Browsing by Author "Bois, Aaron J."
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- ItemOpen AccessArthroscopic Repair of Articular Surface Partial-Thickness Rotator Cuff Tears: Transtendon Technique versus Repair after Completion of the Tear—A Meta-Analysis(2016-07-04) Ono, Yohei; Woodmass, Jarret M.; Bois, Aaron J.; Boorman, Richard S.; Thornton, Gail M.; Lo, Ian K. Y.Articular surface partial-thickness rotator cuff tears (PTRCTs) are commonly repaired using two different surgical techniques: transtendon repair or repair after completion of the tear. Although a number of studies have demonstrated excellent clinical outcomes, it is unclear which technique may provide superior clinical outcomes and tendon healing. The purpose was to evaluate and compare the clinical outcomes following arthroscopic repair of articular surface PTRCT using a transtendon technique or completion of the tear. A systematic review of the literature was performed following PRISMA guidelines and checklist. The objective outcome measures evaluated in this study were the Constant Score, American Shoulder and Elbow Surgeons score, Visual Analogue Scale, physical examination, and complications. Three studies met our criteria. All were prospective randomized comparative studies with level II evidence and published from 2012 to 2013. A total of 182 shoulders (mean age 53.7 years; mean follow-up 40.5 months) were analyzed as part of this study. Both procedures provided excellent clinical outcomes with no significant difference in Constant Score and other measures between the procedures. Both procedures demonstrated improved clinical outcomes. However, there were no significant differences between each technique. Further studies are required to determine the long-term outcome of each technique.
- ItemOpen AccessAssessing Validity and Responsiveness of the Rotator Cuff Quality of Life Index(2018-07-17) Campbell, Caitlin Dawn; Mohtadi, Nicholas G. H.; Wiley, James Preston; Bois, Aaron J.; Sabo, Marlis T.Background: The Rotator Cuff Quality of Life Index (RC-QOL) was developed to evaluate quality of life in patients with rotator cuff disease (RCD). This study provides additional validity and responsiveness testing over a 2-year period in accordance with the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines. Methods: Sixty-six patients (mean age, 59±10) with RCD were evaluated. Methodology testing included criterion (concurrent) and content validity, and responsiveness. Results: Content validity was confirmed with a Cronbach α of 0.91 (95% CI; range, 0.92-0.95) and an absence of floor and ceiling effects. Criterion (concurrent) validity was confirmed using the Western Ontario Rotator Cuff Index as a reference standard (r=0.85, p<0.001). The effect size of distribution-based methods of determining responsiveness were large (0.99-1.09) compared to mixed- and anchor-based methods (0.47-0.8). All responsiveness calculations met minimum requirements for acceptable thresholds. Conclusion: The RC-QOL is a valid and responsive measure of health-related quality of life in patients with chronic RCD. The results of this study added to the methodologic quality assessment of the RC-QOL, completing 7 of 10 COSMIN criteria.
- ItemOpen AccessFungal Infection following Total Elbow Arthroplasty(2019-09-04) Ornell, Samuel S.; Dang, Khang H.; Bois, Aaron J.; Dutta, Anil K.A specific treatment protocol for managing fungal infections after total elbow arthroplasty (TEA) does not currently exist. The purpose of this report is to describe our experience and outline our treatment algorithm for a rare case of prosthetic joint infection (PJI) following a TEA. We present a case of a PJI due to Candida parapsilosis after TEA in a 57 year-old Caucasian woman with a history of hypertension, depression, and three previous surgical procedures to the affected limb. A fungal PJI by the organism C. parapsilosis following TEA has not been previously reported. Successful eradication of the fungal infection was achieved utilizing resection arthroplasty; placement of an amphotericin, vancomycin, and tobramycin-impregnated cement spacer; and 6 months of organism-specific antifungal medication. Although the patient was clinically ready for reimplantation, she passed away due to unrelated issues before reimplantation could be performed. While PJI is a devastating complication following TEA, a fungal infection is a rare complication that imposes difficult challenges to the treating surgeon. With our case report, we hope to contribute to the overall knowledge of fungal infections associated with TEA and describe our successful treatment of this complex case.
- ItemOpen AccessJoint aspiration and serum markers - do they matter in the diagnosis of native shoulder sepsis? A systematic review(2022-05-19) Salazar, Luis M.; Gutierrez-Naranjo, Jose M.; Meza, Clarissa; Gabig, Andrew; Bois, Aaron J.; Brady, Christina I.; Dutta, Anil K.Abstract Background Septic arthritis of the native shoulder is traditionally diagnosed with the same strategies as knee or hip septic arthritis. However, septic arthritis of the shoulder is frequently a missed or delayed diagnosis. Reliance on aspiration and serum markers has been called into question recently. The purpose of this study was to conduct a systematic review investigating the value of joint aspiration and serum markers in the diagnosis of native shoulder joint sepsis. Methods PubMed/MEDLINE, Scopus, and the Cochrane Library were used in the systematic literature search from January 1, 1960, through January 23, 2021. The primary outcome was to report on the synovial white cell count of patients with native shoulder sepsis. Descriptive statistics using percentages, means, and intraclass correlation coefficient (ICC) values were used to summarize the results. Results Thirty-one studies, including 25 case series, one case-control, and five cohort studies with a total of 7434 native shoulder joints, were included. There was no standardized approach to diagnosing septic arthritis of the shoulder. Only 10 studies (32%) reported on synovial white cell count with the majority yielding aspiration counts greater than 50,000 cells/mm3, although one study was as low as 30,000 cells/mm3. Conclusions The diagnosis of native shoulder joint sepsis lacks uniformity. Methods used to evaluate shoulder sepsis are heterogeneous and may lead to delays or misdiagnosis with devastating sequelae. Synovial white cell count is underutilized and may also present with a lower value than expected, which is likely related to the time interval between symptom onset and diagnosis.