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Article: Updates in the Surgical Management of Recurrent Clubfoot Deformity: a Scoping Review.

Gaber, Karim / Mir, Basit / Shehab, Mohammed / Kishta, Waleed

Current reviews in musculoskeletal medicine

2022 Volume 15, Issue 2, Page(s) 75–81

Abstract: Purpose of review: This article focuses on the current advances in surgical management for clubfoot deformity, supported by up-to-date longitudinal studies on each approach.: Recent findings: Long-term analysis following primary and repeated soft ... ...

Abstract	Purpose of review: This article focuses on the current advances in surgical management for clubfoot deformity, supported by up-to-date longitudinal studies on each approach. Recent findings: Long-term analysis following primary and repeated soft tissue releases has demonstrated good results in young patients with low relapse rates. Tibialis anterior transfer following the Ponseti method shows no difference in long-term pedographic analysis in comparison to the Ponseti method alone. Furthermore, tibialis anterior transfer following surgical relapses provides good long-term results with improved correction in talus-first metatarsal angle. Bony osteotomies may also play a role in addressing surgical relapses in older children. However, talar neck osteotomy may result in avascular necrosis of the talar dome. Hexapod external fixation may be considered by experienced surgeons to correct rigid clubfoot deformities in older patients with good long-term results and drastic improvements in pain perception. Long-term analysis of anterior distal tibial epiphysiodesis (ADTE) for recurrent equinus deformity following surgical correction has demonstrated statistical improvements in the anterior distal tibial angle (ADTA) and ankle dorsiflexion. Talectomy and naviculectomy are rarely used in today's practice as long-term studies have demonstrated high relapse rates and residual pain impeding patient mobility. Surgical correction following failure of the conservative approaches can be implemented to achieve full correction in clubfoot deformity. It is difficult to achieve a plantigrade feet with pain-free gait with repeated surgical interventions. Therefore, proper choice of the initial surgical technique is essential for achieving satisfactory long-term outcomes.
Language	English
Publishing date	2022-02-04
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/s12178-022-09739-6
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Child Abuse with Thoracolumbar Fracture-Dislocation Treated with Pedicle Screw Fixation in a 2-Year-Old: A Case Report.

Thornley, Patrick / Peterson, Devin / Kishta, Waleed

JBJS case connector

2021 Volume 11, Issue 4

Abstract: Case: A nonverbal 2-year-old boy presented with acute-on-chronic thoracolumbar fracture-subluxation with associated chylothorax and progressive neurologic dysfunction secondary to nonaccidental trauma. We discussed the successful management of this ... ...

Abstract	Case: A nonverbal 2-year-old boy presented with acute-on-chronic thoracolumbar fracture-subluxation with associated chylothorax and progressive neurologic dysfunction secondary to nonaccidental trauma. We discussed the successful management of this patient with short-segment pedicle screw instrumentation resulting in complete resolution of his chylothoraxes and neurologic impairment. A clinical follow-up is reported out to 12 months after hardware removal. Conclusion: Thoracolumbar fracture-subluxation with massive chylothorax is a rare and important presentation of nonaccidental trauma that must be recognized. Temporary pedicle screw fixation is a successful treatment option for young children presenting with this difficult spinal pathology.
MeSH term(s)	Child ; Child Abuse ; Child, Preschool ; Fracture Fixation, Internal/methods ; Humans ; Lumbar Vertebrae/diagnostic imaging ; Lumbar Vertebrae/injuries ; Lumbar Vertebrae/surgery ; Male ; Pedicle Screws/adverse effects ; Spinal Fractures/diagnostic imaging ; Spinal Fractures/etiology ; Spinal Fractures/surgery ; Thoracic Vertebrae/diagnostic imaging ; Thoracic Vertebrae/injuries ; Thoracic Vertebrae/surgery
Language	English
Publishing date	2021-12-22
Publishing country	United States
Document type	Case Reports ; Journal Article
ISSN	2160-3251
ISSN (online)	2160-3251
DOI	e21.00129
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Article: Effectiveness and Safety of Intrathecal Morphine for Pediatric Patients Undergoing Scoliosis Surgery: A Systematic Review and Meta-Analysis.

