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  1. Article: Lateral Epicondylitis: Treatment Preferences from the Potential Patient Perspective.

    Parikh, Harin B / Stanley, Mackinzie / Tseng, Cassie C / Kulber, David A / Kuschner, Stuart H

    Plastic and reconstructive surgery. Global open

    2024  Volume 12, Issue 4, Page(s) e5706

    Abstract: Background: Knowing the questions and concerns that patients have regarding treatment options for lateral epicondylitis may allow for shared-decision making and potentially superior patient outcomes and satisfaction. In the present study, we aimed to ... ...

    Abstract Background: Knowing the questions and concerns that patients have regarding treatment options for lateral epicondylitis may allow for shared-decision making and potentially superior patient outcomes and satisfaction. In the present study, we aimed to further delineate patient preferences with treatment of lateral epicondylitis.
    Methods: An online, survey-based, descriptive study was conducted through Amazon Mechanical Turk. Survey participants were presented with a clinical scenario regarding lateral epicondylitis and asked four questions regarding treatment preferences for nonoperative treatment, whether they would consider platelet-rich plasma (PRP) injection, and whether they would consider surgical intervention for recalcitrant symptoms. A Likert scale was used for responses. McNemar chi-square test was used for paired nominal data for statistical analysis.
    Results: A total of 238 survey responses were included. A majority (63%) of respondents elected to proceed with formal physical therapy. When given additional information regarding corticosteroid injections, 50.8% of respondents reported preferring physical therapy. There were no differences between groups for questions 1 and 2 (
    Conclusions: It is important to include patient preferences in treatment discussions of lateral epicondylitis. Survey respondents preferred formal physical therapy for initial treatment. A surprising majority of respondents were likely to consider a PRP injection. With prolonged symptoms, respondents were interested in discussions of surgical intervention and thus, it should continue to be offered to patients with recalcitrant symptoms.
    Language English
    Publishing date 2024-04-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2851682-5
    ISSN 2169-7574 ; 2169-7574
    ISSN (online) 2169-7574
    ISSN 2169-7574
    DOI 10.1097/GOX.0000000000005706
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    Zs.A 7091: Show issues Location:
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  2. Article ; Online: Accelerated Return to Play in Professional Basketball Players With Surgically-Treated Metacarpal Shaft Fractures.

    Parikh, Harin B / Herman, Mojca C / Shin, Steven S

    The Iowa orthopaedic journal

    2022  Volume 42, Issue 1, Page(s) 201–206

    Abstract: Background: Traditional rehabilitation protocols for surgically treated metacarpal shaft fracture allow for return to play at 6-8 weeks post-operative. This may be devastating for the elite athlete. We outline a protocol that may allow for professional ... ...

    Abstract Background: Traditional rehabilitation protocols for surgically treated metacarpal shaft fracture allow for return to play at 6-8 weeks post-operative. This may be devastating for the elite athlete. We outline a protocol that may allow for professional basketball players to successfully return to sport within four weeks following surgery.
    Methods: Professional basketball players who sustained non-thumb metacarpal shaft fractures were included. All athletes underwent open reduction and internal fixation of the injured metacarpal. Patients were subsequently enrolled into an accelerated rehabilitation protocol.
    Results: The five athletes in our case series successfully passed return to sport testing within four weeks of surgery.
    Conclusion: A plate and screw construct can potentially allow for professional basketball players to return to play in half the time. Future research studies should include a larger pool of athletes to further investigate accelerated rehabilitation following surgical fixation of metacarpal fractures.
    MeSH term(s) Basketball ; Fracture Fixation, Internal ; Fractures, Bone/surgery ; Hand Injuries ; Humans ; Metacarpal Bones/injuries ; Metacarpal Bones/surgery ; Return to Sport
    Language English
    Publishing date 2022-06-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1204065-4
    ISSN 1555-1377 ; 1541-5457
    ISSN (online) 1555-1377
    ISSN 1541-5457
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  3. Article: Biomechanical Comparison of Ulnar Collateral Ligament Reconstruction Between Palmaris Longus Autograft and Knee Medial Collateral Ligament Allograft.

    Stone, Michael A / Chao, Linda / Huang, Dave T / Parikh, Harin B / Sun, Michael / Kulber, David A / Metzger, Melodie F

    Orthopaedic journal of sports medicine

    2024  Volume 12, Issue 3, Page(s) 23259671241234685

    Abstract: Background: Medial ulnar collateral ligament (mUCL) injury can cause significant pain and alter throwing mechanics. Common autograft options for mUCL reconstruction (UCLR) include the palmaris longus (PL) and hamstring tendons. Allograft use may reduce ... ...

