The goal of this randomized clinical trial is to determine if single-shot ropivacaine peripheral nerve blocks (PNB - perineural injections) for anterior cruciate ligament (ACL) reconstruction procedures in pediatric orthopaedic sports medicine patients provides significant pain relief and decreased narcotic use. The main questions it aims to answer are:
* Does ropivacaine significantly reduce Visual Analog Scale (VAS) pain scores and pain levels up to one week postoperatively?
* Does ropivacaine significantly decrease narcotic use (number of pills taken) up to one week postoperatively?
Researchers will compare the pain outcomes and narcotic use of participants who receive a single-shot ropivacaine peripheral nerve block to those of participants who do not receive a single-shot ropivacaine peripheral nerve block for their ACL reconstruction surgery. The goal is to understand if there is a significant difference in participant pain outcomes and narcotic use outside the first 24 hours postoperatively.
Participants will:
* receive either a single-shot ropivacaine peripheral nerve block intraoperatively or no peripheral nerve block during their ACL Quadriceps tendon graft or bone patellar tendon bone graft reconstruction surgery.
* receive and complete questionnaires at postoperative days 1, 4, and 7 regarding their pain scores, levels, and outcomes, effective pain treatments, overall pain interference, narcotic use (number of pills taken), and overall pain treatment satisfaction
* receive and complete secondary outcome measures of functional and psychological outcomes regarding their ACL reconstruction surgery at postoperative day 1

Start Date01 Dec 2024

Sponsor / Collaborator

Texas Scottish Rite Hospital for Children

NCT06559215 / Not yet recruitingPhase 2IIT

Prospective Evaluation of Post-operative Pain Management Using Exparel in the Pediatric Population

The goal of this randomized clinical trial is to determine if administration of Exparel via local infiltration for medial patellofemoral ligament (MPFL) reconstruction procedures in pediatric orthopaedic sports medicine patients provides significant pain relief and decreased narcotic use. The main questions it aims to answer are:
* Does Exparel significantly reduce Visual Analog Scale (VAS) pain scores and pain levels up to one week postoperatively?
* Does Exparel significantly decrease narcotic use (number of pills taken) up to one week postoperatively?
Researchers will compare the pain outcomes and narcotic use of patients who receive Exparel and Marcaine via local infiltration to those of patients who receive only Marcaine via local infiltration for their MPFL reconstruction surgery. The goal is to understand if there is a significant difference in patient pain outcomes and narcotic use outside the first 24 hours postoperatively.
Participants will:
* receive either Exparel + Marcaine intraoperatively or Marcaine only intraoperatively during their MPFL reconstruction surgery
* receive and complete questionnaires at postoperative days 1, 4, and 7 regarding their pain scores, levels, and outcomes, effective pain treatments, overall pain interference, narcotic use (number of pills taken), and overall pain treatment satisfaction
* receive and complete secondary outcome measures of functional and psychological outcomes regarding their MPFL reconstruction surgery at postoperative day 1

Start Date01 Dec 2024

Sponsor / Collaborator

Texas Scottish Rite Hospital for Children

NCT06048419 / RecruitingNot ApplicableIIT

Acceptability and Efficacy of GO MOVE: A Mobile Health Technology for Youth With Unilateral Cerebral Palsy

The goal of this clinical trial is to learn about the acceptability and efficacy of Go Move, a mobile website developed to assist youth with unilateral cerebral palsy and their caregivers with setting goals and selecting exercises and activities to meet the goals. The main question[s] it aims to answer are:
Is Go Move accepted by youth with unilateral cerebral palsy and their caregivers?
Does Go Move support goal attainment for youth with unilateral cerebral palsy?
Participants will set up and participate in a goal-driven home program using the Go Move mobile website. Participants will spend 1 hour and 15 minutes per week for 6 weeks working on their home program and will complete pre-intervention and post-intervention assessments.

Start Date20 Feb 2024

Sponsor / Collaborator

Texas Scottish Rite Hospital for Children

100 Clinical Results associated with Texas Scottish Rite Hospital for Children

0 Patents (Medical) associated with Texas Scottish Rite Hospital for Children

1,003

Literatures (Medical) associated with Texas Scottish Rite Hospital for Children

01 Jan 2025·JOURNAL OF PEDIATRIC ORTHOPAEDICS-PART B

What is the role of plastic surgery for incisional closures in pediatric spine surgery? Results from a pediatric spine study group survey

Article

Author: Wren, Tishya A.L. ; Tetreault, Tyler A. ; Andras, Lindsay M. ; Skaggs, David L. ; Heffernan, Michael J. ; Valenzuela-Moss, Jacquelyn N. ; Zusman, Natalie L. ; Illingworth, Kenneth D. ; Brooks, Jaysson T.

