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SUNY Downstate Medical Center

Orthopaedic Surgery Residency Program

Research

Research is what allows us as orthopaedic surgeons to continually innovate and improve the lives of our patients. As an academic program, we place importance on resident participation in both clinical and basic science research. As fellowships become increasingly more competitive, research is also one way for a resident to improve their application. Projects that have been completed by our residents have allowed them to meet fellowship directors during national and subspecialty meetings where they have presented their work.

Clinical Research

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Clinical investigation of therapeutic interventions is what allows us to continue to improve clinical outcomes for our patients and advance the field. Residents have the opportunity to pair with a faculty mentor and be intimately involved in both prospective and retrospective clinical trials. Residents who wish to pursue academic careers in orthopaedic surgery are given the opportunity to propose their own studies and see them through completion with assistance from their faculty mentor.

Statistical expertise is provided by the statisticians in the Department of Epidemiology and Biostatistics, who also assist in methodology and study design to ensure adequate study power and to minimize confounders.

Biomechanics Laboratory

Our program is equipped with a complete biomechanics lab that is directed by Dr. Subrata Saha, Ph.D. and is staffed by laboratory engineers and Ph.D. candidates. Here we conduct basic science research in trauma, adult reconstruction, sports medicine, foot and ankle, and spine using both cadaveric specimens and animal models

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Areas of active interest include investigations of novel fixation techniques in sports medicine and foot & ankle, bone mechanical properties, and fracture simulation. We are also actively involved in finite element analysis of femoral fracture models, quantitative computed tomography (qCT) for volumetric assessment of bone mineralization, and generation of digital three dimensional bone models for simulation of traumatic injuries.

Gait Analysis Laboratory

We are the only residency program in New York City with a three-dimensional gait analysis lab which we are currently using for research into the effects of surgery on dynamic gait parameters, particularly in patients with adolescent idiopathic scoliosis (AIS) and for evaluating patient outcomes following high-energy lower extremity trauma.

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Unlike analysis of radiographic parameters, gait analysis allows for assessment of dynamic changes in the boney anatomy, center of mass, and ground reaction forces during all phases of the gait cycle. Gait analysis represents a potentially new direction in the assessment of outcomes following surgery which allows outcomes to be measured dynamically. Any changes following surgery can be compared to a sample of normal patients in our motion library in order to determine how close to normal a patient is functioning.


Publications (in the Past 12 Months):