    Abstract Background: Medial ulnar collateral ligament (mUCL) injury can cause significant pain and alter throwing mechanics. Common autograft options for mUCL reconstruction (UCLR) include the palmaris longus (PL) and hamstring tendons. Allograft use may reduce donor site morbidity and decrease function related to PL autografts.
    Purpose: To compare varus stability and load to failure between a novel allograft for UCLR-knee medial collateral ligament (kMCL)-and a PL autograft in human donor elbow specimens.
    Study design: Controlled laboratory study.
    Methods: A total of 24 fresh-frozen human elbows were dissected to expose the mUCL. Medial elbow stability was tested with the mUCL intact (native), deficient, and reconstructed utilizing the humeral single-docking technique with either a (1) kMCL allograft (n = 12) or (2) a PL autograft (n = 12). A 3-N·m valgus torque was applied to the elbow, and valgus rotation of the ulna was recorded via motion tracking cameras. The elbow was cycled through a full range of motion 5 times. After kinematic testing, specimens were loaded to failure at 70° of elbow flexion, and failure modes were recorded.
    Results: The mUCL-deficient elbows demonstrated significantly greater valgus rotation compared with the intact and reconstructed elbows at every flexion angle tested (10°-120°) (
    Conclusion: Fresh-frozen and aseptically processed kMCL allografts demonstrated similar kinematic and failure properties to PL tendon autografts in UCL-reconstructed elbows, although neither graft fully restored kinematics between 10° and 40°.
    Clinical relevance: Prepared kMCL ligament allografts may provide a viable graft material when reconstructing elbow ligaments while avoiding the potential complications related to PL autografts- including donor site morbidity.
    Language English
    Publishing date 2024-03-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2706251-X
    ISSN 2325-9671
    ISSN 2325-9671
    DOI 10.1177/23259671241234685
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  4. Article ; Online: Amyloid Deposition: An Unusual Case of Deep Gluteal Syndrome and Sciatic Nerve Compression: A Case Report.

    Parikh, Harin B / Matcuk, George R / Leong, Matthew / Vrahas, Mark S / Seruya, Mitchel

    JBJS case connector

    2022  Volume 12, Issue 3

    Abstract: Case: Soft-tissue amyloidomas are exceedingly rare, with only a few cases reported in the literature. There are no reports of sciatic nerve compression secondary to a soft-tissue amyloidoma. We report a unique case of a 71-year-old man with an ... ...

    Abstract Case: Soft-tissue amyloidomas are exceedingly rare, with only a few cases reported in the literature. There are no reports of sciatic nerve compression secondary to a soft-tissue amyloidoma. We report a unique case of a 71-year-old man with an incidentally found amyloidoma who was initially believed to have deep gluteal syndrome. He had a favorable outcome after surgical decompression.
    Conclusion: For patients who do not have classic examination and electromyography/nerve conduction findings of piriformis syndrome, providers should explore other etiologies of peripheral nerve compression including soft-tissue amyloidoma.
    MeSH term(s) Aged ; Humans ; Male ; Piriformis Muscle Syndrome/complications ; Sciatic Nerve ; Sciatic Neuropathy/etiology ; Sciatica/surgery ; Soft Tissue Neoplasms
    Language English
    Publishing date 2022-07-13
    Publishing country United States
    Document type Case Reports ; Journal Article
    ISSN 2160-3251
    ISSN (online) 2160-3251
    DOI 10.2106/JBJS.CC.22.00075
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  5. Article ; Online: Optimizing the Entry Point for Reconstruction Nailing of the Femur.

    Robles, Abrianna S / Najdawi, Jawad J / Wang, Juntian / Rockov, Zachary A / Parikh, Harin B / Little, Milton T M / Marecek, Geoffrey S

    The Journal of the American Academy of Orthopaedic Surgeons

    2023  Volume 31, Issue 18, Page(s) e721–e726

    Abstract: Introduction: Varus after antegrade medullary nailing of the proximal femur is associated with worse outcomes. Anecdotally, a more medialized "trochiformis" entry is beneficial to avoid varus with valgus-bend (greater trochanteric entry) femoral nails. ... ...

