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Nikhil Verma

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https://www.readbyqxmd.com/read/29730138/establishing-maximal-medical-improvement-after-anatomic-total-shoulder-arthroplasty
#1
REVIEW
Richard N Puzzitiello, Avinesh Agarwalla, Joseph N Liu, Gregory L Cvetanovich, Anthony A Romeo, Brian Forsythe, Nikhil N Verma
BACKGROUND: As a heightened emphasis continues to be placed on value-based health care, quality outcomes following orthopedic procedures must be properly defined. With knowledge of the time to maximal medical improvement following total shoulder arthroplasty (TSA), physician resources can be justly allocated to optimize value in ambulatory orthopedic care. MATERIALS AND METHODS: A systematic review was conducted to identify studies reporting sequential follow-up at several time points, up to a minimum of 2 years after TSA...
May 2, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29730136/a-simple-method-to-directly-evaluate-the-lateral-extension-of-the-acromion-an-anatomic-study-of-128-cadaveric-scapulae
#2
Trifon Totlis, Anirudh K Gowd, Eamon D Bernardoni, Brian J Cole, Nikhil N Verma, Konstantinos Natsis
BACKGROUND: The lateral extension of the acromion from the glenohumeral joint is the critical variable that both the acromial index and critical shoulder angle reflect. The purpose of this study was to establish a simple and reproducible method to directly measure the lateral extension of the acromion that will be independent of patient demographic characteristics, scapular rotation, or other morphologic features of the shoulder. METHODS: This study used 128 unpaired cadaveric scapulae with a mean age of 69...
May 2, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29729754/editorial-commentary-outcomes-reporting-in-value-based-care-it-s-complicated
#3
EDITORIAL
Nikhil N Verma
Patient-reported outcomes have received increasing attention as a tool to measure physician performance and value in health care. Lack of standardization, cost, and patient compliance remain significant barriers to the widespread acceptance of patient-reported outcomes in orthopaedic sports medicine.
May 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29643557/reversal-agents-do-we-need-to-administer-with-neuromuscular-monitoring-an-observational-study
#4
Shilpa Goyal, Nikhil Kothari, Deepak Chaudhary, Shilpi Verma, Pooja Bihani, Mahaveer Singh Rodha
Background and Aims: In clinical practice, in the majority of patients, recovery from the effect of muscle relaxants is assessed using subjective methods such as head lift, eye-opening, or by sustained hand grip after giving anticholinesterases (neostigmine) at the end of surgery. We planned a prospective observational cohort study to test the hypothesis that objective neuromuscular monitoring can help us in avoiding the use of anticholinesterases for reversal. Methods: The patients posted for surgery of <2 h duration were included in the study...
March 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29606539/anatomy-of-the-pudendal-nerve-and-other-neural-structures-around-the-proximal-hamstring-origin-in-males
#5
Gregory L Cvetanovich, Bryan M Saltzman, Gift Ukwuani, Rachel M Frank, Nikhil N Verma, Charles A Bush-Joseph, Shane J Nho
PURPOSE: To define the anatomy of the pudendal nerve in relationship to the proximal hamstring and other nearby neurological structures during proximal hamstring repair. METHODS: Six fresh-frozen human cadaveric hemi-pelvises from male patients ages 64.0 ± 4.1 years were dissected in prone position with hips in 10° flexion to identify the relationship of proximal hamstring origin to surrounding neurologic structures including the pudendal nerve, sciatic nerve, and posterior femoral cutaneous nerve...
March 29, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29536023/male-sex-decreased-activity-level-and-higher-bmi-associated-with-lower-completion-of-patient-reported-outcome-measures-following-acl-reconstruction
#6
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
https://www.readbyqxmd.com/read/29401410/lateral-augmentation-procedures-in-anterior-cruciate-ligament-reconstruction-anatomic-biomechanical-imaging-and-clinical-evidence
#7
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
https://www.readbyqxmd.com/read/29399457/anatomic-acromioclavicular-joint-reconstruction-with-semitendinosus-allograft-surgical-technique
#8
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
https://www.readbyqxmd.com/read/29399443/the-floating-labrum-bankart-lesion-repair-with-anterior-capsular-extension-using-2-anterior-working-portals
#9
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
https://www.readbyqxmd.com/read/29389219/outcomes-of-latarjet-versus-distal-tibia-allograft-for-anterior-shoulder-instability-repair-a-matched-cohort-analysis
#10
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...
April 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29366742/utility-of-modern-arthroscopic-simulator-training-models-a-meta-analysis-and-updated-systematic-review
#11
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
https://www.readbyqxmd.com/read/29354480/an-all-arthroscopic-length-tensioned-suprapectoral-biceps-tenodesis-technique
#12
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
https://www.readbyqxmd.com/read/29354434/acl-reconstruction-basics-quadruple-4-strand-hamstring-autograft-harvest
#13
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
https://www.readbyqxmd.com/read/29354416/anterior-cruciate-ligament-reconstruction-basics-bone-patellar-tendon-bone-autograft-harvest
#14
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
https://www.readbyqxmd.com/read/29354413/shoulder-arthroscopy-in-the-lateral-decubitus-position
#15
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
https://www.readbyqxmd.com/read/29354411/shoulder-arthroscopy-in-the-beach-chair-position
#16
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
https://www.readbyqxmd.com/read/29354379/classifying-nitrilases-as-aliphatic-and-aromatic-using-machine-learning-technique
#17
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
https://www.readbyqxmd.com/read/29349003/arthroscopic-anterior-shoulder-stabilization-with-incorporation-of-a-comminuted-bony-bankart-lesion
#18
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
https://www.readbyqxmd.com/read/29334769/topographic-analysis-of-the-distal-femoral-condyle-articular-cartilage-surface-adequacy-of-the-graft-from-opposite-condyles-of-the-same-or-different-size-for-the-osteochondral-allograft-transplantation
#19
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
https://www.readbyqxmd.com/read/29330670/treatment-of-partial-thickness-rotator-cuff-tears-in-overhead-athletes
#20
REVIEW
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...
March 2018: Current Reviews in Musculoskeletal Medicine
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