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Article ; Online: Orthopaedic Personal Statement Thematic Review: Does Topic Matter?

Nham, Fong / Court, Tannor / Steelman, Kevin / Chen, Chaoyang / Tsai, Andrew

JB & JS open access

2024 Volume 9, Issue 2

Abstract: Introduction: In the process of applying into medical residency, the Electronic Residency Application Service (ERAS) requires critical documents including a personal statement. Utility of personal statements are questioned based on suspected congruity ... ...

Abstract	Introduction: In the process of applying into medical residency, the Electronic Residency Application Service (ERAS) requires critical documents including a personal statement. Utility of personal statements are questioned based on suspected congruity of the content within personal statements among those who apply into orthopaedic surgery. The goal of this study was to identify and categorize the thematic elements found within the 2021 to 2022 personal statements of orthopaedic surgery applicants at a single institution and assess a correlation to interview invitation. Methods: Deidentified personal statements among 2021 to 2022 ERAS applicants were reviewed by the research staff and categorized into one of the proposed themes. Three hundred ninty-four applications passed initial screening filters, and 49 applicants were granted an interview. Proposed themes that were collected included: family of physician, working with hands, history of injury/disease, prior professional setting, immigration/travel, athlete/sports, reapplication, previous clinical experience, and other. χ Results: There was a significant difference in theme selection for an applicant's personal statement (χ Conclusion: Despite a significant focus of the application process into orthopaedic surgery residencies, our single-institution study did observe specific themes that were more prevalent. There was an increased interview rate between applicant's themes for immigration/travel and family of physician when comparing groups. Immigration/travel was also identified as the only significant theme associated with interview invitation which may be due to the recent emphasis on promoting diversity within orthopaedic surgery.
Language	English
Publishing date	2024-04-18
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2472-7245
ISSN (online)	2472-7245
DOI	10.2106/JBJS.OA.23.00140
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Pulmonary Blastomycosis: Pediatric Cases Emphasizing Prompt Identification Using C-Reactive Protein and Procalcitonin to Distinguish Fungal vs Bacterial Origin.

Gusho, Charles A / Court, Tannor A

WMJ : official publication of the State Medical Society of Wisconsin

2021 Volume 119, Issue 4, Page(s) 289–292

Abstract: Introduction: Pulmonary blastomycosis is a rare fungal disease with increased prevalence in states such as Wisconsin. Clinical manifestations of blastomycosis may vary from asymptomatic infection to multiorgan, disseminated disease.: Case presentation! ...

Abstract	Introduction: Pulmonary blastomycosis is a rare fungal disease with increased prevalence in states such as Wisconsin. Clinical manifestations of blastomycosis may vary from asymptomatic infection to multiorgan, disseminated disease. Case presentation: We present 2 pediatric patients with blastomycosis who were initially worked up secondary to cough and fever of suspected bacterial origin, though whose subsequent hospital course was notable for deterioration until antifungal treatment was initiated. Discussion: In each case, the disease burden was monitored concurrently with serum procalcitonin and C-reactive protein levels, the former of which remained relatively normal throughout the hospital course signifying lack of bacterial involvement. Conclusion: We emphasize the importance of obtaining an early C-reactive protein and procalcitonin, which may distinguish a bacterial from fungal pulmonary infection such as blastomycosis. This, in turn, may shorten hospital stay and reduce hospital inpatient cost, morbidity, and mortality by means of prompt antifungal intervention.
MeSH term(s)	Antifungal Agents/therapeutic use ; Blastomycosis/diagnosis ; Blastomycosis/drug therapy ; C-Reactive Protein ; Child ; Humans ; Procalcitonin ; Wisconsin/epidemiology
Chemical Substances	Antifungal Agents ; Procalcitonin ; C-Reactive Protein (9007-41-4)
Language	English
Publishing date	2021-01-11
Publishing country	United States
Document type	Case Reports
ZDB-ID	441051-8
ISSN	2379-3961 ; 0043-6542 ; 1098-1861
ISSN (online)	2379-3961
ISSN	0043-6542 ; 1098-1861
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Article: Hamstring Anterior Cruciate Ligament Autograft Contributes to a Delayed Symptomatic Cyclops Lesion: A Case Report.

