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Article ; Online: Symptomatic Coracoid Fracture Nonunion Treated with Arthroscopic Reduction and Suture Anchor Fixation: A Case Report.

Brusalis, Christopher M / Mizels, Joshua / Moverman, Michael A / Chalmers, Peter N

JBJS case connector

2024 Volume 14, Issue 1

Abstract: Case: A 15-year-old female rock climber presented with a traumatic coracoid process fracture of her dominant upper extremity that failed extensive nonoperative treatment. She was treated successfully by arthroscopic reduction and suture anchor fixation.! ...

Abstract	Case: A 15-year-old female rock climber presented with a traumatic coracoid process fracture of her dominant upper extremity that failed extensive nonoperative treatment. She was treated successfully by arthroscopic reduction and suture anchor fixation. Conclusion: A novel surgical technique for coracoid fracture that combines arthroscopic reduction with suture anchor fixation can result in expeditious and durable clinical improvement in a young, high-demand athlete.
MeSH term(s)	Female ; Humans ; Adolescent ; Suture Anchors ; Arthroscopy/methods ; Fractures, Bone/surgery ; Fracture Fixation, Internal/methods ; Fractures, Ununited/diagnostic imaging ; Fractures, Ununited/surgery ; Upper Extremity
Language	English
Publishing date	2024-02-09
Publishing country	United States
Document type	Case Reports ; Journal Article
ISSN	2160-3251
ISSN (online)	2160-3251
DOI	e23.00629
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Functional somatic syndromes are associated with inferior outcomes and increased complications after hip and knee arthroplasty: a systematic review.

Masood, Raisa / Mandalia, Krishna / Pagani, Nicholas R / Moverman, Michael A / Puzzitiello, Richard N / Menendez, Mariano E / Salzler, Matthew J

Arthroplasty (London, England)

2024 Volume 6, Issue 1, Page(s) 2

Abstract: Background: Functional somatic syndromes (FSSs), defined as chronic physical symptoms with no identifiable organic cause, may impact results after hip and knee arthroplasty. The purpose of this study was to perform a systematic review assessing the ... ...

Abstract	Background: Functional somatic syndromes (FSSs), defined as chronic physical symptoms with no identifiable organic cause, may impact results after hip and knee arthroplasty. The purpose of this study was to perform a systematic review assessing the relationship between FSSs and clinical outcomes after primary total hip arthroplasty (THA), total knee arthroplasty (TKA), and unicompartmental knee arthroplasty (UKA). Methods: The PubMed and Web of Science databases were queried from January 1955 through December 2021 for studies investigating the impact of at least one FSS (fibromyalgia, irritable bowel syndrome (IBS), chronic headaches, and chronic low back pain) on outcomes after primary THA/TKA/UKA. Outcomes of interest included patient-reported outcome measures (PROMs), postoperative opioid use, complications, revisions, and costs of care. Results: There were twenty-eight studies, including 768,909 patients, of which 378,384 had an FSS. Five studies reported preoperative PROMs prior to THA/TKA, all of which showed worse PROMs among patients with at least 1 FSS diagnosis. Thirteen studies reported postoperative PROMs after THA/TKA, all of which demonstrated worse PROMs among patients with at least 1 FSS diagnosis. Patients with FSS diagnoses were more likely to continue using opioids at 3, 6, and 12 months following TKA, THA, and UKA. Medical and surgical complications, as well as revision rates, were higher among patients with FSSs. Conclusion: Patients with FSSs have inferior PROMs and are at increased risk for prolonged postoperative opioid use, medical and surgical complications, and revision after hip and knee arthroplasty. Improved understanding of the factors influencing the success of hip and knee arthroplasty is critical. Future studies should address the biopsychosocial determinants of health that can impact outcomes after total joint arthroplasty.
Language	English
Publishing date	2024-01-03
Publishing country	England
Document type	Journal Article
ISSN	2524-7948
ISSN (online)	2524-7948
DOI	10.1186/s42836-023-00223-1
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Article ; Online: The Essential Business Conundrum in COVID-19 Hotspots.

