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5 results on '"Ruby Gilmor"'

1. The Utility of the Area Deprivation Index in Assessing Complications After Total Joint Arthroplasty

Author

Jeremy A. Dubin, BA, Sandeep S. Bains, MD, Daniel Hameed, MD, Rubén Monárrez, MD, Ruby Gilmor, DO, Zhongming Chen, MD, James Nace, DO, and Ronald E. Delanois, MD

Subjects
Orthopedic surgery, RD701-811
Abstract

Background:. Vulnerable populations, including patients from a lower socioeconomic status, are at an increased risk for infection, revision surgery, mortality, and complications after total joint arthroplasty (TJA). An effective metric to quantify and compare these populations has not yet been established in the literature. The Area Deprivation Index (ADI) provides a composite area-based indicator of socioeconomic disadvantage consisting of 17 U.S. Census indicators, based on education, employment, housing quality, and poverty. We assessed patient risk factor profiles and performed multivariable regressions of total complications at 30 days, 90 days, and 1 year. Methods:. A prospectively collected database of 3,024 patients who underwent primary elective total knee arthroplasty or total hip arthroplasty performed by 3 fellowship-trained orthopaedic surgeons from January 1, 2015, through December 31, 2021, at a tertiary health-care center was analyzed. Patients were divided into quintiles (ADI ≤20 [n = 555], ADI 21 to 40 [n = 1,001], ADI 41 to 60 [n = 694], ADI 61 to 80 [n = 396], and ADI 81 to 100 [n = 378]) and into groups based on the national median ADI, ≤47 (n = 1,896) and >47 (n = 1,128). Results:. Higher quintiles had significantly more females (p = 0.002) and higher incidences of diabetes (p < 0.001), congestive heart failure (p < 0.001), chronic obstructive pulmonary disease (p < 0.001), hypertension (p < 0.001), substance abuse (p < 0.001), and tobacco use (p < 0.001). When accounting for several confounding variables, all ADI quintiles were not associated with increased total complications at 30 days, but age (p = 0.023), female sex (p = 0.019), congestive heart failure (p = 0.032), chronic obstructive pulmonary disease (p = 0.001), hypertension (p = 0.003), and chronic kidney disease (p = 0.010) were associated. At 90 days, ADI > 47 (p = 0.040), female sex (p = 0.035), and congestive heart failure (p = 0.001) were associated with increased total complications. Conclusions:. Balancing intrinsic factors, such as patient demographic characteristics, and extrinsic factors, such as social determinants of health, may minimize postoperative complications following TJA. The ADI is one tool that can account for several extrinsic factors, and can thus serve as a starting point to improving patient education and management in the setting of TJA. Level of Evidence:. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Published
2024
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3. List of contributors

