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Nikhil Verma

Eric J Cotter, Charles P Hannon, Philip Locker, Annabelle Davey, Kevin C Wang, Nikhil N Verma, Brian J Cole
Background: Patient-reported outcome (PRO) surveys have become increasingly important in both improving patient care and assessing outcomes. Purpose/Hypothesis: The purpose of this study was to evaluate which variables are associated with compliance with completing PRO surveys in patients who have undergone anterior cruciate ligament reconstruction (ACLR). The authors hypothesized that older patient age and longer time since ACLR would be associated with lower completion rates of PRO surveys preoperatively and at postoperative time points...
March 2018: Orthopaedic Journal of Sports Medicine
Alexander E Weber, William Zuke, Erik N Mayer, Brian Forsythe, Alan Getgood, Nikhil N Verma, Bernard R Bach, Asheesh Bedi, Brian J Cole
BACKGROUND: There has been an increasing interest in lateral-based soft tissue reconstructive techniques as augments to anterior cruciate ligament reconstruction (ACLR). The objective of these procedures is to minimize anterolateral rotational instability of the knee after surgery. Despite the relatively rapid increase in surgical application of these techniques, many clinical questions remain. PURPOSE: To provide a comprehensive update on the current state of these lateral-based augmentation procedures by reviewing the origins of the surgical techniques, the biomechanical data to support their use, and the clinical results to date...
February 1, 2018: American Journal of Sports Medicine
Rachel M Frank, Eamon D Bernardoni, Eric J Cotter, Nikhil N Verma
Acromioclavicular joint separations are common shoulder injuries in the active patient population. Nonoperative management is recommended for Rockwood type I and II injuries, whereas surgical reconstruction is recommended for type IV and VI separations. The management for type III and V injuries is more controversial and is determined on a case-by-case basis. A multitude of surgical reconstruction techniques exist, and there is little evidence to support one technique over another. The anatomic technique aims at reconstructing the coracoclavicular ligaments and bringing the clavicle back into its anatomic position...
October 2017: Arthroscopy Techniques
Allison J Rao, Nikhil N Verma, Scott W Trenhaile
Surgical repair of a Bankart lesion requires thorough recognition of the capsulolabral attachment and adequate visualization for suture anchor repair. The glenoid labrum usually detaches from its capsule and bony attachment anteriorly and inferiorly; however, the labral and capsule detachment can sometimes extend beyond this zone of injury. Identification and repair may require additional viewing and working portals to allow for ease of suture passage and anchor placement. This technique guide describes a case scenario of a Bankart lesion with anterior extension of the capsular tear, repaired with use of 2 anterior working portals...
October 2017: Arthroscopy Techniques
Rachel M Frank, Anthony A Romeo, Catherine Richardson, Shelby Sumner, Nikhil N Verma, Brian J Cole, Gregory P Nicholson, Matthew T Provencher
BACKGROUND: Anterior glenoid reconstruction with fresh distal tibia allograft (DTA) has been described for management of recurrent shoulder instability, with encouraging early outcomes; however, no comparative data with the Latarjet procedure are available. PURPOSE: The purpose of this study was to compare the clinical outcomes between patients undergoing DTA and a matched cohort of patients undergoing Latarjet. STUDY DESIGN: Cohort study; Level of evidence, 3...
February 1, 2018: American Journal of Sports Medicine
Rachel M Frank, Kevin C Wang, Annabelle Davey, Eric J Cotter, Brian J Cole, Anthony A Romeo, Charles A Bush-Joseph, Bernard R Bach, Nikhil N Verma
PURPOSE: To determine the utility of modern arthroscopic simulators in transferring skills learned on the model to the operating room. METHODS: A meta-analysis and systematic review of all English-language studies relevant to validated arthroscopic simulation models using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines from 1999 to 2016 was performed. Data collected included the specific simulator model, the joint used, participant demographic characteristics, participant level of training, training session information, type and number of tasks, pre- and post-training assessments, and overall outcomes of simulator performance...
January 20, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Allison J Rao, Eamon Bernardoni, Nikhil Verma, Scott Trenhaile
Biceps tenodesis remains a popular choice for treating anterior shoulder pain in the setting of primary biceps tendinitis or biceps pain due to concomitant glenohumeral joint pathology. A variety of surgical approaches and fixation construct options are available for biceps tenodesis. The advantages of an all-arthroscopic biceps tenodesis include anatomic maintenance of the length-tension relation with strength preservation and improved cosmetic results. This technique can be technically challenging but allows for a minimally invasive approach to anchor the biceps...
