Browsing by Author "Farooq, Hassan"

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    Efficacy of a Single Image-Guided Corticosteroid Injection for Glenohumeral Arthritis
    (Elsevier, 2020) Metzger, Cameron M.; Farooq, Hassan; Merrell, Gregory A.; Kaplan, F. Thomas D.; Greenberg, Jeffrey A.; Crosby, Nicholas E.; Peck, Kathryn M.; Hoyer, Reed W.; Orthopaedic Surgery, School of Medicine
    Background There is limited data available on the efficacy of cortisone injection for glenohumeral osteoarthritis (GHOA). The amount and longevity of pain relief provided by a single cortisone injection is unclear. Additionally, it remains uncertain how the severity of radiographic GHOA and patient reported function and pain levels impact the efficacy of injection. Therefore, we sought to describe relief provided by a single, image guided glenohumeral injection for patients with GHOA. Additionally, we hypothesized that patients with more severe radiographic GHOA and poorer baseline shoulder function would require earlier secondary intervention. Methods Patients with symptomatic GHOA who elected to receive a corticosteroid injection for pain relief were prospectively enrolled. A phone interview was conducted to record baseline OSS and VAS scores prior to the injection, as well as at months 1, 2, 3, 4, 6, 9, and 12. Endpoints were designated when patients required a second injection, progressed to surgery, or reached month 12. Patients were grouped by their respective baseline OSS (mild, moderate/severe) and Samilson-Prieto radiographic classification (mild, moderate, severe) for analysis. Results Thirty shoulders (29 patients) were analyzed. 52% of patients were male. The average age of 66.1 years. No significant difference was seen in overall survival (defined as no additional intervention) between groups based on either OSS or Samilson-Prieto grades. Additionally, OSS and VAS scores at each follow-up were compared to baseline. For the entire cohort, a clinically significant difference was seen between baseline and months 1-4 for OSS and between baseline and months 1-4, 6,9, and 12 for VAS. Discussion This study aimed to determine the efficacy of corticosteroid injections for GHOA. There were no differences in the need for secondary interventions in this population based on severity of either the OSS or the Samilson-Prieto radiographic classification. However, patients with more severe shoulder dysfunction based on OSS did experience a statistically significant greater symptomatic relief compared with patients with milder dysfunction. Additionally, following a single injection, patients in this cohort experienced statistically and clinically relevant improvements in shoulder function and pain up to 4 months post-injection.
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    Osteoarthritic Severity in Unresurfaced Patellae Does Not Adversely Affect Patient-reported Outcomes in Contemporary Primary TKA
    (Wolters Kluwer, 2022-04-06) Schmidt, Gregory J.; Farooq, Hassan; Deckard, Evan R.; Meneghini, R. Michael; Orthopaedic Surgery, School of Medicine
    Introduction: The degree of osteoarthritis (OA) acceptable to leave in a native patella during unresurfaced total knee arthroplasty (TKA) remains unknown. This study's purpose was to examine the effect of patellofemoral OA severity on patient-reported outcome measures (PROMs) in primary TKAs performed without patellar resurfacing. Methods: One hundred ninety-three primary TKAs performed without patellar resurfacing were retrospectively reviewed. Preoperative patellofemoral OA severity was graded on severity, marginal osteophytes, joint space narrowing, and chondral damage using accepted grading systems. Patellar tilt and tibiofemoral alignment were measured radiographically. PROMs were evaluated at a minimum of 1-year follow-up. Results: In multivariate regression, preoperative lateral patella Kellgren-Lawrence grade ≥2 was associated with superior change in Knee Society Score pain with level walking, higher absolute change in Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (P ≤ 0.029), and knees ‟always feeling normal" (odds ratio [OR] 3.12; P = 0.005). Osteoarthritis Research Society International atlas grades and Outerbridge classification scores did not significantly influence PROMs. Discussion: Worse preoperative OA severity in the lateral patellar facet, graded with the Kellgren-Lawrence system, predicted superior knee-specific PROMs in patients with unresurfaced patellae after contemporary TKA. This observation supports the clinical finding that patients with more severe OA have optimized patient outcomes and highlights the minimal contribution of patella OA to knee function after primary TKA.