Daud, Kashif / Wariach, Sajid / Maqsood, Mubariz / Sarraj, Mohamed / Gaber, Karim / Ewusie, Joycelyne / Khurshed, Abdulaziz / Kishta, Waleed / Nassef, Mohamed

Cureus

2024 Volume 16, Issue 1, Page(s) e51754

Abstract: Adolescent idiopathic scoliosis (AIS) often necessitates spinal fusion surgery in pediatric patients, posing significant challenges in postoperative pain management. Standard care involves the administration of intravenous opioids perioperatively, often ... ...

Abstract	Adolescent idiopathic scoliosis (AIS) often necessitates spinal fusion surgery in pediatric patients, posing significant challenges in postoperative pain management. Standard care involves the administration of intravenous opioids perioperatively, often requiring high doses to achieve adequate analgesia following an operation. This increases the risk of adverse events, may delay recovery and prolong hospital stay, and increases the likelihood of future abuse and dependence. In this systematic review and meta-analysis, we assess the safety and effectiveness of intrathecal morphine (ITM) in pediatric patients undergoing posterior spinal fusion. Ovid Embase and MEDLINE were searched in October 2023 for articles that directly compared ITM use with standard pain management approaches for pediatric patients undergoing posterior spinal fusion. Our primary outcome was postoperative pain scores. Secondary outcomes included opioid usage details, adverse events, and blood loss. Of the 384 unique studies identified, nine studies (one randomized control trial, one prospective review, and seven retrospective reviews) met the inclusion criteria. The total number of patients within the ITM and control groups were 1384 and 676, respectively. Meta-analysis revealed significantly lower pain scores in the ITM group (standardized mean difference (SMD): -1.30 (-2.29, -0.31); p = 0.01). Similarly, ITM patients had significantly lower opioid usage, both intraoperatively (mean difference (MD): -0.71 mg/kg (-0.99, -0.44); p < 0.00001) as well as postoperatively (SMD: -2.10 (-3.48, -0.73); p = 0.003), and significantly lower blood loss (MD: -0.88 L (-1.34, -0.43); p = 0.0001). The occurrence of adverse events was similar across both groups. Our analysis of the available data demonstrates that a low to moderate dose of ITM is a safe and effective adjunct to improve standard postoperative care without increasing the risk of respiratory depression. When compared to control, ITM patients had superior analgesia while using fewer opioids had significantly reduced intraoperative blood loss when ITM was administered before spinal fusion, and had a similar complication profile. While further studies are warranted to establish optimal dosing, these findings underscore the potential of ITM as a valuable addition to multimodal pain management.
Language	English
Publishing date	2024-01-06
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.51754
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Article ; Online: Comparison of Magnetically Controlled Growing Rods with Other Distraction-Based Surgical Technologies for Early-Onset Scoliosis: A Systematic Review and Meta-Analysis.

Bednar, E Dimitra / Bergin, Brad / Kishta, Waleed

JBJS reviews

2021 Volume 9, Issue 1, Page(s) e20.00062

Abstract: Background: Severe and progressive early-onset scoliosis (EOS) has a serious prognosis including cardiopulmonary compromise. Growth-friendly technologies are the current surgical standard of care. Magnetically controlled growing rods (MCGRs) are newer ... ...