October 2017: Arthroscopy Techniques
Rachel M Frank, Jason T Hamamoto, Eamon Bernardoni, Gregory Cvetanovich, Bernard R Bach, Nikhil N Verma, Charles A Bush-Joseph
Hamstring tendon autograft remains a popular graft choice for anterior cruciate ligament (ACL) reconstruction. Although there are a variety of autograft and allograft options available for ACL reconstruction, advantages of hamstring tendon autografts include decreased postoperative knee pain and an overall easier surgical recovery compared with bone patellar tendon bone autograft. In addition, 4-stranded (quadruple) hamstring grafts are among the strongest grafts biomechanically (at time equals zero). Although the technique of hamstring autograft harvest is relatively straightforward, it is critical to pay attention to several technical steps to avoid iatrogenic neurovascular damage as well as to avoid premature amputation of the graft while using a tendon stripper...
August 2017: Arthroscopy Techniques
Rachel M Frank, John Higgins, Eamon Bernardoni, Gregory Cvetanovich, Charles A Bush-Joseph, Nikhil N Verma, Bernard R Bach
Anterior cruciate ligament reconstruction with bone-patellar tendon-bone autograft has long been considered the graft preference for young, active patients with anterior cruciate ligament injuries. The central-third of the native patellar tendon is a reliable graft and is the preferred option for competitive athletes given its excellent track record with high return-to-play rates and low failure rates. Disadvantages to using this graft include donor site morbidity and associated postoperative anterior knee pain, the risk of patellar fracture or patellar tendon tear, and the potential for graft-construct mismatch...
August 2017: Arthroscopy Techniques
Jason T Hamamoto, Rachel M Frank, John D Higgins, Matthew T Provencher, Anthony A Romeo, Nikhil N Verma
Arthroscopic shoulder surgery can be performed in both the beach chair and lateral decubitus positions. The lateral decubitus position allows for excellent exposure to all aspects of the glenohumeral joint and is therefore frequently employed in procedures such as stabilization, in which extensive visualization of the inferior and posterior aspects of the joint is required. Improved visualization is imparted due to applied lateral and axial traction on the operative arm, which increases the glenohumeral joint space...
August 2017: Arthroscopy Techniques
John D Higgins, Rachel M Frank, Jason T Hamamoto, Matthew T Provencher, Anthony A Romeo, Nikhil N Verma
Arthroscopic shoulder surgery can be performed in both the beach chair and lateral decubitus positions. The beach chair position is a reliable, safe, and effective position to perform nearly all types of shoulder arthroscopic procedures. The advantages of the beach chair position include the ease of setup, limited brachial plexus stress, increased glenohumeral and subacromial visualization, anesthesia flexibility, and the ability to easily convert to an open procedure. This position is most commonly used for rotator cuff repair, subacromial decompression, and superior labrum anterior-to-posterior repair procedures...
August 2017: Arthroscopy Techniques
Nikhil Sharma, Ruchi Verma, Savitri, Tek Chand Bhalla
ProCos (Protein Composition Server, script version), one of the machine learning techniques, was used to classify nitrilases as aliphatic and aromatic nitrilases. Some important feature vectors were used to train the algorithm, which included pseudo-amino acid composition (PAAC) and five-factor solution score (5FSS). This clearly differentiated into two groups of nitrilases, i.e., aliphatic and aromatic, achieving maximum sensitivity of 100.00%, specificity of 90.00%, accuracy of 95.00% and Mathew Correlation Coefficient (MCC) of about 0...
January 2018: 3 Biotech
Drew Lansdown, Eamon D Bernardoni, Eric J Cotter, Anthony A Romeo, Nikhil N Verma
Bony Bankart lesions are a common finding in patients with anterior glenohumeral dislocation. Although there are no defined guidelines, small bony Bankart fractures are typically treated arthroscopically with suture anchors. The 2 main techniques used are double- and single-row suture anchor stabilization, with debate over superiority. Biomechanical studies have shown improved reduction and stabilization with the double-row over the single-row suture anchor technique; however, this has not been reported for small or comminuted bony fragments...