  • Maheshwari A, Argawal M, Naziri Q, Pivec R, Mont MA, Rasquinha VJ. Can Cementing Technique Reduce the Cost of a Primary Total Knee Arthroplasty? J Knee Surg. 2014 Apr 21. [Epub ahead of print] PubMed PMID: 24752922
  • Maheshwari AV, Naziri Q, Wong A, Burko I, Mont MA, Rasquinha VJ. Barbed Sutures in Total Knee Arthroplasty: Are These Safe, Efficacious, and Cost-Effective? J Knee Surg. 2014 Apr 24. [Epub ahead of print] PubMed PMID: 24764228
  • Maheshwari AV, Korshunov Y, Naziri Q, Pivec R, Mont MA, Rasquinha VJ. No Additional Benefit With Use of a Fibrin Sealant to Decrease Peri-Operative Blood Loss During Primary Total Knee Arthroplasty. J Arthroplasty. 2014 Mar 6. [Epub ahead of print] PubMed PMID: 24813647.
  • Spivak JM, Paulino CB, Patel A, Shanti N, Pathare N. Safe zone for retractor placement to the lumbar spine via the transpsoas approach. J Orthop Surg. 2013 Apr; 21(1):77-81. [PMID: 23629994]
  • Aibinder WR, Patel A, Arnouk J, El-Gendi H, Korshunov Y, Mitgang J, Uribe J. The rate of sural nerve violation using the Achillon device: a cadaveric study. Foot Ankle Int. 2013 Jun; 34(6):870-5. [PMID: 23696186]
  • Issa K, Naziri Q, Rasquinha VJ, Maheshwari AV, Mont MA. Outcomes of Primary Total Hip Arthroplasty in Systemic Lupus Erythematosus With a Proximally-Coated Cementless Stem. Journal of Arthroplasty. 2013 March. Epub Ahead of Print. [PMID: 23538123]
  • Aditya V. Maheshwari, MD; Mayank Agarwal, MD; Qais Naziri, MD; Robert Pivec, MD; and Vijay J. Rasquinha, MD. Can Cementing Technique Reduce the Cost of a Primary Total Knee Arthroplasty? Journal of Knee Surgery, Under Review (2013). [PMID: 24752922]
  • Gallagher D, Adams B, El-Gendi H, Patel A, Grossman L, Berdia J, Korshunov Y, Goldman A. Is distal locking necessary? A biomechanical investigation of intramedullary nailing constructs for intertrochanteric fractures. J Orthop Trauma. 2013 Jul; 27(7):373-8. [PMID: 23249889]
  • David Gallagher, MD; Lauren Grossman, MD; Brock Adams, MD; Westley Hayes, MS,; Hebah El-Gendi, MS; Ashish Patel, MD; Jay Berdia, BS; Ariel Goldman, MD. Is Distal Locking Necessary? A Biomechanical Investigation of Intramedullary Nailing Constructs for Intertrochanteric Fractures. Journal of Orthopaedic Trauma. 2013 Jul;27(7):373-8. [PMID: 23249889]
  • Aibinder WR, Patel A, Arnouk J, El-Gendi H, Korshunov Y, Mitgang J, Uribe J. The rate of sural nerve violation using the achillon device: a cadaveric study. Foot and Ankle International. 2013 Jun;34(6):870-5. [PMID: 23696186]
  • Issa K, Naziri Q, Maheshwari AV, Rasquinha VJ, Mont MA. Outcomes of cementless primary THA for osteonecrosis in HIV-infected patients. The Journal of Bone & Joint Surgery - American. J Bone Joint Surg Am. 2013 Oct 16;95(20):1845-50. [PMID: 24132358]
  • Issa K, Naziri Q, Rasquinha VJ, Maheshwari AV, Mont MA. Excellent Results and Minimal Complications of Total Hip Arthroplasty in Sickle Cell Hemoglobinopathy at Mid-Term Follow-Up Using Cementless Prosthetic Components. J Arthroplasty. 2013 Oct;28(9):1693-8. [PMID: 23726348]
  • Naziri Q, Issa K, Rasquinha VJ, Pivec R, Harwin SF, Khanuja SK, Mont MA. Post-Traumatic Arthritis From Gunshot Injuries to the Hip Requiring a Primary Total Hip Arthroplasty: A Case Series. Orthopedics. 2013 Dec, 36(12) 1549-54. [PMID: 24579229]
  • Zaino CJ, Maheshwari AV, Goldfarb DS. Impact of mild chronic hyponatremia on falls, fractures, osteoporosis, and death. Am J Orthop (Belle Mead NJ). 2013 Nov;42(11):522-7. [PMID: 24340324]
  • Leven D, Sadr A, Aibinder WR. Brown-Séquard syndrome after a gun shot wound to the cervical spine: a case report. Spine J. 2013 Dec;13(12):e1-5. [PMID: 24051332]
  • Mont MA, Pivec R, Issa K, Kapadia BH, Maheshwari A, Harwin SF. Long-Term Implant Survivorship of Cementless Total Knee Arthroplasty: A Systematic Review of the Literature and Meta-Analysis. J Knee Surg. 2013 Dec 7 [PMID: 24318196]
  • Robert Pivec, MD; Michael Stokes, MPH; Abhishek S. Chitnis, MPharm, PhD; Carl B. Paulino, MD; Steven F. Harwin, MD; Michael A. Mont, MD. Clinical and Economic Impact of TENS in Patients With Chronic Low Back Pain: Analysis of a Nationwide Database. Orthopedics. 2013 Dec. 36(12) 922-928. [PMID: 24579210]
  • Paul JC, Patel A, Bianco K, Godwin E, Naziri Q, Maier S, Lafage V, Paulino C, Errico TJ. Gait stability improvement after fusion surgery for adolescent idiopathic scoliosis is influenced by corrective measures in coronal and sagittal planes. Gait Posture. 2014 Jun 24. [Epub ahead of print] PubMed PMID: 25023225
  • Auerbach JD, McGowan KB, Halevi M, Gerling MC, Sharan AD, Whang PG, Maislin G. Mitigating adverse event reporting bias in spine surgery. J Bone Joint Surg Am. 2013 Aug 21;95(16):1450-6. PubMed PMID: 23965694.
  • Yoshihara H, Yoneoka D. Trends in the Incidence and In-Hospital Outcomes of Elective Major Orthopaedic Surgery in Patients Eighty Years of Age and Older in the United States from 2000 to 2009. J Bone Joint Surg Am. 2014 Jul 16;96(14):1185-1191. [Epub ahead of print] PubMed PMID: 25031373.