Martin, Christine I / Moverman, Michael A / Menendez, Mariano E

Journal of the National Medical Association

2020 Volume 112, Issue 6, Page(s) 619–620

MeSH term(s)	Boston/epidemiology ; COVID-19/economics ; COVID-19/epidemiology ; COVID-19/prevention & control ; COVID-19/transmission ; Commerce ; Humans ; Physical Distancing ; Poverty Areas ; Social Determinants of Health ; Socioeconomic Factors
Keywords	covid19
Language	English
Publishing date	2020-06-14
Publishing country	United States
Document type	Editorial
ZDB-ID	419737-9
ISSN	1943-4693 ; 0027-9684
ISSN (online)	1943-4693
ISSN	0027-9684
DOI	10.1016/j.jnma.2020.06.002
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Article ; Online: Patient Engagement Technologies in Orthopaedics: What They Are, What They Offer, and Impact.

Kavolus, Joseph J / Moverman, Michael A / Karas, Vasili / Iorio, Richard

The Journal of the American Academy of Orthopaedic Surgeons

2021 Volume 29, Issue 12, Page(s) e584–e592

Abstract: The modern era is an increasingly digital and connected world. Most of the Americans now use a smartphone irrespective of age or income level. As smartphone technologies become ubiquitous, there is tremendous interest and growth in mobile health ... ...

Abstract	The modern era is an increasingly digital and connected world. Most of the Americans now use a smartphone irrespective of age or income level. As smartphone technologies become ubiquitous, there is tremendous interest and growth in mobile health applications. One segment of these new technologies are the so-called patient engagement platforms. These technologies present a host of features that may improve care. This article provides an introduction to this growing technology sector, offers insight into what they may offer patients and surgeons, and discusses how to evaluate various platforms.
MeSH term(s)	Humans ; Mobile Applications ; Orthopedics ; Patient Participation ; Smartphone ; Technology ; United States
Language	English
Publishing date	2021-04-11
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-20-00585
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Zs.A 4048: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: State-level Google search volumes for neck and shoulder pain correlate with psychosocial and behavioral health indicators.

Menendez, Mariano E / Moverman, Michael A / Moon, Andrew S / Ring, David

Journal of the National Medical Association

2021 Volume 113, Issue 5, Page(s) 522–527

Abstract: Background: There is growing interest in passively-generated online search data for health sciences research, but limited use to address musculoskeletal illness.: Questions/purposes: (1) To determine geographic and seasonal patterns in Google queries ...

Abstract	Background: There is growing interest in passively-generated online search data for health sciences research, but limited use to address musculoskeletal illness. Questions/purposes: (1) To determine geographic and seasonal patterns in Google queries for shoulder, knee, hip, and neck pain across the United States, and (2) to quantify the state-level correlation of the volume of online symptom searches with rates of various population health indicators. Methods: Using Google trends, we identified queries for shoulder, knee, hip, and neck pain in every state of the United States during 2018. We assessed the correlation of state-level Google search volumes with 9 population health indicators extracted from the 2018 Behavioral Risk Factor Surveillance System survey: tobacco use, obesity, diabetes, hyperlipidemia, depression, arthritis, cardiovascular disease, participation in physical activities, and college education. Results: Neck and shoulder pain were the most common queries in most Southern states, while knee pain was generally the top query elsewhere. Queries for neck and shoulder pain peaked during the late fall and winter, while searches for knee and hip pain peaked in the spring. State-level search volumes for shoulder and neck pain correlated closely with all health indicators--particularly with tobacco use, obesity, cardiovascular disease, hyperlipidemia, participation in physical activities and college education. The only strong correlation of hip pain queries was with self-reported prevalence of arthritis. Knee pain queries were not associated with any of the studied health indicators. Conclusion: This study highlights the potential of search engine data to be utilized as population-level health indicators. The state-level correlation of psychosocial and behavioral health indicators with online search volumes for neck and shoulder pain may reflect the influence of mental and social health on the experience of pain.
MeSH term(s)	Chest Pain ; Humans ; Internet ; Psychiatry ; Search Engine ; Shoulder Pain/epidemiology ; United States/epidemiology
Language	English
Publishing date	2021-05-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	419737-9
ISSN	1943-4693 ; 0027-9684
ISSN (online)	1943-4693
ISSN	0027-9684
DOI	10.1016/j.jnma.2021.04.001
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Article ; Online: Adverse Events Associated With Robotic-Assisted Joint Arthroplasty: An Analysis of the US Food and Drug Administration MAUDE Database.