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    Risk factors for complications within 30 days of operatively fixed periprosthetic femur fractures
    (Elsevier, 2022-06-25) Richard, Raveesh D.; Gaski, Greg E.; Farooq, Hassan; Wagner, Daniel J.; McKinley, Todd O.; Natoli, Roman M.; Orthopaedic Surgery, School of Medicine
    Background: With a rising number of periprosthetic femur fractures (PPFFs) each year, the primary objective of our study was to quantify risk factors that predict complications following operative treatment of PPFFs. Methods: A retrospective cohort study of 231 patients with a periprosthetic femur fracture was conducted at an Academic, Level 1 Trauma Center. The main outcome measurement of interest was complications, as defined by the ACS-NSQIP, within 30 days of surgery. Results: 56 patients had 96 complications. Bivariate analyses revealed ASA score, preoperative ambulatory status, length of stay, discharge disposition, time from admission to surgery, length of surgery, perioperative change in hemoglobin, Charlson comorbidity index, cerebral vascular accident/transient ischemic attack, chronic obstructive pulmonary disease, diabetes mellitus, and receipt of a blood transfusion were associated with development of a complication (p < 0.1). Multivariate logistic regression showed length of stay (OR 1.11, 95% CI 1.03-1.19; p = 0.006), receipt of a blood transfusion (OR 2.48, 95% CI 1.14-5.42; p = 0.02), and diabetes mellitus (OR 2.17, 95% CI 1.03-4.56; p = 0.04) remained independently predictive of complication. Conclusions: Length of stay, receipt of a blood transfusion, and diabetes were associated with increased perioperative risk for developing a complication following operative treatment of periprosthetic femur fractures. Methods to decrease length of stay or transfusion rates may mitigate complication risk in these patients.
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    Transitioning from the Posterior Approach to the Direct Anterior Approach for Total Hip Arthroplasty
    (Korean Hip Society, 2022) Metzger, Cameron M.; Farooq, Hassan; Hur, Jacqueline O.; Hur, John; Orthopaedic Surgery, School of Medicine
    Purpose: Total hip arthroplasty (THA) using the direct anterior approach (DAA) is known to have a learning curve. The purpose of this study was to review cases where surgery was performed by an arthroplasty surgeon transitioning from the posterior approach (PA) to the DAA. We hypothesized similar complication rates and improvements in surgical duration over time. Materials and methods: A review of 2,452 consecutive primary THAs was conducted. Surgical duration, length of stay (LOS), surgical complications, decrease in postoperative day (POD) 1 hemoglobin, transfusion rates, POD 0 and POD 1 pain scores, incision length, leg length discrepancy (LLD), and radiographic cup position were recorded. Results: No differences in surgical duration were observed after the first 50 DAA cases. A shorter LOS was observed for the DAA, and statistical difference was appreciated after the first 100 DAA cases. There were no differences in periprosthetic fractures. A higher rate of infections and hip dislocations were observed with the PA. The PA showed an association with higher transfusion rates without significant difference in POD 1 decrease in hemoglobin over the first 100 DAA cases. Similar POD 0 and POD 1 pain scores with a smaller incision were observed for the first 100 DAA cases. The DAA cohort showed less variation in cup inclination, version, and LLD. Conclusion: DAA is safe and non-inferior in terms of reduced LOS, smaller incision, and less variation in cup position. Fifty DAA cases was noted to be the learning curve required before no differences in duration between approaches were observed.
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    Utility of Plasma Protein Biomarkers and Mid-Infrared Spectroscopy for Diagnosing Fracture-Related Infections: A Pilot Study
    (Wolters Kluwer, 2022-04) Farooq, Hassan; Wessel, Robert P.; Brown, Krista; Slaven, James E.; Marini, Federico; Malek, Sarah; Natoli, Roman M.; Orthopaedic Surgery, School of MedicinE
    Objectives: To compare a large panel of plasma protein inflammatory biomarkers and mid-infrared (MIR) spectral patterns between patients with confirmed fracture related infections (FRIs) and controls without infection. Design: Prospective case-control. Setting: Academic, level 1 trauma center. Patients: Thirteen patients meeting confirmatory FRI criteria were matched to 13 controls based on age, time after surgery, and fracture region. Intervention: Plasma levels of 49 proteins were measured using enzyme-linked immunosorbent assay (ELISA) techniques. Fourier transform infrared (FTIR) spectroscopy of dried films was used to obtain MIR spectra of plasma samples. Main Outcome Measurements: Plasma protein levels and MIR spectra of samples. Results: Multivariate analysis-based predictive model developed utilizing ELISA-based biomarkers had sensitivity, specificity, and accuracy of 69.2±0.0%, 99.9±1.0%, and 84.5±0.6%, respectively, with PDGF-AB/BB, CRP, and MIG selected as the minimum number of variables explaining group differences (P<0.05). Sensitivity, specificity, and accuracy of the predictive model based on MIR spectra were 69.9±6.2%, 71.9±5.9%, and 70.9±4.8%, respectively, with six wavenumbers as explanatory variables (P<0.05). Conclusions: This pilot study demonstrates the feasibility of using a select panel of plasma proteins and FTIR spectroscopy to diagnose FRI. The preliminary data suggest that measurement of these select proteins and MIR spectra may be potential clinical tools to detect FRI. Further investigation of these biomarkers in a larger cohort of patients is warranted.