Corsi, Matthew P / Darwiche, Hussein F / Nham, Fong / Court, Tannor / Goitz, Henry

Cureus

2024 Volume 16, Issue 3, Page(s) e56529

Abstract: Cyclops lesions are characterized as fibroid nodules with granulation tissue that looks similar to a cyclops eye during arthroscopy. These are rare postoperative complications following anterior cruciate ligament reconstruction (ACLR), presenting ... ...

Abstract	Cyclops lesions are characterized as fibroid nodules with granulation tissue that looks similar to a cyclops eye during arthroscopy. These are rare postoperative complications following anterior cruciate ligament reconstruction (ACLR), presenting typically within six months of their reconstruction. This case report presents a 21-year-old male, three years following hamstring autograft ACLR, with a symptomatic cyclops lesion. Contrary to the reported literature, this delayed presentation showed a painful flexion contracture of the knee and intraoperative findings consistent with a cyclops lesion. The treatment consisted of surgical debridement and notchplasty with subsequent posterior medial and lateral meniscal horn repairs. This case report presents a lesson to indicate that cyclops lesions can occur in a delayed setting following ACLR and to show a technique for successful surgical management of the lesion.
Language	English
Publishing date	2024-03-20
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.56529
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Article: Cannabidiol: A Brief Review of Its Therapeutic and Pharmacologic Efficacy in the Management of Joint Disease.

Gusho, Charles A / Court, Tannor

Cureus

2020 Volume 12, Issue 3, Page(s) e7375

Abstract: Cannabis use in the management of musculoskeletal diseases has gained advocacy since several states have legalized its recreational use. Cannabidiol (CBD), a commercially available, non-neurotropic marijuana constituent, has shown promise in arthritic ... ...

Abstract	Cannabis use in the management of musculoskeletal diseases has gained advocacy since several states have legalized its recreational use. Cannabidiol (CBD), a commercially available, non-neurotropic marijuana constituent, has shown promise in arthritic animal models by attenuating pro-inflammatory immune responses. Additional research has demonstrated the benefit of CBD in decreasing the endogenous pain response in mice subjected to acute arthritic conditions, and further studies have highlighted improved fracture healing following CBD use in murine mid-femoral fractures. However, there is a lack of high-quality, novel research investigating the use of CBD in human musculoskeletal diseases aside from anecdotal accounts and retrospective reviews, perhaps due to legal ramifications limiting the enrollment of patients. The purpose of this review article is to highlight the extent of current research on CBD and its biochemical and pharmacologic efficacy in the treatment of joint disease, as well as the evidence for use of CBD and cannabis in patients undergoing joint arthroplasty. Based on available literature relying on retrospective data and case reports, it is challenging to propose a recommendation for CBD use in perioperative pain management. Additionally, a number of CBD products currently available as supplements with different methods of administration, and it is important to remember that these products are non-pharmaceuticals. However, given the increased social relevance of CBD and cannabis-based medicines, future, prospective controlled studies evaluating their efficacy are needed.
Language	English
Publishing date	2020-03-23
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.7375
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Article ; Online: Improved performance of machine learning models in predicting length of stay, discharge disposition, and inpatient mortality after total knee arthroplasty using patient-specific variables.

Zalikha, Abdul K / Court, Tannor / Nham, Fong / El-Othmani, Mouhanad M / Shah, Roshan P

Arthroplasty (London, England)

2023 Volume 5, Issue 1, Page(s) 31

Abstract: Background: This study aimed to compare the performance of ten predictive models using different machine learning (ML) algorithms and compare the performance of models developed using patient-specific vs. situational variables in predicting select ... ...