Pagani, Nicholas R / Menendez, Mariano E / Moverman, Michael A / Puzzitiello, Richard N / Gordon, Matthew R

The Journal of arthroplasty

2022 Volume 37, Issue 8, Page(s) 1526–1533

Abstract: Background: The use of robotic assistance in arthroplasty is increasing; however, the spectrum of adverse events potentially associated with this technology is unclear. Improved understanding of the causes of adverse events in robotic-assisted ... ...

Abstract	Background: The use of robotic assistance in arthroplasty is increasing; however, the spectrum of adverse events potentially associated with this technology is unclear. Improved understanding of the causes of adverse events in robotic-assisted arthroplasty can prevent future incidents and enhance patient outcomes. Methods: Adverse event reports to the US Food and Drug Administration Manufacturer and User Facility Device Experience database involving robotic-assisted total hip arthroplasty (THA), total knee arthroplasty (TKA), and partial knee arthroplasty were reviewed to determine causes of malfunction and related patient impact. Results: Overall, 263 adverse event reports were included. The most frequently reported adverse events were unexpected robotic arm movement for TKA (59/204, 28.9%) and retained registration checkpoint for THA (19/44, 43.2%). There were 99 reports of surgical delay with an average delay of 20 minutes (range 1-120). Thirty-one cases reported conversion to manual surgery. In total, 68 patient injuries were reported, 7 of which required surgical reintervention. Femoral notching (12/36, 33.3%) was the most common for TKA and retained registration checkpoint (19/28, 67.9%) was the most common for THA. Although rare, additional reported injuries included femoral, tibial, and acetabular fractures, MCL laceration, additional retained foreign bodies, and an electrical burn. Conclusion: Despite the increasing utilization of robotic-assisted arthroplasty in the United States, numerous adverse events are possible and technical difficulties experienced intraoperatively can result in prolonged surgical delays. The events reported herein seem to indicate that robotic-assisted arthroplasty is generally safe with only a few reported instances of serious complications, the nature of which seems more related to suboptimal surgical technique than technology. Based on our data, the practice of adding registration checkpoints and bone pins to the instrument count of all robotic-assisted TJA cases should be widely implemented to avoid unintended retained foreign objects.
MeSH term(s)	Arthroplasty, Replacement, Knee/methods ; Humans ; Knee Joint/surgery ; Robotic Surgical Procedures/methods ; Tibia/surgery ; United States/epidemiology ; United States Food and Drug Administration
Language	English
Publishing date	2022-03-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	632770-9
ISSN	1532-8406 ; 0883-5403
ISSN (online)	1532-8406
ISSN	0883-5403
DOI	10.1016/j.arth.2022.03.060
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Zs.A 2134: Show issues

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Article: Functional Somatic Syndromes Are Associated With Varied Postoperative Outcomes and Increased Opioid Use After Spine Surgery: A Systematic Review.

Masood, Raisa / LeRoy, Taryn E / Moverman, Michael A / Feldman, Matthew W / Rogerson, Ashley / Salzler, Matthew J

Global spine journal

2023 , Page(s) 21925682231217706

Abstract: Study design: Systematic Review.: Objective: To perform a systematic review assessing the relationship between functional somatic syndromes (FSSs) and clinical outcomes after spine surgery.: Methods: A systematic review of online databases (PubMed ...

Abstract	Study design: Systematic Review. Objective: To perform a systematic review assessing the relationship between functional somatic syndromes (FSSs) and clinical outcomes after spine surgery. Methods: A systematic review of online databases (PubMed and Web of Science) through December 2021 was conducted via PRISMA guidelines to identify all studies investigating the impact of at least one FSS (fibromyalgia, irritable bowel syndrome (IBS), chronic headaches/migraines, interstitial cystitis, chronic fatigue syndrome, multiple chemical sensitivity) on outcomes after spine surgery. Outcomes of interest included patient reported outcome measures (PROMs), postoperative opioid use, cost of care, complications, and readmission rates. Results: A total of 207 records were identified. Seven studies (n = 40,011 patients) met inclusion criteria with a mean MINORS score of 16.6 out of 24. Four studies (n = 21,086) reported postoperative opioid use; fibromyalgia was a strong risk factor for long-term opioid use after surgery whereas the association with chronic migraines remains unclear. Two studies (n = 233) reported postoperative patient reported outcome measures (PROMs) with mixed results suggesting a possible association between fibromyalgia and less favorable PROMs. One study (n = 18,692) reported higher postoperative complications in patients with fibromyalgia. Conclusion: Patients with fibromyalgia and possibly migraines are at higher risk for prolonged postoperative opioid use and less favorable PROMs after spine surgery. There is limited research on the relationship between other Functional somatic syndromes (FSSs) and outcomes following spine surgery. Growing evidence suggests the variation in outcomes after spine procedures may be attributed to non-identifiable organic patient factors such as FSSs.
Language	English
Publishing date	2023-11-21
Publishing country	England
Document type	Journal Article
ZDB-ID	2648287-3
ISSN	2192-5690 ; 2192-5682
ISSN (online)	2192-5690
ISSN	2192-5682
DOI	10.1177/21925682231217706
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Article ; Online: The Majority of Sports Medicine and Arthroscopy-Related Randomized Controlled Trials Reporting Nonsignificant Results Are Statistically Fragile.