    Abstract Introduction: Varus after antegrade medullary nailing of the proximal femur is associated with worse outcomes. Anecdotally, a more medialized "trochiformis" entry is beneficial to avoid varus with valgus-bend (greater trochanteric entry) femoral nails. However, the optimal entry point remains unknown. The purpose of this study was to define the optimal entry point for reconstruction nailing.
    Methods: Using standing alignment radiographs from 51 patients, we templated the ideal entry point for straight and valgus-bend nails from three major manufacturers using TraumaCad software. We measured the distance from the tip of the trochanter to the ideal entry site for each nail. We compared piriformis (PF) with trochanteric (GT) entry for each company and across manufacturers.
    Results: The mean greater trochanter offset from the femoral axis was 15.2 mm. The mean PF entry was 5.9 to 6.7 mm medial to the mean GT entry for each company's nail and was statistically distinct. No differences were observed in GT and PF entry points across manufacturers. Only 2 of 153 ideal GT entry points were lateral to the tip of the trochanter. An increased neck-shaft angle (NSA) and increased GT offset were correlated with a more medial ideal entry point.
    Discussion: The ideal entry point for GT nails is similar across manufacturers and is medial to the tip of the greater trochanter; however, PF and GT entry sites remain distinct. During preoperative planning and when executing femoral nailing intraoperatively, it may also be important to consider the NSA and GT offset of a patient before committing to a certain entry point.
    MeSH term(s) Humans ; Femoral Fractures/diagnostic imaging ; Femoral Fractures/surgery ; Fracture Fixation, Intramedullary ; Bone Nails ; Femur/diagnostic imaging ; Femur/surgery ; Radiography
    Language English
    Publishing date 2023-05-18
    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-22-00778
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    Zs.A 4048: Show issues Location:
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  6. Article: Increased Duration and Frequency of Lateral C-Arm Draping Does Not Increase Contamination Rates.

    Haggerty, Erin K / Parikh, Harin B / Rockov, Zachary A / Hampton, David M / Little, Milton T M / Moon, Charles N / Lin, Carol A

    Journal of surgical orthopaedic advances

    2023  Volume 32, Issue 2, Page(s) 107–110

    Abstract: This study sought to quantify the rate of culture-positive drape contamination with varying degrees of drape manipulation for intra-operative fluoroscopic imaging. In this prospective cohort study, 30 patients with operatively closed lower extremity ... ...

    Abstract This study sought to quantify the rate of culture-positive drape contamination with varying degrees of drape manipulation for intra-operative fluoroscopic imaging. In this prospective cohort study, 30 patients with operatively closed lower extremity fractures were evaluated. The clip-drape technique was employed to cover the emitter. Swab samples were collected for bacterial growth. A t-test was applied for statistical comparison. Three of 30 cases (10% of operations) showed evidence of contamination. There was no statistically significant difference between duration of drape use or the amount of drape manipulations. None of the 30 patients in this study developed surgical site infection 90-days post-surgery. The clip drape technique for lateral fluoroscopy appears to be effective in maintaining surgical field sterility. Moreover, the number of drape manipulations and length of time the drape was in use was not related to drape contamination. Level of Evidence: Therapeutic Level II. (Journal of Surgical Orthopaedic Advances 32(2):107-110, 2023).
    MeSH term(s) Humans ; Prospective Studies ; Fluoroscopy ; Fractures, Bone ; Orthopedics ; Surgical Wound Infection/epidemiology ; Surgical Wound Infection/prevention & control
    Language English
    Publishing date 2023-09-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2189157-6
    ISSN 2158-3811 ; 1548-825X ; 1059-1052
    ISSN (online) 2158-3811
    ISSN 1548-825X ; 1059-1052
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    Zs.A 4751: Show issues Location:
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  7. Article ; Online: How Do We Best Educate Our Patients' Caregivers? Comparing the Efficacy of Print Versus Media-based Education Materials in Peripheral Nerve Catheter and Pain Pump Education.

    Parikh, Harin B / Gagliardi, Alexia G / Carry, Patrick M / Albright, Jay C / Mandler, Tessa N

    Journal of pediatric orthopedics

    2021  Volume 42, Issue 1, Page(s) 35–39

    Abstract: Background: Media-based educational materials (EMs) are becoming prominent. The purpose of this study was to compare print versus media-based EMs given to caregivers of pediatric and young adult patients undergoing surgery. We aimed to see whether print ...