Abstract	Background: This study aimed to compare the performance of ten predictive models using different machine learning (ML) algorithms and compare the performance of models developed using patient-specific vs. situational variables in predicting select outcomes after primary TKA. Methods: Data from 2016 to 2017 from the National Inpatient Sample were used to identify 305,577 discharges undergoing primary TKA, which were included in the training, testing, and validation of 10 ML models. 15 predictive variables consisting of 8 patient-specific and 7 situational variables were utilized to predict length of stay (LOS), discharge disposition, and mortality. Using the best performing algorithms, models trained using either 8 patient-specific and 7 situational variables were then developed and compared. Results: For models developed using all 15 variables, Linear Support Vector Machine (LSVM) was the most responsive model for predicting LOS. LSVM and XGT Boost Tree were equivalently most responsive for predicting discharge disposition. LSVM and XGT Boost Linear were equivalently most responsive for predicting mortality. Decision List, CHAID, and LSVM were the most reliable models for predicting LOS and discharge disposition, while XGT Boost Tree, Decision List, LSVM, and CHAID were most reliable for mortality. Models developed using the 8 patient-specific variables outperformed those developed using the 7 situational variables, with few exceptions. Conclusion: This study revealed that performance of different models varied, ranging from poor to excellent, and demonstrated that models developed using patient-specific variables were typically better predictive of quality metrics after TKA than those developed employing situational variables. Level of evidence: III.
Language	English
Publishing date	2023-07-02
Publishing country	England
Document type	Journal Article
ISSN	2524-7948
ISSN (online)	2524-7948
DOI	10.1186/s42836-023-00187-2
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Article ; Online: Predicting Factors for Blood Transfusion in Primary Total Knee Arthroplasty Using a Machine Learning Method.

Cavazos, Daniel R / Sayeed, Zain / Court, Tannor / Chen, Chaoyang / Little, Bryan E / Darwiche, Hussein F

The Journal of the American Academy of Orthopaedic Surgeons

2023 Volume 31, Issue 19, Page(s) e845–e858

Abstract: Introduction: Acute blood loss anemia requiring allogeneic blood transfusion is still a postoperative complication of total knee arthroplasty (TKA). This study aimed to use machine learning models for the prediction of blood transfusion after primary ... ...

Abstract	Introduction: Acute blood loss anemia requiring allogeneic blood transfusion is still a postoperative complication of total knee arthroplasty (TKA). This study aimed to use machine learning models for the prediction of blood transfusion after primary TKA and to identify contributing factors. Methods: A total of 2,093 patients who underwent primary TKA at our institution were evaluated using data extracted from the hospital quality improvement database to identify patient demographics and surgical variables that may be associated with blood transfusion. A multilayer perceptron neural network (MPNN) machine learning algorithm was used to predict risk factors for blood transfusion and factors associated with increased length of stay. Statistical analyses including bivariate correlate analysis, Chi-Square test, and Student t-test were performed for demographic analysis and to determine the correlation between blood transfusion and other variables. Results: The results demonstrated important factors associated with transfusion rates, including preoperative hemoglobin level, preoperative creatinine level, length of surgery, simultaneous bilateral surgeries, tranexamic acid usage, American Society of Anesthesiologists Physical Status score, preoperative albumin level, ethanol usage, preoperative anticoagulation medications, age, and TKA type (conventional versus robotic-assisted). Patients who underwent a blood transfusion had a markedly greater length of stay than those who did not. The MPNN machine learning model achieved excellent performance across discrimination (AUC = 0.894). Discussion: The MPNN machine learning model showed its power as a statistical analysis tool to predict the ranking of factors for blood transfusion. Traditional statistics are unable to differentiate importance or predict in the same manner as a machine learning model. Conclusion: This study demonstrated that MPNN for the prediction of patient-specific blood transfusion rates after TKA represented a novel application of machine learning with the potential to improve preoperative planning for treatment outcomes.
MeSH term(s)	Humans ; Arthroplasty, Replacement, Knee/adverse effects ; Research Design ; Algorithms ; Blood Transfusion ; Machine Learning
Language	English
Publishing date	2023-08-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	1200524-1
ISSN	1940-5480 ; 1067-151X
ISSN (online)	1940-5480
ISSN	1067-151X
DOI	10.5435/JAAOS-D-23-00063
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Article ; Online: The Impact of Clinical Practice Guidelines on Preoperative Antibiotic Administration for Carpal Tunnel Release.

