4^th International Conference on Orthopedics & Rheumatology October 26-28, 2015 Baltimore, Maryland, USA

Wendell Cole has completed his B.S. at the age of 20 years from Georgia State University and is a current MD2 student at Morehouse School of Medicine. He is a 2015 scholar of the American Academy of Orthopaedic Surgeons Nth dimensions educational solutions program. He has presented this poster at the National Medical Association 113th Annual Convention and Scientific Assembly in Detroit, MI

Background: Osteoarthritis is the most common joint disorder in the world that will affect nearly half of all adults by age 85. The appropriate management in patients with mild to severe osteoarthritis still remains a challenging area where viscosupplemtation (SYNVISC) can play an important role.\r\nObjective: To analyze the efficacy of intra-articular injections of SYNVISC (Hylan G-F 20) for the treatment of Grade II-IV painful knee osteoarthritis using validated outcome scores (KOOS). \r\nDesign: This is a retrospective case series study including patients over a span of 6 years.\r\nParticipants: A convenience sample of 140 patients with Grade II-IV knee osteoarthritis participated in this study. Patients had an age range from 41-83 years of age with a mean age 60 years old. Patients were included if they completed a baseline KOOS survey and a 6-week follow-up KOOS survey after intra-articular injection of Hylan G-F 20. \r\nMain outcome: After Hylan G-F 20 injection, a significant increase (P<.05) in the KOOS survey categories of pain (17.4% increase), symptoms (14.7%), activities of daily life(15.1%), sports and recreation(11.6%) and knee related quality of life(20.2%) were seen. \r\nConclusion: Previous literature on viscosupplementation has shown a failure of efficacy based on a lack of statistically significant clinical improvement. The data from this study was statistically significant, and indicates that patients are satisfied and find it easier to perform daily activities with less knee pain after a viscosupplementation injection. Hylan G-F 20 injections provide good clinical benefits for the patient and are a safe treatment for knee osteoarthritis\r\n

Jamal Fitts has completed his BS from the University of Alabama at Birmingham. He is currently pursuing Medicine at Morehouse School of Medicine. He is an Nth Dimension Scholar of American Academy of Orthopedic Surgeons. He presented this poster at the National Medical Association 113th Annual Convention and Scientific Assembly

Background: Peri-prosthetic joint infection (PJI) is the third leading reason for revision of total hip arthroplasty (THA). Two-stage exchange arthroplasty has become the “gold standard” for treatment of a chronically infected THA. This case demonstrates a classical presentation of a two-stage revision arthroplasty for the treatment of PJI. \r\n\r\nMethods & Patients: The patient presented to clinic with blood and purulence draining from a wound on his right hip. He previously had a THA and has had recurrent chronic infection. After evaluation of his blood sample and fluid aspirated from his hip, it was decided that it would be most appropriate to undergo a two-stage exchange arthroplasty. \r\n\r\nManagement & Outcome: The previous hip implant was removed. The antibiotic cement spacer was placed in without incident. \r\n\r\nDiscussion: After lab testing shows that the infection has been eradicated, the permanent prosthesis will be implanted. Two-stage revision is just one of the means of treatment for infection. The route of treatment depends on multiple factors that must be considered when managing the patient’s infection.\r\n

Darrell V Morris completed his Bachelor’s of Science degree at the University of Georgia and is currently pursuing his Doctorate of Medicine at Morehouse School of Medicine. He is a member and former vice-president of Morehouse School of Medicine’s Bonnie Simpson-Mason’s Orthopedic Interest Society. Moreover, he is a member of the 2015 cohort of Nth Dimensions Orthopedic Summer Internship Scholars Program. During this program he functioned under the mentorship of foot and ankle orthopedic surgeon Dr. Gary Stewart, MD and additionally, worked with the orthopedic residency program at Atlanta Medical Center.

BerbereX, an FDA approved wound cleanser with established antibiotic and anti-inflammatory properties, has been shown to help decrease the duration of time needed to attain complete wound healing. It is known that berberine illustrates antimicrobial and antifungal properties and if used in conjunction with ionic silver, Berberine’s antimicrobial action is amplified. Additionally, Berberine’s pH regulation properties and its ability to decrease skin free radicals further helps with retention of a viable wound healing environment. The way in which the berberine molecule inhibits bacterial growth is not entirely understood but some evidence notes that it may bind to bacterial DNA inhibiting transcription and replication. This study aims to evaluate the effectiveness of BerbereX on chronic wounds, specifically foot and ankle insults over a 10-week period. Patients were chosen based on presentation in foot and ankle orthopedic practice, with wounds that had not responded to previous standard practice treatment including dressings, antibiotics, and debridement. Participants applied BerbereX twice a day alongside their normal wound care routine approved by the physician, and wounds were evaluated according to clinical protocol or at 2-week intervals. Those patients randomized to the BerbereX treatment responded favorably with 75% of wounds healed over the course of 3.75 weeks. Additionally, healing time was comparable between diabetics and non-diabetics with usage of BerbereX. This study demonstrates that BerbereX treatment helps to reduce the duration in which wound healing occurs in problematic foot and ankle insults while facilitating overall reduction of wound dimensions. Moreover, BerbereX use as a wound cleanser decreases the duration of wound healing independent of the presence of diabetes.