Louisiana Via Research Day Book 2026

Case Studies: Section 1

Case Studies: Section 1

Nicholas Villar, OMS-III; Grace Lee, OMS-III; Joseph Vo, OMS-III; Cameron Cluney, OMS-III; Lee Allen Dennis, OMS-III; Jenna Dittmar, PhD VCOM-Louisiana 49 THE FIRST BILATERAL STAGED OXFORD CEMENTLESS UNICOMPARTMENTAL KNEE ARTHROPLASTY IN LOUISIANA POST FDA APPROVAL: A CASE REPORT

Justin Nguyen, OMS-IV 1 ; Breanna Campbell, MD 2 1 VCOM-Louisiana; 2 Baton Rouge General – Hospital Medicine Group (Infectious Disease) 50 THE MONO-TONOUS STOMACH: POST-VIRAL GASTROPARESIS REQUIRING PEG-J IN A 19-YEAR-OLD

Context: We present the case of a 63-year old woman with bilateral medial compartment osteoarthritis who underwent the first staged bilateral cementless Oxford unicompartmental knee arthroplasty (OUKA) done in the state of Louisiana shortly after its FDA approval in 2024. Report of Case: The patient had a five-year history of increasingly progressive knee pain refractory to conservative therapy, including corticosteroid injections and physical therapy. Imaging confirmed isolated medial compartment disease with preserved lateral compartments and intact cruciate ligaments. Following right OUKA, she demonstrated rapid recovery, full extension, and near complete resolution of pain within four weeks. Due to persistent pain in the contralateral results. Postoperative imaging confirmed appropriate prosthesis positioning bilaterally without evidence of loosening, migration, or malalignment. The patient resumed full ambulation and reported restoration of functional capacity. knee, a left OUKA was performed six weeks later with similarly favorable

Conclusions: This case highlights the early postoperative benefits and potential long term promise of cementless OUKA, including faster recovery, reduced surgical time, and avoidance of cement-related complications. The implant’s titanium and hydroxyapatite coating may further enhance biological fixation and durability. As cementless technology gains traction in the United States, continued follow-up and longitudinal studies will be essential to confirm its long-term survivorship and clinical efficacy compared to traditional cemented designs.

Context: Gastroparesis, defined as delayed gastric emptying without mechanical obstruction, is uncommon, affecting approximately 14-24 per 100,000 persons. Post-viral gastroparesis is typically mild and self limited in adolescents, yet this case highlights a rare, severe EBV-associated presentation that progressed to profound malnutrition requiring PEG-J support. Management was further complicated by extrapyramidal symptoms from metoclopramide, underscoring the limited therapeutic options and the need for heightened clinical vigilance in unusually aggressive post viral gastric dysmotility. Report of Case: A 19-year-old previously healthy male presented with persistent vomiting, lightheadedness, and significant weight loss following acute EBV infection. Laboratory evaluation revealed dehydration, transaminitis, and protein-calorie malnutrition. Gastric emptying scintigraphy demonstrated markedly delayed emptying (2% at 90 minutes), consistent with severe gastroparesis. Metoclopramide was initiated but discontinued due to extrapyramidal side effects. Total parenteral nutrition was started; however, due to persistent inability to

tolerate oral intake, the patient underwent PEG-J tube placement for enteral feeding. Fluctuating mental status, likely multifactorial delirium, was managed with quetiapine and melatonin. J-tube feeds were gradually titrated to goal prior to transfer for continued multidisciplinary care. Conclusions: Post-viral gastroparesis has been described in the literature as an uncommon but recognized sequela of viral infections, with most reported cases involving norovirus, rotavirus, or influenza. EBV is cited far less frequently as a precipitating factor, and available case reviews describe only isolated instances of EBV-associated gastroparesis, particularly in adolescents. In contrast to typical descriptions in the literature, where symptoms gradually improve over weeks to months, this patient experienced an unusually aggressive course with rapid nutritional decline and failure of standard prokinetic therapy. While metoclopramide remains the most frequently used medication for symptomatic relief, its use is limited by the risk of extrapyramidal symptoms. This patient developed acute EPS shortly after initiation, immediately removing the primary pharmacologic option and leaving

few alternatives. This distinguishes the case further, as most published reports describe at least partial response to prokinetic therapy. Additionally, in the majority of documented pediatric or adolescent cases, gastroparesis improves without the need for enteral access devices. The requirement for PEG-J placement in this patient emphasizes the severity of functional impairment and highlights an escalation of care not commonly necessary in post-viral gastric dysmotility. This case contributes novel insight into an extremely rare EBV-associated gastrointestinal complication in a previously healthy adolescent.

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2026 Research Recognition Day