Sudah, Suleiman Y / Moverman, Michael A / Masood, Raisa / Mojica, Edward S / Pagani, Nicholas R / Puzzitiello, Richard N / Menendez, Mariano E / Salzler, Matthew J

Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association

2023 Volume 39, Issue 9, Page(s) 2071–2083.e1

Abstract: Purpose: To evaluate the robustness of sports medicine and arthroscopy related randomized controlled trials (RCTs) reporting nonsignificant results by calculating the reverse fragility index (RFI) and reverse fragility quotient (RFQ).: Methods: All ... ...

Abstract	Purpose: To evaluate the robustness of sports medicine and arthroscopy related randomized controlled trials (RCTs) reporting nonsignificant results by calculating the reverse fragility index (RFI) and reverse fragility quotient (RFQ). Methods: All sports medicine and arthroscopic-related RCTs from January 1, 2010, through August 3, 2021, were identified. Randomized-controlled trials comparing dichotomous variables with a reported P value ≥ .05 were included. Study characteristics, such as publication year and sample size, as well as loss to follow-up and number of outcome events were recorded. The RFI at a threshold of P < .05 and respective RFQ were calculated for each study. Coefficients of determination were calculated to determine the relationships between RFI and the number of outcome events, sample size, and number of patients lost to follow-up. The number of RCTs in which the loss to follow-up was greater than the RFI was determined. Results: Fifty-four studies and 4,638 patients were included in this analysis. The mean sample size and loss to follow-up were 85.9 patients and 12.5 patients, respectively. The mean RFI was 3.7, signifying that a change of 3.7 events in one arm was needed to flip the results of the study from non-significant to significant (P < .05). Of the 54 studies investigated, 33 (61%) had a loss to follow-up greater than their calculated RFI. The mean RFQ was 0.05. A significant correlation between RFI with sample size (R Conclusions: The RFI and RFQ are statistical tools that allow the fragility of studies reporting nonsignificant results to be appraised. Using this methodology, we found that the majority of sports medicine and arthroscopy-related RCTs reporting nonsignificant results are fragile. Clinical relevance: RFI and RFQ serve as tools that can be used to assess the validity of RCT results and provide additional context for appropriate conclusions.
MeSH term(s)	Humans ; Arthroscopy ; Randomized Controlled Trials as Topic ; Sample Size ; Research Design ; Sports Medicine
Language	English
Publishing date	2023-03-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	632528-2
ISSN	1526-3231 ; 0749-8063
ISSN (online)	1526-3231
ISSN	0749-8063
DOI	10.1016/j.arthro.2023.02.022
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Zs.A 2046: Show issues

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Article ; Online: The reverse fragility index: RCTs reporting non-significant differences in failure rates between hamstring and bone-patellar tendon-bone autografts have fragile results.

Ruelos, Verdinand C B / Masood, Raisa / Puzzitiello, Richard N / Moverman, Michael A / Pagani, Nicholas R / Menendez, Mariano E / Salzler, Matthew J

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA

2023 Volume 31, Issue 8, Page(s) 3412–3419

Abstract: Purpose: The reverse fragility index (RFI) is a novel metric to appraise the results of studies reporting statistically non-significant results. The purpose of this study was to determine the statistical robustness of randomized controlled trials (RCTs) ...