Abstract	Background: Severe and progressive early-onset scoliosis (EOS) has a serious prognosis including cardiopulmonary compromise. Growth-friendly technologies are the current surgical standard of care. Magnetically controlled growing rods (MCGRs) are newer implants with the potential for better quality of life and cost savings; however, they have not been well compared with the traditional distraction-based implants. The objective of this study was to compare the surgical outcomes, complications, metal ion levels, quality-of-life outcomes, and cost of MCGRs with other distraction-based surgical technologies for the treatment of EOS. Methods: The MEDLINE, Embase, and Web of Science databases were searched. Record screening and data abstraction were completed in duplicate. Summary outcomes were calculated in a meta-analysis, if heterogeneity was appropriate, using a fixed-effects model. Results: This systematic review and meta-analysis included 18 studies. MCGRs were as clinically effective as other distraction-based technologies, with no significant difference in the Cobb angle at the latest follow-up (mean difference [MD], 1.20°; 95% confidence interval [CI], -1.80° to 4.20°; p = 0.43) and a significantly lower complication rate (odds ratio, 0.42; 95% CI, 0.25 to 0.71; p = 0.001). Quality of life measured using the EOSQ-24 (24-Item Early-Onset Scoliosis Questionnaire) was better in the MCGR group compared with other technologies (MD, 2.18; 95% CI, 0.40 to 3.95; p = 0.02). Serum titanium levels were 2.98 ng/mL (95% CI, 1.41 to 4.55 ng/mL; p = 0.0002) greater in patients with MCGRs, but the clinical impact is unclear. MCGRs had greater cost for the device and insertion but became cost-neutral or cost-effective compared with other technologies by 4 years postoperatively. Conclusions: MCGRs are clinically equivalent and cost-effective in the long term compared with other distraction-based technologies for the treatment of EOS. Level of evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
MeSH term(s)	Humans ; Orthopedic Procedures ; Prostheses and Implants ; Quality of Life ; Reoperation ; Scoliosis/surgery
Language	English
Publishing date	2021-01-20
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ISSN	2329-9185
ISSN (online)	2329-9185
DOI	10.2106/JBJS.RVW.20.00062
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Article ; Online: Surgical Technique for the Removal of a Bullet From the Sacroiliac Joint in a Child: A Case Report and Literature Review.

Bosakhar, Batool / Liu, Kathy / Thornley, Patrick / Kishta, Waleed

JBJS case connector

2021 Volume 11, Issue 3

Abstract: Case: This report presents a logical and effective technique for removing a bullet from the sacroiliac joint (SIJ). The surgery involved a fluoroscopy-guided anterior extraperiosteal lateral window approach. Other than a transient femoral nerve ... ...

Abstract	Case: This report presents a logical and effective technique for removing a bullet from the sacroiliac joint (SIJ). The surgery involved a fluoroscopy-guided anterior extraperiosteal lateral window approach. Other than a transient femoral nerve neuropraxia, there were no complications. A literature review identified 3 reports on bullet removal from the SIJ of adult patients. Conclusion: An anterior extraperiosteal approach for removing bullets from the SIJ in pediatric patients provides satisfactory results. When deciding whether to remove a bullet from the SIJ, the location, joint diastasis, and patient's age should be considered.
MeSH term(s)	Adult ; Child ; Fluoroscopy/methods ; Humans ; Sacroiliac Joint/diagnostic imaging ; Sacroiliac Joint/surgery
Language	English
Publishing date	2021-08-16
Publishing country	United States
Document type	Case Reports ; Journal Article ; Review
ISSN	2160-3251
ISSN (online)	2160-3251
DOI	e21.00110
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Article ; Online: Developmental Foot Deformities in Patients with Connective Tissue Disorders.

Mir, Basit / Gaber, Karim / Ghali, Daniel / Merabia, Bouchra Ghania / Lin, Celina / Kishta, Waleed

JBJS reviews

2023 Volume 11, Issue 2

Abstract: Foot deformities make up a large percentage of all orthopaedic complaints in patients with Down syndrome, Marfan syndrome, Ehlers-Danlos syndrome, Larsen syndrome, and osteogenesis imperfecta.: »: Some common causes of foot deformities in these ... ...

