and institutional resilience, and vaccine rollout.
    MeSH term(s) Humans ; British Columbia/epidemiology ; Waiting Lists ; Retrospective Studies ; Pandemics ; COVID-19/epidemiology ; Neoplasms/epidemiology ; Neoplasms/surgery
    Language English
    Publishing date 2023-12-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2375268-3
    ISSN 1938-744X ; 1935-7893
    ISSN (online) 1938-744X
    ISSN 1935-7893
    DOI 10.1017/dmp.2023.223
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Arthroscopic repair of traumatic rotator cuff tear following total shoulder arthroplasty: A case report and review of literature.

    Guzman, Alvarho / Shin, Caleb / Gamboa, Miles / Wu, Didi / Dela Rueda, Therese / Jenkins, Sarah / McGahan, Patrick / Chen, James

    Clinical case reports

    2023  Volume 11, Issue 5, Page(s) e7210

    Abstract: Key clinical message: We highlight the rare case of arthroscopic repair of a traumatic tear following total shoulder arthroplasty. Moreover, there is no reported literature describing the arthroscopic repair of a rotator cuff tear after total shoulder ... ...

    Abstract Key clinical message: We highlight the rare case of arthroscopic repair of a traumatic tear following total shoulder arthroplasty. Moreover, there is no reported literature describing the arthroscopic repair of a rotator cuff tear after total shoulder arthroplasty.
    Abstract: This case report highlights an arthroscopic rotator cuff repair involving full-thickness tears of the supraspinatus and infraspinatus after a total shoulder arthroplasty performed 7 years prior. To our best knowledge, no published literature exists highlighting the arthroscopic repair of a traumatic rotator cuff tear following total shoulder arthroplasty.
    Language English
    Publishing date 2023-05-04
    Publishing country England
    Document type Case Reports
    ZDB-ID 2740234-4
    ISSN 2050-0904
    ISSN 2050-0904
    DOI 10.1002/ccr3.7210
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Single-Portal Arthroscopic Posterior Capsulorrhaphy for Recurrent Shoulder Capsule Laxity and Instability.

    Guzman, Alvarho J / Fong, Scott / Jenkins, Sarah / Dela Rueda, Therese / Talwar, Camille / McGahan, Patrick / Chen, James

    Arthroscopy techniques

    2022  Volume 11, Issue 9, Page(s) e1583–e1588

    Abstract: Arthroscopic stabilization for posterior shoulder instability is well documented in the literature, offering good to excellent clinical outcomes after injury with favorable return-to-sport and patient satisfaction rates. Posterior capsulorrhaphy ... ...

    Abstract Arthroscopic stabilization for posterior shoulder instability is well documented in the literature, offering good to excellent clinical outcomes after injury with favorable return-to-sport and patient satisfaction rates. Posterior capsulorrhaphy addresses recurrent laxity by decreasing the size of the posterior capsule through arthroscopic placement of sutures, in addition to addressing posterior labral tears and any intra-articular pathology within the joint. This technical note describes an arthroscopic posterior capsulorrhaphy for recurrent posterior shoulder capsule laxity and instability in an active patient. This technique uses a single posterior working portal and 2 suture anchors to tighten the posterior capsule onto the intact labrum.
    Language English
    Publishing date 2022-08-17
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2653101-X
    ISSN 2212-6287
    ISSN 2212-6287
    DOI 10.1016/j.eats.2022.05.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Subpectoral Biceps Tenodesis Using an All-Suture Anchor.

    Jenkins, Sarah M / Hwang, Inga M / Del Sol, Shane Rayos / Guzman, Alvarho J / Dela Rueda, Therese / McGahan, Patrick / Chen, James

    Arthroscopy techniques

    2022  Volume 11, Issue 4, Page(s) e555–e562

    Abstract: Long head biceps tendon pathology is a substantial contributor to anterior shoulder pain and often requires surgical intervention to offer a return to normal functionality. Surgical treatment options consist of both open and arthroscopic tenodesis or ... ...