Author

Arad Abadi, Sherwin Abdoli, Benjamin Acton, Alexandra M. Adams, Aderinsola A. Aderonmu, Rakesh Ahuja, Saleh Aiyash, Gabriel Akopian, Benjamin G. Allar, Michael F. Amendola, Taylor Anderson, Athena Andreadis, Darwin N. Ang, Ersilia Anghel, Favour Mfonobong Anthony, Precious Idorenyin Anthony, Jordan C. Apfeld, Youssef Aref, Fernando D. Arias, Margaret Arnold, Abbasali Badami, Jeffrey Alexander Bakal, Varun V. Bansal, J. Barney, Jessica Barson, Lauren L. Beck, Andrew R. Bender, Vivek Bhat, Saptarshi Biswas, David Blitzer, Tayt Boeckholt, John S. Bolton, Sourav K. Bose, Gerald M. Bowers, Mary E. Brindle, Matthew A. Brown, F. Charles Brunicardi, Richard A. Burkhart, Jennifer L. Byk, M. Campbell, Danilea M. Carmona Matos, Kenny J. Castro-Ochoa, Juan Cendan, Shane Charles, Angel D. Chavez-Rivera, Hao Wei Chen, Herbert Chen, Kevin Chen, Wendy Chen, Darren C. Cheng, Nicole B. Cherng, Christina Shree Chopra, G. Travis Clifton, Jason Crowner, Houston Curtis, Temilolaoluwa O. Daramola, Aria Darbandi, Serena Dasani, Kaci DeJarnette, Jeremiah Deneve, Karuna Dewan, Marcus Dial, Jody C. DiGiacomo, Andrew L. DiMatteo, Tsering Y. Dirkhipa, James M. Dittman, Ashley C. Dodd, Israel Dowlat, Hans E. Drawbert, Juan Duchesne, Omar Elfanagely, Yousef Elfanagely, Javed Khader Eliyas, Chukwuma N. Eruchalu, James C. Etheridge, Erfan Faridmoayer, Arjumand Faruqi, Jessica Dominique Feliz, Martin D. Fleming, Laura M. Fluke, Jason M. Flynn, Kathryn L. Fowler, Miguel Garcia, Tushar Garg, Patrick C. Gedeon, Ruby Gilmor, Julie Goldman, Christian Gonzalez, Rachael E. Guenter, Brian C. Gulack, Matthew Handmacher, Ivy N. Haskins, Carl Haupt, Kshipra Hemal, Matthew T. Hey, Perez Holguin, Christopher S. Hollenbeak, Andrew Holmes, Hyo Jung Hong, Nicholas Huerta, Mohamad A. Hussain, Yaritza Inostroza-Nieves, Marc J. Kahn, Sunil S. Karhadkar, Mohammed A. Kashem, Qingwen Kawaji, Syed Faraz Kazim, Kathryn C. Kelley, Monty U. Khajanchi, Shaarif Rauf Khan, Quynh Kieu, Charissa Kim, Roger Klein, Suzanne Kool, Jessica S. Kruger, Afif N. Kulaylat, Audrey S. Kulaylat, Elizabeth Laikhter, Samuel Lance, Megan LeBlanc, David Lee, Frank V. Lefevre, Jacob Levy, Deacon J. Lile, Carol A. Lin, Xinyi Luo, David A. Machado-Aranda, Kashif Majeed, Madhu Mamidala, Nizam Mamode, Abhishek Mane, Samuel M. Manstein, Jenna Maroney, Jessica Maxwell, Patrick M. McCarthy, Philip McCarthy, Hector Mejia, Pallavi Menon, Albert Moeller, Dennis Spalla Morris, Haley Nadone, Anil Nanda, Allison Nauta, Matthew Navarro, Daniel W. Nelson, Daniel C. Neubauer, Kaitlin A. Nguyen, Louis L. Nguyen, Katherine Nielson, Austin O. McCrea, Delia S. Ocaña Narváez, Peter Oro, Gezzer Ortega, Adena J. Osband, Ahmad Ozair, Rohan Palanki, Jaime Pardo Palau, Juliet Panichella, Panini Patankar, Aneri Patel, Nirmit Patel, Gehan A. Pendlebury, Christina Poa-Li, Sangeetha Prabhakaran, Hashir Qamar, Ramesh Raghupathi, Faique Rahman, Mohan Ramalingam, Syed S. Razi, Aminah Abdul Razzack, Abdul Razzaq, Amanda J. Reich, Christopher Reid, Clay Resweber, Mark Riddle, Mehida Rojas-Alexandre, Susan Rowell, Vanessa Roxo, Debosree Roy, Jacqueline L. Russell, Mala Sachdev, Ruben D. Salas-Parra, Ali Salim, John H. Sampson, Andrea Valquiria Sanchez, Tiffany R. Sanchez, Jane R. Schubart, C. Schwartz, Alexander Schwartzman, Erin M. Scott, Ali Seifi, Aditya Sekhani, Chan Shen, Eric Shiah, Jeffrey W. Shupp, Meaghan Sievers, Rachel E. Silver, Kirit Singh, Robert D. Sinyard, Kevin L. Smith, Tandis Soltani, Abhinav Arun Sonkar, Dallas J. Soyland, Mackinzie A. Stanley, David E. Stein, Sean C. Stuart, Linh Tran, Andrew Vierra, Vanessa M. Welten, Kate Whelihan, Brandon M. White, Rebecca L. Williams-Karnesky, Emily E. Witt, Heather X. Rhodes, Seiji Yamaguchi, Ravali Yenduri, Andrew Yiu, Benjamin R. Zambetti, Christa Zino, and Haley A. Zlomke