Abstract	Purpose: The reverse fragility index (RFI) is a novel metric to appraise the results of studies reporting statistically non-significant results. The purpose of this study was to determine the statistical robustness of randomized controlled trials (RCTs) reporting non-significant differences in anterior cruciate ligament reconstruction (ACLR) graft failure rates, defined as re-rupture/revision ACLR rate, between hamstring tendon (HT) and bone-patellar tendon-bone (BTB) autografts by calculating RFIs. Methods: A systematic review was performed to identify RCTs that compared HT to BTB grafts for ACLR through January 2022. Studies reporting non-significant differences in graft re-rupture and revision ACLR rate (n.s.) were included. The RFI, defined as the fewest number of event reversals needed to change the non-significant graft re-rupture/revision outcome to statistically significant (P < 0.05), was recorded for each study. In addition, the number of studies in which the loss to follow-up exceeded the RFI was recorded. Results: Among the 16 included RCTs, the median (interquartile range [IQR]) sample size was 71 (64-114), and the median (IQR) total number of graft re-rupture/revision ACLR events was 4 (4-6). The median (IQR) graft re-rupture/revision ACLR rate was 4.3% (3.0-6.4) overall, 4.1% (2.6-6.7) in the BTB group, and 5.4% (3.0-6.3) in the HT group. The median (IQR) RFI was 3 (3-4), signifying that a reversal of the outcome in 3 patients in one arm was needed to flip the studies' result from non-significant to statistically significant (P < 0.05). The median (IQR) number of participants lost to follow-up was 11 (3-13), and 13 (81.3%) of the included studies had a loss to follow-up greater than the studies' RFI. Conclusion: The results of RCTs reporting statistically non-significant re-rupture/revision ACLR rates between HT and BTB autografts would become significant if the outcome were reversed in a small number of patients-a number that was less than the loss to follow-up in the majority of studies. Thus, the neutrality of these studies is fragile, and a true statistically significant difference in re-rupture/revision rates may have been undetected. Level of evidence: Level I.
MeSH term(s)	Humans ; Patellar Ligament/surgery ; Autografts/surgery ; Anterior Cruciate Ligament Injuries/surgery ; Anterior Cruciate Ligament Reconstruction/methods ; Transplantation, Autologous ; Hamstring Tendons/transplantation ; Bone-Patellar Tendon-Bone Grafting/methods ; Randomized Controlled Trials as Topic
Language	English
Publishing date	2023-04-24
Publishing country	Germany
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	1159064-6
ISSN	1433-7347 ; 0942-2056
ISSN (online)	1433-7347
ISSN	0942-2056
DOI	10.1007/s00167-023-07420-0
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Article ; Online: Google Search Analytics for Lateral Epicondylitis.

Dubin, Jeremy / Sudah, Suleiman Y / Moverman, Michael A / Pagani, Nicholas R / Puzzitiello, Richard N / Menendez, Mariano E / Guss, Michael S

Hand (New York, N.Y.)

2023 , Page(s) 15589447231199799

Abstract: Background: The use of online search engines for health information is becoming common practice. We analyzed Google search queries to identify the most frequently asked topics and questions related to lateral epicondylitis ("tennis elbow") and the Web ... ...

Abstract	Background: The use of online search engines for health information is becoming common practice. We analyzed Google search queries to identify the most frequently asked topics and questions related to lateral epicondylitis ("tennis elbow") and the Web sites provided to address these questions. Methods: Four search terms for lateral epicondylitis were entered into Google Web Search. A list of the most frequently asked questions along with their associated Web sites was extracted and categorized by 2 independent reviewers. Results: A total of 400 questions were extracted with 168 associated Web sites. The most popular question topics were related to indications/management (39.0%), risks/complications (19.5%), and the ability to perform specific activities (18.8%). Frequently asked questions had to do with the duration of symptoms, self-management strategies (eg, brace use and self-massage), and the indications for surgery. The most common Web sites provided to address these questions were social media (27.5%), commercial (24.5%), academic (16.5%), and medical practice (16.3%). Conclusion: The most frequently asked questions about lateral epicondylitis on Google centered around symptom duration and management, with most information originating from social media and commercial Web sites. Our data can be used to anticipate patient concerns and set expectations regarding the prognosis and management of lateral epicondylitis.
Language	English
Publishing date	2023-09-25
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	10.1177/15589447231199799
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