December 2017: Arthroscopy Techniques
Adam B Yanke, Atsushi Urita, Jason J Shin, Greg L Cvetanovich, Erin K Moran, Bernard R Bach, Brian J Cole, Nozomu Inoue, Nikhil N Verma
Objective To analyze the topography of the opposite condyle to treat focal femoral condyle articular defects with an osteochondral allograft (OCA). Design Three groups were created: Group 1, same condyle with same width; Group 2, opposite condyle with same width; Group 3, opposite condyle with different width. Computed tomography (CT) of 22 cadaveric femoral hemi-condyles was used to create 3-dimensional CT models that were exported into point-cloud models. Three zones of the donor condyle (anterior, middle, and posterior) were quantified...
January 1, 2018: Cartilage
Joseph N Liu, Grant H Garcia, Anirudh K Gowd, Brandon C Cabarcas, Michael D Charles, Anthony A Romeo, Nikhil N Verma
PURPOSE OF REVIEW: To review the etiology, classification, presentation, evaluation, treatment strategy, and outcomes in overhead athletes with partial thickness rotator cuff tears. RECENT FINDINGS: Despite advances in surgical repair techniques, return to play following surgical repair of partial rotator cuff tears remains modest at best. Overhead athletes may be particularly prone to rotator cuff pathology due to the supraphysiological strains within the tendon during the throwing motion, as well as mechanical stress with contact between the undersurface of the rotator cuff and the glenoid...
January 13, 2018: Current Reviews in Musculoskeletal Medicine
Andrew J Riff, Rachel M Frank, Shelby Sumner, Nicole Friel, Bernard R Bach, Nikhil N Verma, Anthony A Romeo
Background: Arthroscopic stabilization is the most broadly used surgical procedure in the United States for management of recurrent shoulder instability. Latarjet coracoid transfer has been considered a salvage surgical procedure for failed arthroscopic repairs or cases of significant glenoid bone loss; however, with recent literature suggesting reduced risk of recurrent instability with Latarjet, several surgeons have advocated its broader utilization as a primary operation for treatment of shoulder instability...
December 2017: Orthopaedic Journal of Sports Medicine
Brandon J Erickson, Junyoung Ahn, Peter N Chalmers, Christopher S Ahmad, Bernard R Bach, Nikhil N Verma, Anthony A Romeo
Background: Ulnar collateral ligament reconstruction (UCLR) has become an increasingly common procedure among Major League Baseball (MLB) pitchers. The long-term effects of this procedure on the career of an MLB pitcher are largely unknown. Purpose/Hypothesis: The purpose of this study was to determine why and when MLB pitchers who underwent UCLR during their careers retired from baseball as compared with controls. We hypothesized that pitchers who underwent UCLR are no more likely than control pitchers to retire from elbow or shoulder problems...
December 2017: Orthopaedic Journal of Sports Medicine
Christopher R Mellano, Rachel M Frank, Jason J Shin, Akshay Jain, William A Zuke, Randy Mascarenhas, Elizabeth Shewman, Brian J Cole, Anthony A Romeo, Nikhil N Verma, Brian Forsythe
PURPOSE: To quantify the torsional load to fracture for subpectoral biceps tenodesis with interference screw fixation. METHODS: We randomized 28 specimens from 14 matched-pair full-length humeri (mean age, 55.3 years) into 3 groups: (1) empty ream group (ERG), (2) screw-only group (SOG), and (3) screw-plus-biceps tendon group (SBG). In each group, 1 humerus of each matched pair was prepared according to group allocation and the contralateral humerus remained intact as a control...
December 26, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
Aditi Kumar, Vikrant Sood, Rajeev Khanna, Sanjeev Kumar Verma, Nikhil Mehra, Dinesh Rawat, Seema Alam
Limited literature is available in pediatric population regarding drug-induced liver injury (DILI) making it a diagnostic challenge. This study was thus planned to determine the clinical spectrum and the outcome of DILI in children. All patients with DILI under 18 y of age were retrospectively reviewed and details regarding clinical presentation, Roussel Uclaf Causality Assessment Method (RUCAM) scale, drugs implicated, biochemical abnormalities and outcome were noted. DILI constituted 3.7% of all children with liver disease...
December 16, 2017: Indian Journal of Pediatrics
Peter N Chalmers, Brandon J Erickson, Nikhil N Verma, John D'Angelo, Anthony A Romeo
PURPOSE: To determine return to play (RTP) rates after biceps tenodesis (BT) in professional baseball players. METHODS: Major League Baseball has maintained a prospective database containing all major and minor league baseball players who have undergone shoulder surgery since 2010. All players who had undergone BT were included. Minimum follow-up was 24 months, and thus we included data from 2010 to 2013. Using this database we determined the incidence, demographics, prior surgery history, concomitant procedures, RTP rates, and time to RTP...
November 13, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
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