Superior Capsular Reconstruction Outcomes Wrightington 2020Lennard Funk
Hariharan Mohan, Jagwant Singh, Michael Walton, Lennard Funk, Puneet Monga
Cautious optimism following SCR may be offered to this challenging subset of patients with symptomatic irreparable rotator cuff tears. It is likely that the relatively low re-operation rates can be further improved by considering the negative prognostic factors in defining indications for surgery. Further studies with longer term followup are recommended.
Winner of the Richard O'Connor Research Award from the Arthroscopy Association of North America 2017. This study demonstrates major improvement in the outcome of ACL reconstruction when an extra-articular procedure (ALL reconstruction) is also performed. The full manuscript is published in AJSM. Anterolateral Ligament Reconstruction Is Associated With Significantly Reduced ACL Graft Rupture Rates at a Minimum Follow-up of 2 Years: A Prospective Comparative Study of 502 Patients From the SANTI (Scientific ACL NeTwork International) Study Group
Presentation delivered at 2020 AAOS annual meeting by Dr Adnan Saithna, Professor of Orthopedic Surgery, Overland Park, Kansas. This randomised controlled study demonstrates that combined ACL and anterolateral ligament reconstruction is not associated with an increased risk of adverse events when compared to isolated ACL reconstruction
Superior Capsular Reconstruction Outcomes Wrightington 2020Lennard Funk
Hariharan Mohan, Jagwant Singh, Michael Walton, Lennard Funk, Puneet Monga
Cautious optimism following SCR may be offered to this challenging subset of patients with symptomatic irreparable rotator cuff tears. It is likely that the relatively low re-operation rates can be further improved by considering the negative prognostic factors in defining indications for surgery. Further studies with longer term followup are recommended.
Winner of the Richard O'Connor Research Award from the Arthroscopy Association of North America 2017. This study demonstrates major improvement in the outcome of ACL reconstruction when an extra-articular procedure (ALL reconstruction) is also performed. The full manuscript is published in AJSM. Anterolateral Ligament Reconstruction Is Associated With Significantly Reduced ACL Graft Rupture Rates at a Minimum Follow-up of 2 Years: A Prospective Comparative Study of 502 Patients From the SANTI (Scientific ACL NeTwork International) Study Group
Presentation delivered at 2020 AAOS annual meeting by Dr Adnan Saithna, Professor of Orthopedic Surgery, Overland Park, Kansas. This randomised controlled study demonstrates that combined ACL and anterolateral ligament reconstruction is not associated with an increased risk of adverse events when compared to isolated ACL reconstruction
Case-control Study on 2nd Hammertoe Deformity Correction TechniquesWenjay Sung
This is my case-control study on second hammertoe deformity correction techniques: arthroplasty, arthrodesis, and interpositional implant arthroplasty.
Lecture given by Dr Saithna, Orthopedic Surgeon, Overland Park, Kansas on his latest research related to knee and shoulder injuries, including: Anterior cruciate ligament (ACL), ACL repair, ACL reconstruction, ACL rehabilitation, Rotator cuff and Long head of biceps injuries
Presentation given by Dr Saithna at the 2019 AANA (Arthroscopy Association North America) Annual Meeting on the Outcomes of Combined ACL and anterolateral ligament reconstruction in Professional Athletes
Case-control Study on 2nd Hammertoe Deformity Correction TechniquesWenjay Sung
This is my case-control study on second hammertoe deformity correction techniques: arthroplasty, arthrodesis, and interpositional implant arthroplasty.
Lecture given by Dr Saithna, Orthopedic Surgeon, Overland Park, Kansas on his latest research related to knee and shoulder injuries, including: Anterior cruciate ligament (ACL), ACL repair, ACL reconstruction, ACL rehabilitation, Rotator cuff and Long head of biceps injuries
Presentation given by Dr Saithna at the 2019 AANA (Arthroscopy Association North America) Annual Meeting on the Outcomes of Combined ACL and anterolateral ligament reconstruction in Professional Athletes
Investing in Collaboration - Architectural Concepts for Machine Learning in Healthcare - Peter A D Steel, Weill Cornell Medicine and Yiye Zhang, Weill Cornell Medicine.
Machine learning (ML) has the potential to transform healthcare, utilizing big data to improve individual patient care and optimize healthcare systems. We examine applications of machine learning in clinical medicine, and the associated challenges, to elucidate the necessary culture, expertise, processes and infrastructure to ensure ML's value in healthcare is realized.
Right Anterior Thoracotomy Minimally Invasive Aortic Valve Replacement vs. Co...semualkaira
This research aims to compare intraoperative
and postoperative outcomes of Right Anterior Thoracotomy minimally invasive aortic valve replacement (RAT-MIAVR) surgery
with conventional aortic valve replacement (C-AVR) surgery and
analyze the results.
Right Anterior Thoracotomy Minimally Invasive Aortic Valve Replacement vs. Co...semualkaira
This research aims to compare intraoperative
and postoperative outcomes of Right Anterior Thoracotomy minimally invasive aortic valve replacement (RAT-MIAVR) surgery
with conventional aortic valve replacement (C-AVR) surgery and
analyze the results
Right Anterior Thoracotomy Minimally Invasive Aortic Valve Replacement vs. Co...semualkaira
This research aims to compare intraoperative
and postoperative outcomes of Right Anterior Thoracotomy minimally invasive aortic valve replacement (RAT-MIAVR) surgery
with conventional aortic valve replacement (C-AVR) surgery and
analyze the results.
