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Outcomes After Revision Anterior Cruciate Ligament Reconstruction

Chapter by: Hurley, Eoghan T; Matache, Bogdan A; Shah, Mehul; Campbell, Kirk A
in: Revision Anterior Cruciate Ligament Reconstruction : A Case-Based Approach by Alaia, Michael J; Jones, Kristofer J [Eds]
Cham : Springer International Publishing AG, 2022
pp. 353-360
ISBN: 9783030969967
CID: 5363762

The Ethics of Telemedicine

Campbell, Kirk A; Bosco, Joseph A; Shah, Mehul R
PMID: 34081881
ISSN: 2328-5273
CID: 5295012

Meniscal Pathology: Presentation and Diagnosis

Chapter by: Gotlin, Matthew J; Shah, Mehul R
in: The management of meniscal pathology : from meniscectomy to repair and transplantation by Strauss, Eric J; Jazrawi, Laith M [Eds]
Cham, Switzerland : Springer, [2020]
pp. 27-52
ISBN: 9783030494872
CID: 5301082

Primary anterior cruciate ligament reconstruction: perioperative considerations and complications

Nadarajah, Vidushan; Roach, Ryan; Ganta, Abhishek; Alaia, Michael J; Shah, Mehul R
Anterior cruciate ligament (ACL) injuries are among the most commonly studied orthopaedic injuries. Despite having an excellent prognosis, complications do occur. The timely recognition and management of complications is imperative to ensure the success of reconstruction. Avoiding such complications requires thorough preoperative planning, proficient technical skills to properly manage intraoperative complications, and an extensive knowledge of possible postoperative complications.
PMID: 28276989
ISSN: 2326-3660
CID: 2477192

Type ii slap tear in a 50-year-old recreational athlete treated with biceps tenodesis

Chapter by: Begly, John P.; Shah, Mehul
in: The Biceps and Superior Labrum Complex: A Clinical Casebook by
[S.l.] : Springer International Publishing, 2017
pp. 145-158
ISBN: 9783319549323
CID: 3030332

Synovial Hemangioma Presenting as a Painful Locked Knee A Case Report

Begly, John P; Rapp, Timothy B; Shah, Mehul R
A 39-year-old man presented to orthopaedic care with a painful, fully locked knee. Workup revealed free intraarticular nodules, which were subsequently arthroscopically removed and identified to be synovial hemangioma. To the investigators' knowledge, this is the second reported case of synovial hemangioma presenting as a painful, definitively locked knee. Synovial hemangioma should be considered in the differential diagnosis of knee pain, particularly after more common diagnoses have been ruled out. Efficient and appropriate diagnosis and treatment may result in favorable patient outcomes and avoid long-term disability and dysfunction.
PMID: 27815956
ISSN: 2328-5273
CID: 2357572

A Randomized Controlled Trial of Two Distinct Shared Decision-Making Aids for Hip and Knee Osteoarthritis in an Ethnically Diverse Patient Population

Shue, Jennifer; Karia, Raj J; Cardone, Dennis; Samuels, Jonathan; Shah, Mehul; Slover, James D
OBJECTIVES: To evaluate the use of decision aids for hip and knee osteoarthritis (OA) regarding the potential risks and benefits of different treatment options. METHODS: A prospective, randomized controlled trial was conducted of 147 patients with advanced hip or knee OA to compare the effect of two decision aids (booklet-only vs. booklet with DVD). RESULTS: Both decision aid programs were well received and demonstrated improvements in patient knowledge and willingness to participate in treatment decisions. The decision aids, however, had a marginal effect on patient willingness to participate in OA management, with an increase of 0.11 and 0.6 on a scale of 2 (P = 0.58) between groups. CONCLUSIONS: The decision aids were accepted for most patients and effective in improving patient knowledge and willingness to participate in the decision process. Nevertheless, the addition of a more expensive DVD to the booklet program did not improve patient acceptance or knowledge.
PMID: 27325341
ISSN: 1524-4733
CID: 2157932

