Louisiana Research Day Program Book 2025

Anatomy and Epidemiology

Anatomy and Epidemiology

Paxton Holder, OMS-IV; Tyson Hillock, OMS-IV; Annabel O’Conner, OMS-III; Brady Levron, OMS-III; Samantha Valaitis, OMS-III; Justin Nguyen, OMS-III; Savanna Gonzalez, OMS-III; Erick Barnard, OMS-III; Savannah Newell, PhD VCOM-Louisiana 56 ASSOCIATION OF ATHEROSCLEROTIC PLAQUE AND INTIMA-MEDIA THICKNESS OF PERIPHERAL ARTERIES TO CORONARY ARTERIES

Ryan Jordan, OMS-I; Stephen Johns, OMS-I; Matthew Badeaux, OMS-I VCOM-Louisiana 55 POST-OPERATIVE STIFFNESS IN TOTAL KNEE ARTHROPLASTY: INCIDENCE AND RISK FACTORS

Context: Total knee arthroplasty (TKA) is an operation involving reconstruction of the knee joint most commonly performed on patients with end stage osteoarthritis. This is a last resort option to restore function to the patient’s knee, but stiffness may linger, or develop, in some cases. Post-operative stiffness can significantly impact functional outcomes, making it an important area of study. Objective: This literature review aims to evaluate the incidence and risk factors associated with post-operative stiffness following a TKA. Methods: Literature review was conducted on studies from PubMed and Google Scholar. Risk factors and incidence of stiffness in TKA patients were the main outcome measures. Keywords risk factors, incidence, pre-operative, post-operative, total knee arthroplasty, total knee replacement, stiffness, and comorbidities were used to find relevant studies. Only papers containing stiffness data were included. Figures 2-5 were generated using the findings of each relevant paper (mean data was calculated in Figures 2-4).

Results: The mean incidence of post-operative stiffness in TKA patients was 3.7% (n=53,073). The most common risk factor associated with post-operative stiffness in TKA patients was limited pre-operative range of motion (ROM), also referred to as pre-operative stiffness. Mean pre-operative and post-operative ROM in non-stiff patients was 109.7° and 115.15°, respectively (n=525). Mean pre-operative and post-operative ROM in patients reporting stiffness was 68.25° and 101.1°, respectively (n=4,252). The most common comorbidity seen in patients reporting stiffness was hypertension (51.9%). This study is ongoing and more results are expected if they fit the inclusion criteria. Conclusions: TKA patients with less pre operative ROM, particularly when less than 90°, have an increased chance of experiencing post-operative knee stiffness. Optimizing pre operative health may lower the risk of stiffness.

Context: Atherosclerosis most commonly becomes clinically relevant in coronary artery disease (CAD), cerebral vascular accidents (CVA), and peripheral artery disease (PAD). Due to the identification of modifiable risk factors, proper screening tools and preventative measures have been implemented. These efforts have led to a decrease in mortality rates, but recently a plateau in improvement has been reached. Further investigation into prevention and screening modalities is necessary to continue this progression. Ultrasound (US) measurement of the intima-media thickness (IMT) has been suggested as a potential assessment tool. Currently, very little association of IMT between PAD and CAD has been evaluated. Objective: This study aims to investigate whether a strong correlation between the AHA classification and IMT of specific peripheral arteries to coronary arteries exists, with the goal of highlighting the clinical utility of US in predicting atherosclerotic progression and complications.

Method: Samples from four coronary arteries, four carotid arteries, and six bilateral peripheral arteries were collected from 60 cadavers. Each vessel was fixed in formalin and sectioned to produce three histological samples for analysis. The histological examination included measurements of the IMT. Additionally, vessels were graded (I–IV) based on the American Heart Association (AHA) Atherosclerosis Histology Guideline classification. Pearson’s correlation was performed to establish a relationship between each vessel’s assigned AHA classification and IMT measurement. Welch’s t-test was employed to compare the IMT measurement of peripheral vessels with that of coronary vessels. Results: Strong positive correlations were observed in only the AHA-V classification between the left coronary artery (LCA) vs posterior tibial artery (PTA) (r(14)=0.78, p<0.001) and LCA vs carotid bifurcation (CB) (r(10)=0.71, p<0.01). Mean IMT of LCA AHA-V was 1.0 mm (95% CI [0.84,1.16], PTA AHA-V was 0.59 mm (95% CI [0.46,0.72]), and CB AHA-V was 0.96 mm (95% CI [0.79,1.12]).

IMT was significant between LCA vs PTA (p<0.001); however, insignificance was observed between LCA vs CB (p=0.68). No other AHA classification or vessel IMT showed strong correlation or significance. Conclusions: Atherosclerosis is a major contributor to morbidity and mortality in the United States. In this study we observed a strong correlation between the LCA vs PTA and LCA vs CB AHA classifications; however, significance was only observed between LCA vs PTA IMT. This study suggests the potential use of US measurement of the PTA in CAD management.

68

69

2025 Research Recognition Day