Abstract	»: Foot deformities make up a large percentage of all orthopaedic complaints in patients with Down syndrome, Marfan syndrome, Ehlers-Danlos syndrome, Larsen syndrome, and osteogenesis imperfecta. »: Some common causes of foot deformities in these conditions include increased ligament laxity, hypotonia, and hypermobility of the joints. »: Treatment options for syndromic foot deformities include the use of foot orthoses, physical therapy, bracing, and various surgical procedures. »: There is limited evidence supporting the use of surgical intervention to correct foot deformities associated with Down syndrome, Marfan syndrome, Ehlers-Danlos syndrome, Larsen syndrome, and osteogenesis imperfecta. Therefore, further research is needed to determine the short-term and long-term outcomes of these procedures.
MeSH term(s)	Humans ; Marfan Syndrome/complications ; Osteogenesis Imperfecta/complications ; Down Syndrome/complications ; Joint Instability ; Connective Tissue Diseases/complications ; Ehlers-Danlos Syndrome/complications ; Foot Deformities/surgery ; Foot Deformities/complications ; Connective Tissue
Language	English
Publishing date	2023-02-17
Publishing country	United States
Document type	Journal Article
ISSN	2329-9185
ISSN (online)	2329-9185
DOI	e22.00219
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Article: Assessing the Outcomes Associated with Accessory Navicular Bone Surgery-a Systematic Review.

Wariach, Sajid / Karim, Kunwar / Sarraj, Mohamed / Gaber, Karim / Singh, Amardeep / Kishta, Waleed

Current reviews in musculoskeletal medicine

2022 Volume 15, Issue 5, Page(s) 377–384

Abstract: Purpose of review: The purpose of this review is to evaluate the existing literature in order to compare the clinical outcomes and complications associated with the kidner procedure and simple excision procedure. Furthermore, this review will help ... ...

Abstract	Purpose of review: The purpose of this review is to evaluate the existing literature in order to compare the clinical outcomes and complications associated with the kidner procedure and simple excision procedure. Furthermore, this review will help determine if one procedure is advantageous over the other in treating accessory navicular among patients. Recent findings: Previous research on this topic has seen a low success rate in treating patients with symptomatic accessory navicular using conservative treatment options such as shoe-wear modification, braces, and/or nonsteroidal anti-inflammatory. Surgical treatment such as simple excision and kidner procedure has shown to have minor complications including scarring and wound irritation with a generally high satisfaction rate from patients. However, cases where patients that had planovalgus or hindfoot valgus accompanying the accessory navicular were required to undergo revision surgery to treat the recurrent pain following the kidner procedure. Similarly, patients that underwent simple excision procedure with having flat foot were unable to complete the heel test postoperatively despite not reporting feelings of pain. Both simple excision and the Kidner procedure appear to be efficacious procedures with low complication profiles and high rates of patient satisfaction. Moreover, it has appeared that the female demographic is more likely to present symptomatic accessory navicular and undergo surgical treatment. To further explore the ideal indication for each, more prospective comparative studies are needed as well as radiological assessments pre- and post-operatively to evaluate anatomical changes in the posterior tibialis tendon area between both procedures.
Language	English
Publishing date	2022-07-01
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/s12178-022-09772-5
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Article: Surgical Soft Tissue Management for Glenohumeral Deformity and Contractures in Brachial Plexus Birth Injury : A Systematic Review and Meta-analysis.

McKellar, Sean R / Kay, Jeffrey / Memon, Muzammil / Simunovic, Nicole / Kishta, Waleed / Ayeni, Olufemi R

Current reviews in musculoskeletal medicine

2022 Volume 15, Issue 2, Page(s) 107–120

Abstract: Purpose of the review: Consensus on the effects of soft tissue surgical intervention in the management of brachial plexus birth injury (BPBI) sequalae is lacking. The purpose of this review is to examine the available literature on the functional and ... ...