    Abstract Background: Media-based educational materials (EMs) are becoming prominent. The purpose of this study was to compare print versus media-based EMs given to caregivers of pediatric and young adult patients undergoing surgery. We aimed to see whether print or media-based EMs lead to greater caregiver satisfaction, comfort, and preparedness for outpatient peripheral nerve catheter and pain pump management. We also assessed caregiver preference for EM modality.
    Hypothesis: We hypothesized that media-based EMs would demonstrate greater overall efficacy and thus generate higher caregiver preference.
    Study design: Randomized control trial.
    Methods: After IRB approval, clinicaltrials.gov registration (17-0638), and informed consent, caregivers were randomized to either media or print-based EM groups. Caregivers reviewed their assigned EM and completed a standardized assessment of their comprehension. We assessed caregiver satisfaction, preparedness, and comfort level with the content on a 5-point Likert scale. On postoperative days 1 to 2, caregivers reported satisfaction, comfort, and preference for EM modality. An intent-to-treat analysis was used to compare the 2 groups.
    Results: From our final cohort of 135 caregivers, we found no difference [P>0.05] in satisfaction, comfort level, level of preparedness, or discharge readiness scores between groups. After the caregivers were given both EMs, they were evenly split in their preference for print (49.6%) versus video (50.4%) based methods.
    Conclusions: We did not detect a significant difference in caregiver preference or feelings of preparedness between groups. Interestingly, a significant proportion of caregivers (25%) did not feel comfortable managing the peripheral nerve catheter and its pain pump at home. Future studies should work to improve caregiver comfort with educational content before patient discharge.
    Clinical relevance: Providers and institutions should feel comfortable providing both print and media-based patient and caregiver education. Caregiver education may be best suited based on caregiver preference of one EM modality versus the other.
    Level of evidence: Level I.
    MeSH term(s) Caregivers ; Catheters ; Child ; Educational Status ; Humans ; Pain/etiology ; Peripheral Nerves ; Young Adult
    Language English
    Publishing date 2021-10-29
    Publishing country United States
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 604642-3
    ISSN 1539-2570 ; 0271-6798
    ISSN (online) 1539-2570
    ISSN 0271-6798
    DOI 10.1097/BPO.0000000000001997
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  8. Article ; Online: Sterile techniques during regional anesthesia placement among pediatric anesthesiologists.

    Mandler, Tessa N / Gagliardi, Alexia G / Parikh, Harin B / Austin, Thomas M / Yaster, Myron / Polaner, David M

    Paediatric anaesthesia

    2022  Volume 33, Issue 4, Page(s) 326–327

    MeSH term(s) Child ; Humans ; Anesthesiologists ; Anesthesia, Conduction/methods ; Anesthesia, Local
    Language English
    Publishing date 2022-12-08
    Publishing country France
    Document type Journal Article
    ZDB-ID 1086049-6
    ISSN 1460-9592 ; 1155-5645
    ISSN (online) 1460-9592
    ISSN 1155-5645
    DOI 10.1111/pan.14611
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    Zs.A 3306: Show issues Location:
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  9. Article ; Online: Outcomes of Quadriceps Tendon With Patellar Bone Block Anterior Cruciate Ligament Reconstruction in Adolescent Patients With a Minimum 2-Year Follow-up.

    Gagliardi, Alexia G / Carry, Patrick M / Parikh, Harin B / Albright, Jay C

    The American journal of sports medicine

    2019  Volume 48, Issue 1, Page(s) 93–98

    Abstract: Background: The incidence of anterior cruciate ligament (ACL) injury in the adolescent population is increasing. The quadriceps tendon-patellar bone autograft (QPA) has been established as a reliable graft choice for ACL reconstruction in the adult ... ...

