Browsing by Author "Anastasio, Albert T"

Now showing 1 - 6 of 6
  • Thumbnail Image
    ItemOpen Access
    A Solution to After-Hours Fatigue and Surgical Backlog.
    (Geriatric orthopaedic surgery & rehabilitation, 2021-01) Anastasio, Albert T; Patel, Preet Shailesh; Fernandez-Moure, Joseph; Gage, Mark J
    After-hours surgery represents a novel solution that can effectively combat surgical fatigue of care teams in addition to addressing the high volume of surgical backlog associated with the repercussions of the COVID-19 pandemic. This commentary seeks to rationalize how successful employment of a dedicated after-hours surgical team and protocol has tremendous potential for increased efficiency while maintaining good surgical outcomes in patients.
  • Thumbnail Image
    ItemOpen Access
    Charcot Neuroarthropathy of the Foot and Ankle in the Acute Setting: An Illustrative Case Report and Targeted Review.
    (The western journal of emergency medicine, 2023-09) Bagheri, Kian; Anastasio, Albert T; Krez, Alexandra; Siewny, Lauren; Adams, Samuel B
    Charcot neuroarthropathy (CN) is a rare but serious sequela of diabetes and other diseases that cause peripheral neuropathy. It is most commonly characterized by degeneration of the foot and/or ankle joints leading to progressive deformity and altered weight-bearing. If left untreated, the deformities of CN lead to ulceration, infection, amputation, and even death. Because of the associated peripheral neuropathy and proprioception deficits that accompany CN, patients typically do not perceive the onset of joint destruction. Moreover, in the hands of the untrained clinician, the initial presentation of CN can easily be mistaken for infection, osteoarthritis, gout, or inflammatory arthropathy. Misdiagnosis can lead to the aforementioned serious sequelae of CN. Thus, an early accurate diagnosis and off-loading of the involved extremity, followed by prompt referral to a specialist trained in the care of CN are crucial to prevent the late-term sequelae of the disease. The purpose of this article was to create an opportunity for enhanced understanding between orthopedic surgeons and emergency physicians, to improve patient care through the optimization of diagnosis and early management of CN in the emergent setting.
  • Thumbnail Image
    ItemOpen Access
    Evaluating the Distribution, Quality, and Educational Value of Videos Related to Shoulder Instability Exercises on the Social Media Platform TikTok.
    (Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews, 2023-06) Bethell, Mikhail A; Anastasio, Albert T; Taylor, Joshua R; Tabarestani, Troy Q; Klifto, Christopher S; Anakwenze, Oke

    Background

    Because of the lack of scientific oversight, the quality, applicability, and consistency of healthcare-related TikTok videos have become a focus of research exploration. The orthopaedic surgery literature lags behind other medical fields in analyzing the widespread utilization of TikTok videos for medical information delivery.

    Methods

    TikTok was queried using the hashtag #shoulderstabilityexercises, and 109 videos were included. The videos were collected by two authors and independently evaluated using DISCERN (a well-validated informational analysis tool) and shoulder stability exercise education score (a self-designed tool for the evaluation of shoulder instability-related exercises).

    Results

    DISCERN scores of videos uploaded by general users had significantly lower scores in all four categories than those uploaded by healthcare professionals (P < 0.001, P = 0.005, P = 0.002, and P < 0.001). For the shoulder stability exercise education score, general users had a significantly lower score than the healthcare professionals at 3.36 and 4.91 on a 25-point scale, respectively (P = 0.034). General users had more videos graded as very poor (84.2%) in comparison to the number of videos uploaded by healthcare professionals deemed very poor (51.5%). However, the remainder of healthcare professionals had their videos graded as poor (48.5%).

    Conclusion

    Despite slightly improved video quality from healthcare professionals, the overall educational of the videos related to shoulder instability exercises was poor.
  • Thumbnail Image
    ItemOpen Access
    Fabrication of a Novel 3D Extrusion Bioink Containing Processed Human Articular Cartilage Matrix for Cartilage Tissue Engineering.
    (Bioengineering (Basel, Switzerland), 2024-03) Aitchison, Alexandra Hunter; Allen, Nicholas B; Shaffrey, Isabel R; O'Neill, Conor N; Abar, Bijan; Anastasio, Albert T; Adams, Samuel B
    Cartilage damage presents a significant clinical challenge due to its intrinsic avascular nature which limits self-repair. Addressing this, our study focuses on an alginate-based bioink, integrating human articular cartilage, for cartilage tissue engineering. This novel bioink was formulated by encapsulating C20A4 human articular chondrocytes in sodium alginate, polyvinyl alcohol, gum arabic, and cartilage extracellular matrix powder sourced from allograft femoral condyle shavings. Using a 3D bioprinter, constructs were biofabricated and cross-linked, followed by culture in standard medium. Evaluations were conducted on cellular viability and gene expression at various stages. Results indicated that the printed constructs maintained a porous structure conducive to cell growth. Cellular viability was 87% post printing, which decreased to 76% after seven days, and significantly recovered to 86% by day 14. There was also a notable upregulation of chondrogenic genes, COL2A1 (p = 0.008) and SOX9 (p = 0.021), suggesting an enhancement in cartilage formation. This study concludes that the innovative bioink shows promise for cartilage regeneration, demonstrating substantial viability and gene expression conducive to repair and suggesting its potential for future therapeutic applications in cartilage repair.
  • Thumbnail Image
    ItemOpen Access
    Outcomes and Complications Associated with the Learning Curve for Endoscopic Cervical Foraminotomy: A Systematic Review and Meta-Analysis.
    (Spine, 2023-10) Baumann, Anthony N; Callaghan, Megan E; Walley, Kempland C; Anastasio, Albert T; Muralidharan, Aditya; Talaski, Grayson; Rocos, Brett