Current best practice guidelines recommend a plastics-style multilayer wound closure for high-risk pediatric spine surgery. However, plastic surgery closure of spinal incisions remains controversial. This study investigates surgeon perceptions and practice patterns regarding plastic surgery multilayered closure (PMC) in pediatric spine surgery. All surgeons in an international pediatric spine study group received a 30-question survey assessing incisional closure practices, frequency of plastic surgery collaboration, and drain management. Relationship to practice size, setting, geographic region, and individual diagnoses were analyzed. 87/178 (49%) surgeons responded from 79% of participating sites. Plastics utilization rates differed by diagnosis: neuromuscular scoliosis 16.9%, early onset scoliosis 7.8%, adolescent idiopathic scoliosis 2.8% (P < 0.0001). Plastics were used more for early onset scoliosis [odds ratio (OR) 18.5, 95% confidence interval (CI): 8.5, 40.2; P < 0.001] and neuromuscular scoliosis [OR 29.2 (12.2, 69.9); P < 0.001] than adolescent idiopathic scoliosis. Plastics use was unrelated to practice size, setting, or geographic region (P ≥ 0.09). Respondents used plastics more often for spina bifida and underweight patients compared to all other indications (P < 0.001). Compared to orthopaedic management, drains were utilized more often by plastic surgery (85 vs. 21%, P = 0.06) and for longer durations (P = 0.001). Eighty-nine percent of surgeons felt plastics increased operative time (58 ± 37 min), and 34% felt it increased length of hospitalization. Surgeons who routinely utilize plastics were more likely to believe PMC decreases wound complications (P = 0.007). The perceived benefit of plastic surgery varies, highlighting equipoise among pediatric spine surgeons. An evidence-based guideline is needed to optimize utilization of plastics in pediatric spine surgery.

01 Dec 2024·AMERICAN JOURNAL OF SPORTS MEDICINE

A Simple Clinical Predictive Model for Arthroscopic Mobility of Osteochondritis Dissecans Lesions of the Knee

Article

Author: Perkins, Crystal ; Hoi Po Hui, James ; Ellermann, Jutta ; Lyon, Roger M. ; Erickson, John ; Shea, Kevin G. ; Wilson, Philip ; Green, Daniel W. ; Wall, Eric J. ; Busch, Michael T. ; Ganley, Theodore J. ; Nissen, Carl W. ; Wright, Rick W. ; Latz, Kevin ; Gossman, Emma C. ; Coene, Ryan P. ; Milewski, Matthew D. ; Chambers, Henry G. ; Lee Pace, James ; Heyworth, Benton E. ; Nepple, Jeffrey J. ; Mayer, Stephanie ; Zbojniewicz, Andy ; Nelson, Bradley J. ; Paterno, Mark V. ; Carey, James L. ; Nguyen, Jie C. ; Krych, Aaron J. ; Fabricant, Peter D. ; Kocher, Mininder S. ; Polousky, John D. ; Miller, Patricia E. ; Ellis Jr, Henry B. ; Saluan, Paul ; Edmonds, Eric W. ; Willimon, Clifton ; Tompkins, Marc A. ; Anderson, Christian N. ; Weiss, Jennifer M. ; Pennock, Andrew T. ; Bauer, Kathryn ; Myer, Gregory D. ; Carsen, Sasha

Background::

Osteochondritis dissecans (OCD) of the knee is a focal idiopathic alteration of subchondral bone and/or its precursor with risk for instability and disruption of adjacent cartilage. Treatment options focused on preventing premature osteoarthritis vary depending on multiple patient and lesion characteristics, including lesion mobility.

Purpose::

To differentiate lesion mobility before arthroscopy using a multivariable model that includes patient demographic characteristics and physical examination findings.

Study Design::

Cohort study (Diagnosis); Level of evidence, 2.

Methods::

Demographic, preoperative physical examination, and radiographic data were collected from a multicenter national prospective cohort of patients with OCD of the knee. Inclusion criteria included patients <19 years of age and patients with arthroscopically confirmed mobility status based on the Research on Osteochondritis Dissecans of the Knee arthroscopy classification. Multivariable logistic regression analysis using stepwise model selection was used to determine factors associated with the likelihood of a mobile versus an immobile lesion. A 75% partition of the data was used for model training, and 25% was used as a validation cohort. Quantitative model fit statistics were computed using the holdout data, including sensitivity, specificity, and the area under the receiver operating characteristic curve (AUC), along with the corresponding 95% CI.

Results::

A total of 407 patients in the prospective cohort met inclusion criteria, and 62% were male. The mean ± SD age was 13.7 ± 2.2 years, height 161.8 ± 5.3 cm, and weight 59.2 ± 42.2 kg. Arthroscopic evaluation yielded 235 immobile and 172 mobile lesions. Multivariable analysis determined that the best model to predict lesion mobility included chronologic age ≥14 years ( P < .001), effusion on physical examination ( P < .001), and any loss of range of motion on physical examination ( P = .07), while controlling for male sex ( P = .38) and weight >54.4 kg ( P = .12). In the 25% holdout validation sample (n = 102), a sensitivity of 83%, a specificity of 82%, and an AUC of 0.89 (95% CI, 0.82-0.95) were achieved with these predictive factors.