Abstract	Purpose of the review: Consensus on the effects of soft tissue surgical intervention in the management of brachial plexus birth injury (BPBI) sequalae is lacking. The purpose of this review is to examine the available literature on the functional and structural outcomes following soft tissue surgical management of BPBI sequalae. Recent findings: EMBASE, PubMed, and MEDLINE were searched for related literature from the point of database inception until April 2021. Relevant papers were screened by two reviewers independently and in duplicate. A meta-analysis was performed using a random effects model. A total of 25 studies (852 patients) were included in the review, with the number included in each meta-analysis varying based on outcome of interest. There were significant improvements from pre- to post-operative time points for the following measures: Mallet aggregate scores (5.0 points, p<0.0001), active external rotation in adduction (48.9°, p=0.003), passive external rotation in adduction (64.6°, p< 0.00001), active abduction (46.2°, p<0.00001), glenoid version (14.4°, p< 0.00001), and percentage of the humeral head anterior to the scapular line (17.53°, p< 0.00001). Furthermore, data revealed an overall complication rate of 9.3% (79/852 patients) and a major complication rate of 0.47% (4/852 patients). Patients with BPBI sequela experience statistically significant improvements in functional, structural, and range of motion outcomes of the GH joint following soft tissue surgical management. Understanding the ideal indications for each procedure and age of surgical management with future prospective studies will help to optimize surgical management of these patients.
Language	English
Publishing date	2022-02-14
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/s12178-022-09747-6
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Article: The McMaster osteotomy-a novel surgical treatment to chronic slipped capital femoral epiphysis: description of surgical technique and case study.

Li, Zhi / Qiu, Reva Y / Khurshed, Abdulaziz / Alomran, Dana / Williams, Dale S / Ayeni, Olufemi R / Kishta, Waleed

Journal of hip preservation surgery

2023 Volume 11, Issue 1, Page(s) 59–66

Abstract: Slipped capital femoral epiphysis (SCFE) is a common adolescent hip disorder that can lead to complex proximal femur deformities and devastating consequences such as avascular necrosis, femoroacetabular impingement syndrome and early-onset osteoarthritis. ...

Abstract	Slipped capital femoral epiphysis (SCFE) is a common adolescent hip disorder that can lead to complex proximal femur deformities and devastating consequences such as avascular necrosis, femoroacetabular impingement syndrome and early-onset osteoarthritis. Existing surgical techniques are often insufficient to fully address the constellation of multiplanar deformities in patients with severe SCFE. Therefore, the McMaster Osteotomy, a novel intertrochanteric proximal femur osteotomy, was developed to improve anatomic correction and hip mechanics in patients with chronic SCFE. The McMaster Osteotomy was implemented in two patients (A: 16-year-old male, B: 17-year-old female) with proximal femur deformities due to chronic SCFE. Surgical planning was facilitated with a 3D-printed pelvic model generated from a CT scan of a patient with the SCFE deformity. Patient B also underwent concurrent arthroscopic osteochondroplasty and labral repair. Pre- and post-operative function and radiographic measurements were recorded. Post-operatively, patient A's neck-shaft angle improved from 125° to 136°, Southwick angle from 52° to 33°, neck length from 66 mm to 80 mm and hip internal rotation from 5° to 25°. Patient B's post-operative neck-shaft angle improved from 122° to 136°, Southwick angle from 25° to 15°, neck length from 76 mm to 84 mm, hip internal rotation from 5° to 20° and alpha angle from 87.6° to 44.3°. Both patients are pain-free and have obtained full union of their osteotomies. The McMaster Osteotomy is a versatile technique that can produce a more anatomic reconstruction of hip anatomy and restoration of abductor mechanics. As an extracapsular technique, the risk of femoral head avascular necrosis is minimized.
Language	English
Publishing date	2023-11-29
Publishing country	England
Document type	Journal Article
ZDB-ID	2773022-0
ISSN	2054-8397
ISSN	2054-8397
DOI	10.1093/jhps/hnad042
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Article ; Online: Developmental Dysplasia of the Hip in Patients with Connective-Tissue Disorders.

Kerrigan, Alicia / Ayeni, Olufemi R / Kishta, Waleed

JBJS reviews

2019 Volume 7, Issue 4, Page(s) e5

MeSH term(s)	Connective Tissue Diseases/complications ; Connective Tissue Diseases/diagnostic imaging ; Connective Tissue Diseases/physiopathology ; Guidelines as Topic ; Hip Dislocation, Congenital/diagnostic imaging ; Hip Dislocation, Congenital/etiology ; Hip Dislocation, Congenital/physiopathology ; Humans ; Radiography
Language	English
Publishing date	2019-04-30
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2329-9185
ISSN (online)	2329-9185
DOI	10.2106/JBJS.RVW.18.00092
Database	MEDical Literature Analysis and Retrieval System OnLINE

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