    Study design

    Systematic review and meta-analysis.

    Objective

    The objective of this study is to examine the impact of the learning curve for endoscopic cervical foraminotomy for clinical outcomes and patient safety.

    Summary of background data

    Endoscopic cervical foraminotomy is a minimally invasive surgical technique emerging in the literature for surgical management of cervical radiculopathy without the use of open incision. The adoption of endoscopic cervical foraminotomy may be hindered by the learning curve, although no review and meta-analysis exists to date on the topic.

    Methods

    A systematic review and meta-analysis was performed using PubMed, CINAHL, and MEDLINE from database inception until July 11th, 2023. Inclusion criteria were articles that examined endoscopic cervical foraminotomy, reported outcomes and/or complications for endoscopic cervical spine surgery relevant to the learning curve and had full-text. A random effects meta-analysis was performed for outcomes and complications.

    Results

    A total of three articles (n=203 patients) were included from 792 articles initially retrieved. The learning curves from four surgeons were examined with a frequency weighted mean 21 procedures until the competency phase. There was no significant difference in the postoperative hospitalization length (P=0.669), postoperative recovery room time (P=0.415), intraoperative blood loss (P=0.064), and total complication rates (10.9% vs. 1.2%, P=0.139) between endoscopic cervical foraminotomy procedures performed in the learning phase as compared to the competency phase of the learning curve. There was a significant decrease in operative time from the learning phase to the competency phase (P=0.005).

    Conclusion

    Competency was achieved on the learning curve for endoscopic cervical foraminotomy after about 21 procedures. There is no significant difference in postoperative hospitalization time, postoperative recovery room time, intraoperative blood loss, and complication rates between the learning phase and the competency phase of the learning curve for endoscopic cervical foraminotomy, noting the relatively small sample size of this study that may underpower this finding.
  • Thumbnail Image
    ItemOpen Access
    Use of a 5-item modified Fragility Index for risk stratification in patients undergoing surgical management of proximal humerus fractures.
    (JSES international, 2021-03) Evans, Daniel R; Saltzman, Eliana B; Anastasio, Albert T; Guisse, Ndeye F; Belay, Elshaday S; Pidgeon, Tyler S; Richard, Marc J; Ruch, David S; Anakwenze, Oke A; Gage, Mark J; Klifto, Christopher S

    Hypothesis

    We hypothesized that the modified Fragility Index (mFI) would predict complications in patients older than 50 years who underwent operative intervention for a proximal humerus fracture.

    Methods

    We retrospectively reviewed the American College of Surgeons National Surgery Quality Improvement Program database, including patients older than 50 years who underwent open reduction and internal fixation of a proximal humerus fracture. A 5-item mFI score was then calculated for each patient. Postoperative complications, readmission and reoperation rates as well as length of stay (LOS) were recorded. Univariate as well as multivariable statistical analyses were performed, controlling for age, sex, body mass index, LOS, and operative time.

    Results

    We identified 2,004 patients (median age, 66 years; interquartile range: 59-74), of which 76.2% were female. As mFI increased from 0 to 2 or greater, 30-day readmission rate increased from 2.8% to 6.7% (P-value = .005), rate of discharge to rehabilitation facility increased from 7.1% to 25.3% (P-value < .001), and rates of any complication increased from 6.5% to 13.9% (P-value < .001). Specifically, the rates of renal and hematologic complications increased significantly in patients with mFI of 2 or greater (P-value = .042 and P-value < .001, respectively). Compared with patients with mFI of 0, patients with mFI of 2 or greater were 2 times more likely to be readmitted within 30 days (odds ratio = 2.2, P-value .026). In addition, patients with mFI of 2 or greater had an increased odds of discharge to a rehabilitation center (odds ratio = 2.3, P-value < .001). However, increased fragility was not significantly associated with an increased odds of 30-day reoperation or any complication after controlling for demographic data, LOS, and operative time.

    Conclusion

    An increasing level of fragility is predictive of readmission and discharge to a rehabilitation center after open reduction and internal fixation of proximal humerus fractures. Our data suggest that a simple fragility evaluation can help inform surgical decision-making and counseling in patients older than 50 years with proximal humerus fractures.