Conclusion::

Age, effusion, and loss of motion can predict knee OCD lesion mobility at the time of arthroscopy. Education about lesion mobility can help with surgical planning and patient and family counseling.

01 Nov 2024·International Journal of Surgery Case Reports

Transverse tibial bone transport for non-healing heel wound: A case report

Article

Author: Yang, Ally A ; Park, Nancy ; Samchukov, Mikhail ; Gazes, Michael I. ; Yang, Ally A. ; Frumberg, David B. ; Gazes, Michael I ; Frumberg, David B

INTRODUCTION:

Treatment of diabetic foot ulcer is complex and expensive, and frequently results in amputation. Transverse Tibia Transport is a new strategy for diabetic foot ulcers, which is based on the techniques of distraction histogenesis.

PRESENTATION OF CASE:

We present a 32-year-old male with longstanding insulin-dependent diabetes mellitus and many medical comorbidities with a non-healing heel ulcer of greater than 1 year. Following diagnosis of his diabetic foot ulcer complicated by osteomyelitis, he underwent a series of vascular and local wound interventions unsuccessfully. Transverse tibia transport was successful in healing the ulcer after 4 months. No complications were observed during follow up.

DISCUSSION:

Distraction histogenesis mechanically stimulates regeneration of soft tissues such as muscles, tendons, and blood vessels by sustained tension. Inducing vascular regeneration at a targeted site has broad potential value for treating various disorders such as atrophic union and osteomyelitis.

CONCLUSION:

For patients with refractory diabetic foot ulcers, transverse tibia transport may be considered as a treatment option.

News (Medical) associated with Texas Scottish Rite Hospital for Children

14 Dec 2023

·www.prnewswire.com

The Inner Circle Acknowledges, Wale Charles Abolarin as a Distinguished Healthcare Professional for his contributions to the field of Clinical Informatics Technology

OWINGS MILLS, Md., Dec. 14, 2023 /PRNewswire/ -- Prominently featured in The Inner Circle, Wale Charles Abolarin is acknowledged as a Distinguished Healthcare Professional for his contributions to the field of Clinical Informatics Technology. Dr. Abolarin received his Doctorate of Medicine specializing in Anesthesiology from the Ladoke Akintola University of Technology in 2009. He furthered his education in the United States at the University of South Florida, obtaining a graduate certificate in Health Informatics in 2016 and a Master's degree in Health informatics in 2017. In addition, Dr. Abolarin boasts an impressive array of prestigious certifications in Leadership and Health Information Technology, among them the notable Physician IT Architect Certificate. Touting more than 14 years in the Healthcare, Dr. Abolarin stands at the forefront as the CEO and Chief Medical Informatics Officer of Helix Healthcare Inc. This esteemed institution is not just a provider but a beacon of hope for those with developmental disabilities in Maryland and beyond. Championing the cause of local communities, Dr. Abolarin passionately avers that the mission of Helix Healthcare goes beyond medical care. It's about sculpting an ecosystem where patients and their families can effortlessly avail themselves of equitable healthcare, find promising employment opportunities, access top-notch job training, community development, and harness the power of education through technology. Helix Healthcare is a lifeline, providing indispensable services like Alternative living units and remote support services. Before stepping into his current role, Dr. Abolarin accumulated an expansive range of experiences across various capacities in the medical field. He has held esteemed roles such as Physician Champion, Physician Executive, Physician Advisor, and Physician Informatics Architect. His association with significant institutions includes the McLaren Health Care Corporation, Atos Digital Health Solutions, Midland Memorial Hospital, Texas Scottish Rite Hospital for Children, Our Lady of Lourdes's Memorial Hospital, MedStar Good Samaritan Hospital, and a number of hospitals in Nigeria. Beyond these roles, Dr. Abolarin has provided consultation services to several US hospitals, pioneering multiple informatics projects. These projects, powered by technology, have been meticulously designed to mitigate physician burnout and amplify productivity. In his relentless pursuit of excellence, he is a member of the American College of Healthcare Executives, the American Society of Anesthesiology, and the Nigerian Medical Association. With an unwavering and formidable passion for serving others, Dr. Abolarin has not only achieved immense success but has also set himself apart in the realm of informatics. One of his crowning achievements is his role as the architect behind the sepsis advisor at McLaren Health Care Corporation, an algorithmic powerhouse designed to swiftly diagnose sepsis, thus acting as a bulwark against potential fatalities. As we gaze into the horizon, let it be known that Dr. Abolarin's legacy as a leader isn't just rooted in his unmatched expertise in healthcare or informatics alone. It's his unparalleled versatility and prowess across diverse fields, from healthcare to entrepreneurship, that truly sets him apart from the crowd. Contact: Katherine Green 516-825-5634 [email protected] SOURCE The Inner Circle

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100 Translational Medicine associated with Texas Scottish Rite Hospital for Children

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