    Abstract Long head biceps tendon pathology is a substantial contributor to anterior shoulder pain and often requires surgical intervention to offer a return to normal functionality. Surgical treatment options consist of both open and arthroscopic tenodesis or tenotomy of the long head biceps brachii. Several techniques exist for tenodesis and tenotomy of the biceps, although current debate continues regarding which surgical approach is the optimal intervention for symptomatic bicep pathology. In this technical note, we describe a subpectoral biceps tenodesis of the long head bicep tendon using an all-suture anchor. Our technique offers the advantages of using an all-suture anchor that incorporates a self-tensioning mechanism with direct visualization of the tendon during biceps tenodesis and anchor insertion.
    Language English
    Publishing date 2022-03-16
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2653101-X
    ISSN 2212-6287
    ISSN 2212-6287
    DOI 10.1016/j.eats.2021.12.007
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article: Rehabilitation After Anterior Cruciate Ligament Injury: Review of Current Literature and Recommendations.

    Jenkins, Sarah M / Guzman, Alvarho / Gardner, Brandon B / Bryant, Stewart A / Del Sol, Shane Rayos / McGahan, Patrick / Chen, James

    Current reviews in musculoskeletal medicine

    2022  Volume 15, Issue 3, Page(s) 170–179

    Abstract: Purpose of review: Anterior cruciate ligament reconstruction (ACLR) is a common surgical procedure with an estimated 120,000 cases performed in the USA each year. Physical therapy plays a critical role in the successful recovery of both surgically and ... ...

    Abstract Purpose of review: Anterior cruciate ligament reconstruction (ACLR) is a common surgical procedure with an estimated 120,000 cases performed in the USA each year. Physical therapy plays a critical role in the successful recovery of both surgically and non-surgically managed patients. Interestingly, ACL rehabilitation protocols vary greatly with little consensus among practitioners. Nonetheless, there has been agreement over the last decade to shift from conservative, standardized length protocols to more accelerated, individualized protocols that vary in length and modalities based on patient-specific findings and preferences. This review summarizes the most recent trends, opinions, and modalities in ACL rehabilitation research, with a specific focus on novel methods to treat the specific psychosocial needs of ACL deficient patients.
    Recent findings: We found that new protocols emphasize early weight bearing, open kinetic chain (OKC) exercises, and other alternative modalities such as neuromuscular electrical stimulation and blood flow restriction. We also found a recent trend toward the use of clinical milestones to determine when a patient is ready for the next phase of a "step-up" rehabilitation program. One particularly nascent topic of research is the inclusion of methods to treat the psychosocial impacts of ACL injury, recovery, and the anxiety around return to sport. Rehabilitation strategy has become increasingly patient-dependent, and the new modalities being utilized are accelerating patient recovery. Return to sport is a particularly important factor for many ACLR patients, and recovery has an important psychological component that has only recently been addressed in the literature, with positive preliminary findings.
    Language English
    Publishing date 2022-04-06
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2407827-X
    ISSN 1935-9748 ; 1935-973X
    ISSN (online) 1935-9748
    ISSN 1935-973X
    DOI 10.1007/s12178-022-09752-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Combined Double-Pulley Remplissage and Bankart Repair.

    Kim, Dong Hyeon / Kim, Joo Yeon / Park, Juho / Talwar, Mika / Jenkins, Sarah / Gardner, Brandon / McGahan, Patrick / Chen, James L

    Arthroscopy techniques

    2022  Volume 11, Issue 3, Page(s) e419–e425

    Abstract: The use of arthroscopic Bankart repair to treat anterior shoulder instability has become increasingly widespread. However, high rates of recurrent instability within the presence of glenohumeral bony defects, specifically Hill-Sachs lesions, have well ... ...

    Abstract The use of arthroscopic Bankart repair to treat anterior shoulder instability has become increasingly widespread. However, high rates of recurrent instability within the presence of glenohumeral bony defects, specifically Hill-Sachs lesions, have well documented a key concern regarding the arthroscopic Bankart repair process. Our technique describes the pairing of a remplissage to fill the Hill-Sachs lesion with the Bankart repair, preventing loss in shoulder stiffness and stability. This technique involves a double-pulley-combined remplissage and Bankart repair to maintain a low-failure, minimally invasive procedure.
    Language English
    Publishing date 2022-02-18
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2653101-X
    ISSN 2212-6287
    ISSN 2212-6287
    DOI 10.1016/j.eats.2021.11.011
    Database MEDical Literature Analysis and Retrieval System OnLINE

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