Published
2023
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4. Core Decompression Versus Nonoperative Management of Osteonecrosis of the Ankle: A Systematic Review

Author

Ruby, Gilmor, Zhongming, Chen, Michael A, Mont, Ronald E, Delanois, and James, Nace

Subjects
Surgery
Abstract

Introduction: The purpose of this study is to investigate the efficacy of core decompression for treating osteonecrosis of the ankle, including the distal tibia and talus, compared to nonoperative management. A systematic review was performed to specifically evaluate: (1) clinical results (patient-reported pain as well as functional scores, physician clinical reported assessment); (2) radiographic outcomes (i.e., radiographic progression of collapse); and (3) need for further procedures. Materials and Methods: A search of PubMed, EMBASE, and the Cochrane Library found eight reports that fit the inclusion criteria for core decompression or nonoperative management of osteonecrosis of the ankle. Four studies totaling 194 ankles diagnosed with osteonecrosis that underwent core decompression were analyzed. An additional four papers examined 64 ankles diagnosed with osteonecrosis that underwent nonoperative management. Level of evidence of the studies ranged from II to IV. Outcomes of core decompression and nonoperative management analyzed clinical scores such as the American Foot and Ankle Severity Score (AOFASS) and Mazur ankle grading system. Radiographic progression was studied with Ficat and Arlet as well as Hawkins scores. Results: Overall, there was an improvement in clinical scores and decreased radiographic progression in ankles treated with core decompression. AOFASS scores rose from 41.5 + 0.7 to 89 + 0.7, while the mean Mazur score increased from 34.5 + 0.7 preoperatively to 91.5 + 0.7 postoperatively. After core decompression, only 21% (40 out of 194 ankles) progressed radiographically to Ficat and Arlet stage III or IV postoperatively. Furthermore, core decompression showed less requirement for further surgical management compared to nonoperative management. Conclusions: Osteonecrosis of the ankle is not as commonly encountered in practice compared to other joints, such as the hips and knees. The results of this study suggest that core decompression is a successful option for treating osteonecrosis of the ankle.

Published
2022

5. Investigating the Correlation Between Anterior-Posterior and Lateral Asymmetric Muscular Balance With Low Back Pain

Author

Kevin Calvelo, Ruby Gilmor, Rehman Afraz, Stephen Albano, Javed Siddiqi, and Mary Grace Bacani

Subjects
medicine.medical_specialty, Neurosurgery, 030204 cardiovascular system & hematology, Correlation, 03 medical and health sciences, 0302 clinical medicine, Linear regression, Back pain, medicine, Pain Management, sagittal balance, low back pain, Balance (ability), business.industry, General Engineering, muscular balance, Odds ratio, Low back pain, Confidence interval, Sagittal plane, Orthopedics, medicine.anatomical_structure, Physical therapy, medicine.symptom, business, 030217 neurology & neurosurgery
Abstract

Objective The objective of this pilot study was to determine if there is a correlation between the proposed physical testing protocol and low back pain. The proposed physical testing protocol is an attempt to assess muscular asymmetry in the anterior-posterior plane and the lateral plane. Methods A total of 96 volunteers were recruited from Touro University after obtaining IRB approval. Volunteers were initially provided a questionnaire regarding demographics and back pain. After ensuring participants satisfied the inclusion criteria, a physical test protocol was performed. After data compilation, odds ratios as well and linear regression models were generated to assess for correlation with back pain. Results A total of 96 participants were recruited. The odds ratio for asymmetric anterior-posterior balance in relation to back pain is 3.00 with a 95% confidence interval 1.26-7.12. The odds ratio for total ability to tolerate asymmetric loads greater than 50% of ideal body weight is 0.44 with a 95% confidence interval 0.11-1.77. The linear regression coefficient of anterior-posterior balance greater than 25% of ideal body weight in relation to level of pain is 1.96. Conclusions Increased muscular asymmetry in the sagittal plane and lateral plane showed a trend toward increased levels of low back pain; however, there is a weak correlation. This is a correlation and not an association. Future studies to assess the relationship between muscular balance and low back pain are needed to determine if therapy can be targeted to improve muscular sagittal balance, which can improve symmetry and back pain.

Published
2020
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