Mehta, Saurabh / Court, Tannor / Graf, Alexander / Best, Cameron / Havlik, Robert

Hand (New York, N.Y.)

2022 Volume 18, Issue 5, Page(s) 780–784

Abstract: Background: ...

Abstract	Background:
MeSH term(s)	Humans ; Anti-Bacterial Agents/therapeutic use ; Antibiotic Prophylaxis ; Carpal Tunnel Syndrome/surgery ; Orthopedics ; Retrospective Studies ; United States ; Practice Guidelines as Topic
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2022-01-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	2277325-3
ISSN	1558-9455 ; 1558-9447
ISSN (online)	1558-9455
ISSN	1558-9447
DOI	10.1177/15589447211063543
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Article: Assessing the predictive capacity of machine learning models using patient-specific variables in determining in-hospital outcomes after THA.

Nham, Fong H / Court, Tannor / Zalikha, Abdul K / El-Othmani, Mouhanad M / Shah, Roshan P

Journal of orthopaedics

2023 Volume 41, Page(s) 39–46

Abstract: Background: Machine learning is a subset of artificial intelligence using algorithmic modeling to progressively learn and create predictive models. Clinical application of machine learning can aid physicians through identification of risk factors and ... ...

Abstract	Background: Machine learning is a subset of artificial intelligence using algorithmic modeling to progressively learn and create predictive models. Clinical application of machine learning can aid physicians through identification of risk factors and implications of predicted patient outcomes. Aims: The aim of this study was to compare patient-specific and situation perioperative variables through optimized machine learning models to predict postoperative outcomes. Methods: Data from 2016 to 2017 from the National Inpatient Sample was used to identify 177,442 discharges undergoing primary total hip arthroplasty, which were included in the training, testing, and validation of 10 machine learning models. 15 predictive variables consisting of 8 patient-specific and 7 situational specific variables were utilized to predict 3 outcome variables: length of stay, discharge, and mortality. The machine learning models were assessed in responsiveness via area under the curve and reliability. Results: For all outcomes, Linear Support Vector Machine had the highest responsiveness among all models when using all variables. When utilizing patient-specific variables only, responsiveness of the top 3 models ranged between 0.639 and 0.717 for length of stay, 0.703-0.786 for discharge disposition, and 0.887-0.952 for mortality. The top 3 models utilizing situational variables only produced responsiveness of 0.552-0.589 for length of stay, 0.543-0.574 for discharge disposition, and 0.469-0.536 for mortality. Conclusions: Linear Support Vector Machine was the most responsive machine learning model of the 10 algorithms trained, while decision list was most reliable. Responsiveness was observed to be consistently higher with patient-specific variables than situational variables, emphasizing the predictive capacity and value of patient-specific variables. The current practice in machine learning literature generally deploys a single model, it is suboptimal to develop optimized models for application into clinical practice. The limitation of other algorithms may prohibit potential more reliable and responsive models.
Language	English
Publishing date	2023-05-30
Publishing country	India
Document type	Journal Article
ZDB-ID	2240839-3
ISSN	0972-978X
ISSN	0972-978X
DOI	10.1016/j.jor.2023.05.012
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Rare popliteal mass following retrograde nailing of ballistic femur fracture: a case report.