The utility of plain radiographs in the initial evaluation of knee pain amongst sports medicine patients

Alaia, Michael J; Khatib, Omar; Shah, Mehul; A Bosco, Joseph; M Jazrawi, Laith; Strauss, Eric J
PURPOSE: To evaluate whether screening radiographs as part of the initial workup of knee pain impacts clinical decision-making in a sports medicine practice. METHODS: A questionnaire was completed by the attending orthopaedic surgeon following the initial office visit for 499 consecutive patients presenting to the sports medicine centre with a chief complaint of knee pain. The questionnaire documented patient age, duration of symptoms, location of knee pain, associated mechanical symptoms, history of trauma within the past 2 weeks, positive findings on plain radiographs, whether magnetic resonance imaging was ordered, and whether plain radiographs impacted the management decisions for the patient. Patients were excluded if they had prior X-rays, history of malignancy, ongoing pregnancy, constitutional symptoms as well as those patients with prior knee surgery or intra-articular infections. Statistical analyses were then performed to determine which factors were more likely do correspond with diagnostic radiographs. RESULTS: Overall, initial screening radiographs did not change management in 72 % of the patients assessed in the office. The mean age of patients in whom radiographs did change management was 57.9 years compared to 37.1 years in those patients where plain radiograph did not change management (p < 0.0001). Plain radiographs had no impact on clinical management in 97.3 % of patients younger than 40. In patients whom radiographs did change management, radiographs were more likely to influence management if patients were over age forty, had pain for over 6 months, had medial or diffuse pain, or had mechanical symptoms. A basic cost analysis revealed that the cost of a clinically useful radiographic series in a patient under 40 years of age was $7,600, in contrast to $413 for a useful series in patients above the age of 40. CONCLUSION: Data from the current study support the hypothesis that for the younger patient population, routine radiographic imaging as a screening tool may be of little clinical benefit. Factors supporting obtaining screening radiographs include age greater than 40, knee pain for greater than 6 months, the presence of medial or diffuse knee pain, and the presence of mechanical symptoms. LEVEL OF EVIDENCE: II.
PMID: 24832691
ISSN: 0942-2056
CID: 996492

Management of focal cartilage defects in the knee - Is ACI the answer?

Strauss, Eric J; Fonseca, Lauren E; Shah, Mehul R; Yorum, Thomas
Injuries to the articular cartilage of the knee are common. They alter the normal distribution of weightbearing forces and predispose patients to the development of degenerative joint disease. The management of focal chondral lesions continues to be problematic for the treating orthopaedic surgeon. Although many treatment options are currently available, none fulfill the criteria for an ideal repair solution: a hyaline repair tissue that completely fills the defect and integrates well with the surrounding normal cartilage. Autologous chondrocyte implantation (ACI) is a relatively new cell-based treatment method for full-thickness cartilage injuries that in recent years has increased in popularity, with early studies showing promising results. The current article reviews the nature of cartilage lesions in the knee and the treatment modalities utilized in their management, focusing on the role ACI plays in the surgical treatment of these complex injuries
PMID: 21332441
ISSN: 1936-9727
CID: 128797

Femoroacetabular impingement--diagnosis and treatment

Kaplan, Kevin M; Shah, Mehul R; Youm, Thomas
Femoroacetabular impingement results from an abnormal contact between the femur and the pelvis. This abnormal contact leads to developmental changes in the femoral neck, labrum, and acetabulum. Secondary to the altered hip joint mechanics, chondral damage occurs and initiates the degenerative process, eventually leading to osteoarthritis. Numerous etiologies have been implicated in femoroacetabular impingement, and a variety of treatment algorithms have been established, with no definitive gold standard. However, the treatment of this disorder with joint preserving techniques offers a viable option between the extremes of nonoperative treatment and total joint arthroplasty
PMID: 20632980
ISSN: 1936-9727
CID: 111376