    Abstract Background: The incidence of anterior cruciate ligament (ACL) injury in the adolescent population is increasing. The quadriceps tendon-patellar bone autograft (QPA) has been established as a reliable graft choice for ACL reconstruction in the adult population.
    Purpose: To investigate graft failure, ability to return to sport, patient-reported functional outcomes, joint laxity, and subsequent injury among adolescent patients >2 years after primary ACL reconstruction with the QPA.
    Study design: Case series; Level of evidence, 4.
    Methods: Consecutive patients who underwent QPA ACL reconstruction performed by a single surgeon were identified from an existing database. Information available in the database included demographics, concomitant/subsequent injuries, surgical procedures, graft failure, return to sport, and Lachman examination collected by medical record review. Pediatric International Knee Documentation Committee (Pedi-IKDC) and Lysholm scores were collected by telephone or during a clinic visit >2 years postoperatively.
    Results: The final cohort included 81 of 104 consecutive adolescent patients aged 10 to 18 years (mean ± SD, 15.9 ± 1.7 years at the time of surgery) for whom follow-up information was collected at >2 years after surgery. The cumulative incidence of graft failure within the 36-month follow-up period was 1.2% (95% CI, 0.1%-11.4%). The rate of ipsilateral non-ACL injuries was similar (1.2%; 95% CI, 0.2%-7.6%). Contralateral ACL and non-ACL injuries requiring surgical intervention were documented in 9.8% (95% CI, 4.9%-19.5%). The median Pedi-IKDC score was 94 (interquartile range, 89-98). The median Lysholm score was 99.5 (interquartile range, 89.0-100.0). At 36 months after surgery, 87.9% (95% CI, 81.4%-94.9%) of individuals had returned to play.
    Conclusion: The quadriceps tendon-patellar autograft is a novel graft that demonstrates excellent stability and favorable patient-reported outcomes. Based on these results, the QPA is a reliable choice for primary ACL reconstruction in adolescent patients.
    MeSH term(s) Adolescent ; Anterior Cruciate Ligament Injuries/surgery ; Anterior Cruciate Ligament Reconstruction/methods ; Bone Transplantation ; Child ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Joint Instability/surgery ; Knee Joint/surgery ; Male ; Patella/surgery ; Patellar Ligament/surgery ; Quadriceps Muscle/surgery ; Tendons/transplantation
    Language English
    Publishing date 2019-11-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 197482-8
    ISSN 1552-3365 ; 0363-5465
    ISSN (online) 1552-3365
    ISSN 0363-5465
    DOI 10.1177/0363546519885371
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  10. Article ; Online: Femoral nerve catheters and limb strength asymmetry at 6 months after primary anterior cruciate ligament reconstruction in pediatric patients.

    Parikh, Harin B / Gagliardi, Alexia G / Howell, David R / Albright, Jay C / Mandler, Tessa N

    Paediatric anaesthesia

    2020  Volume 30, Issue 10, Page(s) 1109–1115

    Abstract: Background: The postoperative implications of single-injection femoral nerve blockade and femoral nerve catheter placement for anterior cruciate ligament reconstruction are not well defined among pediatric patients. Femoral nerve blockade may be ... ...

    Abstract Background: The postoperative implications of single-injection femoral nerve blockade and femoral nerve catheter placement for anterior cruciate ligament reconstruction are not well defined among pediatric patients. Femoral nerve blockade may be associated with deficits in quadriceps symmetry at 6 months postoperative.
    Aims: We compared outcomes after primary anterior cruciate ligament reconstruction surgery in pediatric patients who received either a single-injection femoral nerve block or femoral nerve catheter and a single-injection popliteal nerve block.
    Methods: We conducted a retrospective chart review of patients 10-19 years of age who underwent anterior cruciate ligament reconstruction with quadriceps tendon-patellar bone autograft by a single orthopedic surgeon at two of our locations. Of 88 patients analyzed, 31 received single-injection femoral nerve blockade (52% female, mean age = 15.6 ± 1.8 years) and 57 received femoral nerve catheter (53% female, mean age = 15.6 ± 1.7 years). Time from surgery to return-to-sport clearance and movement symmetry were compared between groups at approximately 6 months postoperatively.
    Results: The single-injection femoral nerve blockade group exhibited significantly greater single-leg squat symmetry than did the femoral nerve catheter group (95.5 ± 6.7% vs 88.3 ± 9.3%; P = 0.02; mean difference = 7.2%, 95% CI = -1.1, 13.3) 6 months postoperatively. There was no difference in time from surgery to return-to-sport clearance between groups (median = 247 [interquartile range = 218-295] days vs 268 [241-331] days; P = 0.22; mean difference = 40 days; 95% CI = -23, 102).
    Conclusion: Though time to return to sport did not differ, patients in the femoral nerve catheter group exhibited greater single-leg squat asymmetry than did those in the femoral nerve blockade group approximately 6 months postoperatively. Persistent functional deficits may be important to consider when treating pediatric patients undergoing anterior cruciate ligament reconstruction.
    MeSH term(s) Anterior Cruciate Ligament Injuries/surgery ; Anterior Cruciate Ligament Reconstruction ; Catheters ; Child ; Female ; Femoral Nerve ; Humans ; Infant, Newborn ; Knee Joint/surgery ; Male ; Retrospective Studies
    Language English
    Publishing date 2020-08-28
    Publishing country France
    Document type Journal Article
    ZDB-ID 1086049-6
    ISSN 1460-9592 ; 1155-5645
    ISSN (online) 1460-9592
    ISSN 1155-5645
    DOI 10.1111/pan.13983
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