Court, Tannor / Gusho, Charles A / Graf, Alexander / Schmeling, Gregory

OTA international : the open access journal of orthopaedic trauma

2021 Volume 4, Issue 1, Page(s) e094

Abstract: Introduction: Civilian ballistic injuries are commonly associated with fracture, vascular injury, and soft tissue trauma. Posttraumatic pseudoaneurysms represent an extremely rare subset of vascular injuries following ballistic fractures.: Case: We ... ...

Abstract	Introduction: Civilian ballistic injuries are commonly associated with fracture, vascular injury, and soft tissue trauma. Posttraumatic pseudoaneurysms represent an extremely rare subset of vascular injuries following ballistic fractures. Case: We present the rare case of a posttraumatic pseudoaneurysm that occurred after retrograde femoral nailing of a ballistic distal femur fracture. The patient presented in clinic postoperatively with a pulsatile popliteal mass. Distal pulses were intact but subsequent ultrasound and angiography revealed a pseudoaneurysm of the distal superficial femoral artery. The pseudoaneurysm was subsequently treated with a covered stent and the patient's recovery was uncomplicated. Conclusion: Due to the potential life and limb-threating complications from pseudoaneurysm rupture, this case report emphasizes the early recognition and expeditious management of vascular complications following ballistic fractures in the civilian population.
Language	English
Publishing date	2021-02-11
Publishing country	United States
Document type	Case Reports
ISSN	2574-2167
ISSN (online)	2574-2167
DOI	10.1097/OI9.0000000000000094
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Article ; Online: Systematic Review of Ligament Reconstruction of Traumatic Isolated Thumb Carpometacarpal Joint Dislocation.

Court, Tannor / Hussain, Kumail / Kim, Jennifer Sohjeong / Patel, Ishan / Higginbotham, Devan O / Tsai, Andrew G

Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews

2022 Volume 6, Issue 12

Abstract: Introduction: Thumb carpometacarpal (CMC) joint dislocations are rare with minimal agreement on surgical management. The dorsoradial ligament (DRL) is the primary joint stabilizer but has not historically been reconstructed. We hypothesize that the ... ...

Abstract	Introduction: Thumb carpometacarpal (CMC) joint dislocations are rare with minimal agreement on surgical management. The dorsoradial ligament (DRL) is the primary joint stabilizer but has not historically been reconstructed. We hypothesize that the reported reconstruction of first CMC joint dislocations primarily uses the flexor carpi radialis (FCR) without collective agreement on a surgical technique. Methods: A systematic review of the PubMed database from 1996 to 2022 was done. Keywords were "thumb dislocation," "thumb carpometacarpal dislocation," and "carpometacarpal joint ligament repair." Inclusion criteria included isolated, unstable thumb CMC dislocations with reconstruction. The Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines were used. Results: Four hundred thirty-seven records were identified, and nine met inclusion criteria. Two articles were cohort studies, and seven were case reports. Thirty-seven patients were included, and 26 patients had reconstruction with tendonous autograft. Twenty-five (96.2%) used the FCR and 1 (3.9%) from the palmaris longus. Three patients had reconstruction with a suture anchor. Surgical techniques varied between studies. Discussion: The recommendation of the authors recreates the DRL during autograft repair. Current repair techniques that recreate the DRL use the FCR, but quantitative comparisons of tendonous autografts or suture anchors have not been done.
MeSH term(s)	Humans ; Carpometacarpal Joints/surgery ; Thumb/surgery ; Joint Dislocations/surgery ; Plastic Surgery Procedures ; Ligaments, Articular/surgery
Language	English
Publishing date	2022-12-05
Publishing country	United States
Document type	Systematic Review ; Journal Article
ZDB-ID	2898328-2
ISSN	2474-7661 ; 1067-151X
ISSN (online)	2474-7661
ISSN	1067-151X
DOI	10.5435/JAAOSGlobal-D-22-00103
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