  • Yoshihara H, Yoneoka D. National Trends and In-Hospital Outcomes in HIV-Positive Patients Undergoing Spinal Fusion. Spine (Phila Pa 1976). 2014 Jun 11. [Epub ahead of print] PubMed PMID: 24921848.
  • Yoshihara H, Yoneoka D. Predictors of Allogeneic Blood Transfusion in Total Hip and Knee Arthroplasty in the United States, 2000-2009. J Arthroplasty. 2014 Apr 26.[Epub ahead of print] PubMed PMID: 24891002.
  • Yoshihara H, Yoneoka D. National Trends in the Utilization of Blood Transfusions in Total Hip and Knee Arthroplasty. J Arthroplasty. 2014 Apr 26. [Epub ahead of print] PubMed PMID: 24890994.
  • Yoshihara H, Yoneoka D. Understanding the statistics and limitations of large database analyses. Spine (Phila Pa 1976). 2014 Jul 15;39(16):1311-2. PubMed PMID: 24732861.
  • Yoshihara H, Yoneoka D. National trends in spinal fusion for pediatric patients with idiopathic scoliosis: demographics, blood transfusions, and in-hospital outcomes. Spine (Phila Pa 1976). 2014 Jun 15;39(14):1144-50. PubMed PMID: 24732849.
  • Yoshihara H, Yoneoka D. Comparison of in-hospital morbidity and mortality rates between anterior and nonanterior approach procedures for thoracic disc herniation. Spine (Phila Pa 1976). 2014 May 20;39(12):E728-33. PubMed PMID: 24718068.
  • Yoshihara H, Yoneoka D. Demographic epidemiology of unstable pelvic fracture in the United States from 2000 to 2009: trends and in-hospital mortality. J Trauma Acute Care Surg. 2014 Feb;76(2):380-5. PubMed PMID: 24398776.
  • Yoshihara H. Surgical treatment for thoracic disc herniation: an update. Spine (Phila Pa 1976). 2014 Mar 15;39(6):E406-12. PubMed PMID: 24365906.
  • Yoshihara H, Yoneoka D. Incidental Dural Tear in Cervical Spine Surgery: Analysis of a Nationwide Database. J Spinal Disord Tech. 2013 Dec 10. [Epub ahead of print] PubMed PMID: 24326240.
  • Yoshihara H, Yoneoka D. Trends in the surgical treatment for spinal metastasis and the in-hospital patient outcomes in the United States from 2000 to 2009. Spine J. 2013 Nov 27. [Epub ahead of print] PubMed PMID: 24291034.
  • Yoshihara H, Yoneoka D. Predictors of allogeneic blood transfusion in spinal fusion in the United States, 2004-2009. Spine (Phila Pa 1976). 2014 Feb 15;39(4):304-10. PubMed PMID: 24253792.
  • Yoshihara H, Yoneoka D. Trends in the utilization of blood transfusions in spinal fusion in the United States from 2000 to 2009. Spine (Phila Pa 1976). 2014 Feb 15;39(4):297-303. PubMed PMID: 24253791.
  • Yoshihara H, Yoneoka D. Incidental dural tear in spine surgery: analysis of a nationwide database. Eur Spine J. 2014 Feb;23(2):389-94. Epub 2013 Nov 9. PubMed PMID: 24212480; PubMed Central PMCID: PMC 3906460.
  • Yoshihara H, Yoneoka D. Trends in the treatment for traumatic central cord syndrome without bone injury in the United States from 2000 to 2009. J Trauma Acute Care Surg. 2013 Sep;75(3):453-8. PubMed PMID: 24089116.
  • Yoshihara H, Passias PG, Errico TJ. Screw-related complications in the subaxial cervical spine with the use of lateral mass versus cervical pediclescrews: a systematic review. J Neurosurg Spine. 2013 Nov;19(5):614-23. Epub 2013 Sep 13. Review. PubMed PMID: 24033303.
  • Yoshihara H, Yoneoka D. Incidental dural tear in lumbar spinal decompression and discectomy: analysis of a nationwide database. Arch Orthop Trauma Surg. 2013 Nov;133(11):1501-8. Epub 2013 Sep 4. PubMed PMID: 24002253.
  • Yoshihara H. Surgical options for lumbosacral fusion: biomechanical stability, advantage, disadvantage and affecting factors in selecting options. Eur J Orthop Surg Traumatol. 2014 Jul;24 Suppl 1:73-82. Epub 2013 Jul 17. PubMed PMID: 23860810.
  • Yoshihara H. Rods in spinal surgery: a review of the literature. Spine J. 2013 Oct;13(10):1350-8. Epub 2013 Jun 15. Review. PubMed PMID: 23773430.
  • Voigt C, Illical E, Goyal KS, Farrell DJ, Van Eck CF, Tarkin IS. Cadaveric Investigation on Radial Nerve Strain Using Different Posterior Surgical Exposures for Extra-articular Distal Humeral ORIF: Merits of Nerve Decompression through a Lateral Paratricipital Exposure. J Orthop Trauma. 2014 Jul 21. [Epub ahead of print] PubMed PMID: 25050751.
  • Illical EM, Farrell DJ, Siska PA, Evans AR, Gruen GS, Tarkin IS. Comparison of outcomes after triceps split versus sparing surgery for extra-articular distal humerus fractures. Injury. 2014 Apr 16. [Epub ahead of print] PubMed PMID: 24813383.

Non-Peer Reviewed Works

  • Christen Marie Russo MD, Hamilton Mu MD, Carl Paulino MD, Andrew Merola MD. Case Report: Atraumatic Acute Spinal Subdural Hematoma & Oral Anticoagulation Therapy- Pending Re-Submission Spine 2013.
  • Patel A; Paulino C. Study Finds Smartphone Apps to be Effective, Accurate Scoliosis Screening Tools. Accepted: Spine Surgery Today. To appear: July/August 2014 Issue

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