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Permanent URI for this collectionhttps://hdl.handle.net/20.500.12503/30446
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Browsing Other by Author "Bibb, Patrick"
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Item Biomechanic Comparison of Reconstruction Techniques for AC joint Dislocation(2021) Tran, Apollo; Bibb, PatrickBackground: Acromioclavicular (AC) joint disruption comprises 8% of all shoulder injuries. There is still broad debate on when treatment with surgery is indicated and what surgery technique will provide optimal results. Purpose: In this study, we propose a modified technique that we hypothesize will provide the most security to a Rockwood type III AC joint dislocation with the least amount of post-operative complications. Materials and Methods: A rig to mount the cadaver specimens was constructed using a steel rails, screws, and L-brackets and fastened securely to the MTS apparatus. A total of 20 cadaveric shoulders will be gathered and each randomly assigned to one of three groups: 1) reconstruction with graft loop with fibertape augmentation and 2) reconstruction loop using two fibertapes and 3) reconstruction with the Mazzocca technique. The AC and CC ligaments will be released to simulate a Rockwood type III injury and reconstructed using one of the techniques listed above. The reconstructed specimen will then undergo load to failure (120 mm/min) in the superior direction to evaluate maximal loading capacity of the repair construct. Discussion: Difference compared to native for vertical migration of the AC joint, load to failure and mode of failure of the technique will be analyzed for variance if statistical significance is found (P< 0.05) followed by a Bonferroni post hoc analysis. With trials still underway, we anticipate the AC joint repair with augmented graft loop will decrease vertical migration and increase strength compared to previously described techniques.Item The Impact of Comorbidities on Chronic Low Back Pain(2021) Bibb, Patrick; Licciardone, John C.Background: With an estimated treatment cost of $635 billion, low back pain is one of the costliest national public health challenges. The NIH Pain Consortium defines chronic low back pain as pain lasting longer than 3 months, with pain symptoms in more than half of the days during the past 6 months. Since 2016, the PRECISION Pain Research Registry has been collecting data from patients with CLBP in Texas. Purpose: This purpose of this study is to determine the impact of multiple comorbidities on psychological and physical components of pain in patients with CLBP. Methods: There were 519 patients in the study, including 264 (50.9%) standard patients with < 2 comorbidities (CLBP-L) and 255 (49.1%) patients with >3 comorbidities (CLBP-H). The psychological characteristics of these two comorbidity groups were compared using the Pain Self-Efficacy Questionnaire (PSEQ) and the Pain Catastrophizing Scale (PCS). The physical characteristics of the groups were compared using a numerical rating scale for pain intensity (NRS) and the Roland-Morris Disability Questionnaire (RMDQ). Results: There was a statistically significant (p< 0.05) negative correlation between comorbidity scores and PSEQ scores, and there were significant positive correlations between comorbidity scores and PCS, NRS, and RMDQ scores. Conclusions: These results provide evidence that patients with CLBP and a greater number of comorbidities may experience more difficulty in psychologically coping with physical pain and disabilities than such patients with fewer comorbidities. These results suggest that psychological interventions, such as cognitive behavioral therapy, may benefit patients with CLBP and numerous comorbidities.