Reunion Anual Madeira 2015 Imagen y análisis funcional intracoronarios
YgraftPOSTER (1)
1. Hemodynamic comparison of the traditional Fontan baffle and Y-graft modification under
simulated exercise conditions
Kasey Rice, Ajit P. Yoganathan, PhD
Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia
Introduction
Materials and Methods
Results Conclusions
Patient-Specific Geometry and Boundary Conditions
Flow Field Diagrams for Y-Graft and Traditional Baffle
Exercise Performance (iPL) Comparison
Post-Simulation Analysis
Computational Fluid Dynamics (CFD) Simulation
Future Directions
Acknowledgments
A special thanks given to Children’s Healthcare of Atlanta (CHOA)
and Children’s Hospital of Philadelphia (CHOP) for providing MRI
patient data with confidentiality. Additional thanks to Phillip Trusty,
Dr. Zhenglun Wei, Dr. Maria Restrepo, Jaci Carithers and Dr. Ajit
P. Yoganathan for participation in the study. A special
acknowledgement given to my baby cousin Isaiah Deslauriers,
who was born with HLHS.
Correlations of iPL with Y-graft patient geometries
(1) Whitehead, K. K.; Pekkan, K.; Kitajima, H. D.; Paridon, S. M.; Yoganathan, A. P.; Fogel, M. A., Nonlinear Power Loss During Exercise in Single-
Ventricle Patients After the Fontan: Insights From Computational Fluid Dynamics. Circulation 2007, 116 (11 suppl), I-165-I-171.
(2) Khiabani, R. H.; Whitehead, K. K.; Han, D.; Restrepo, M.; Tang, E.; Bethel, J.; Paridon, S. M.; Fogel, M. A.; Yoganathan, A. P., Exercise capacity
in single-ventricle patients after Fontan correlates with haemodynamic energy loss in TCPC. Heart 2015, 101 (2), 139-143.
• Compare exercise performance for both TCPC types in real-
time (e.g. MRI-compatible cycle ergometer)
• Flow field diagram analysis
Literature Cited*
Fontan Procedure
• Routes blood around dysfunctional ventricle
• Last Stage for surgical procedure
Traditional Baffle
Y-Graft
Fontan
Anatomy
Boundary
Conditions
Patient MRI 3D Anatomy Meshed Geometry
CFD Simulation
• Navier-Stokes
Equation
• Inputs: Geometry
and Boundary
Conditions
Flow Field Results
• Anatomy Flow
Patterns
• Pressure Drop
• Particle
Resonance Time
Power Loss Calculations (𝟏)
• Macroscopic energy balance:
Patient MRI Velocity Segmentation
𝐸 =
𝑆𝑢𝑟𝑓𝑎𝑐𝑒
[𝜌 +
1
2
𝜌𝑢𝑗 𝑢𝑖] 𝑢𝑗 𝑛𝑗 𝑑𝑆 ≅ 𝜌 +
1
2
𝜌𝑣2
𝑄
𝐸 𝑑𝑒𝑙𝑡𝑎 = 𝐸𝑆𝑉𝐶 + 𝐸𝐼𝑉𝐶 − 𝐸𝐿𝑝𝐴 − 𝐸 𝑅𝑃𝐴
• Total Power Loss:
Correlations of iPL from intense exercise with iPL at rest
Y-GraftTraditionalSPSS
• Student t-test
• Mann Whitney
test
• Bivariate
comparisons
• Y-Grafts have significantly greater iPL which suggests
decreased exercise performance
• No strong correlation of iPL with patient geometry
• Exercise performance can be predicted for Y-graft patients
Patient
Demographics
Y-graft (n=20) LT/ECC (n=20) p-value
Age (years) 3.53±0.60 3.23±0.19 0.52
BSA (m2) 0.63±0.05 0.63±0.01 0.16
Male/Female 12/8 14/6 N/A
HLHS/non-HLHS 7/13 10/10 N/A
Systemic Venous
Flow (L/min)*
1.51±0.14 2.12±0.11 <0.01
PFD (% LPA) 48±4 44±3 0.49
Nakata Index
(mm2/m2)*
108±12 143±8 0.02
IVC Stenosis (%) 23±4 25±2 0.14
LPA Stenosis (%) 36±4 45±4 0.08
RPA Stenosis (%) 20±3 27±3 0.13
Overall PA
Stenosis (%)
26±3 35±3 0.05
R² = 0.118
0
0.1
0.2
0.3
0.4
0.5
0.6
0 5 10 15 20
iPL(3x) Minimum IVC size
R² = 0.23
-0.1
0
0.1
0.2
0.3
0.4
0.5
0.6
0 50 100 150 200 250
iPL(3x)
Nakata Index
R² = 0.40
-0.1
0
0.1
0.2
0.3
0.4
0.5
0.6
0 10 20 30 40 50 60
iPL(3x)
Overall Pa St. (%)
R² = 0.08
R² = 0.13
-0.1
0
0.1
0.2
0.3
0.4
0.5
0.6
0 5 10 15 20
iPL(3x)
Minimum LPA/RPA size
LPA min
RPA min
0.00
0.02
0.04
0.06
0.08
0.10
0.12
Rest Moderate
Exercise
Intense
Exercise
IndexedPower
Loss(iPL) Ygraft
Traditional
y = 0.9858x + 0.0028
R² = 0.98
y = 1.4028x + 0.0013
R² = 0.40
0
0.02
0.04
0.06
0.08
0.1
0.12
0.14
0.16
0.18
0.2
0 0.02 0.04 0.06 0.08 0.1 0.12 0.14 0.16 0.18 0.2
iPL(3x)
iPL (1x)
Ygraft
Traditional
Rest Moderate
Exercise
Intense
Exercise