Jeremy D. Podolnick

Bio: Jeremy D. Podolnick is an academic researcher from Mount Sinai Hospital. The author has contributed to research in topics: Glasgow Coma Scale & Intensive care unit. The author has an hindex of 3, co-authored 7 publications receiving 34 citations. Previous affiliations of Jeremy D. Podolnick include Mount Sinai St. Luke's and Mount Sinai Roosevelt.

Is Pes Cavus Alignment Associated With Lisfranc Injuries of the Foot

Abstract: Background Lisfranc (tarsometatarsal joint) injuries are relatively rare, accounting for less than 1% of all fractures, and as many as 20% of subtle Lisfranc injuries are missed at the initial patient presentation An undiagnosed Lisfranc injury can have devastating consequences to the patient Therefore, any factor that can raise a clinician’s index of suspicion to make this diagnosis is potentially important The cavus foot has been associated with various maladies of the lower extremity, but to our knowledge, it has not been reported to be associated with Lisfranc injury

Incidence of Delayed Diagnosis of Orthopaedic Injury in Pediatric Trauma Patients.

Abstract: Objective Determine the incidence of the delayed diagnosis of orthopaedic injuries in pediatric trauma patients. Design Cross-sectional retrospective analysis. Setting Level I pediatric trauma center. Patients/participants All patients with an orthopaedic consultation after a trauma activation with a diagnosis of fracture, dislocation, traumatic arthrotomy, neurovascular injury, amputation, and tendon or ligament injury requiring intervention. A total of 1009 trauma codes and alerts occurred during the study period, of which 196 patients were diagnosed with an orthopaedic injury. Intervention Charts were reviewed to obtain demographic information, time of presentation, Glasgow Coma Score (GCS) on presentation, injury severity score (ISS), mechanism of injury, intubation status, length of intensive care unit and hospital stay, primary and secondary survey diagnoses, discharge diagnoses, time of additional diagnoses, and reason for delayed diagnosis. Main outcome measures Incidence of delayed diagnosis of injury (DDI). Results There were 196 patients with a confirmed orthopaedic injury, of which, 18 were classified as a delayed diagnosis (9.18%). The mean time to detection of injury was 77.46 hours and the mean patient age was 132.22 months. One of the 18 patients required surgical intervention while the rest were treated conservatively. The mean GCS score of patients with a DDI were significantly lower than patients without a missed injury, 12 versus 14.19 (P = 0.0009). The median ISS, 21 versus 9 (P = 0.0021), and median hospital length of stay, 4 days versus 3 days (P = 0.0369) were significantly higher for patients with a missed injury compared with those without a missed injury. The intensive care unit length of stay approached significance with a median of 2 days for patients with a missed injury versus 1 day for patients without a missed injury (P = 0.057). Conclusions In our study, factors that were associated with a DDI included lower GCS, higher ISS, and greater hospital length of stay. There was only 1 missed injury that required surgical intervention, and the remainder were treated conservatively. The initial evaluation of the trauma patient is able to detect life-threatening injuries, but the tertiary survey remains an important part of patient care to detect missed injuries. Level of evidence Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Accuracy and Reliability of Radiographic Estimation of Volar Lip Fragment Size in PIP Dorsal Fracture-Dislocations.

Abstract: Background: A cadaveric study was performed to evaluate the accuracy and reliability of radiographic estimation of the volar lip fragment size in proximal interphalangeal joint fracture-dislocations. Methods: Middle phalangeal base volar lip fractures of varying size and morphology were simulated in 18 digits. Radiographs and digital photographs of the middle phalangeal joint surface were obtained pre- and postinjury. Ten orthopedic surgeons of varying levels of training estimated the fracture size based on radiographs. The estimated joint involvement on radiograph was compared with the digitally measured joint involvement. Results: Radiographic estimation underestimated the volar lip fragment size by 9.02%. Estimations possessed high intraobserver (0.76-0.98) and interobserver (0.88-0.97) reliabilities. No differences were detected between levels of surgeon training. Conclusions: The significant underestimation of the volar lip fragment size demonstrates the lack of radiographic estimation accuracy and suggests that surgeons should be mindful of these results when making treatment plans.

A Paradigm for Functional Tissue Engineering of Articular Cartilage

Abstract: Deformational loading represents a primary component of the chondrocyte physical environment in vivo. This review summarizes our experience with physiologic deformational loading of chondrocyte-seeded agarose hydrogels to promote development of cartilage constructs having mechanical properties matching that of the parent calf tissue, which has a Young's modulus EY = 277 kPa and unconfined dynamic modulus at 1 Hz G*=7 MPa. Over an 8-week culture period, cartilage-like properties have been achieved for 60 × 106 cells/ml seeding density agarose constructs, with EY = 186 kPa, G*=1.64 MPa. For these constructs, the GAG content reached 1.74% ww and collagen content 2.64% ww compared to 2.4% ww and 21.5% ww for the parent tissue, respectively. Issues regarding the deformational loading protocol, cell-seeding density, nutrient supply, growth factor addition, and construct mechanical characterization are discussed. In anticipation of cartilage repair studies, we also describe early efforts to engineer cylindrical and anatomically shaped bilayered constructs of agarose hydrogel and bone (i.e., osteochondral constructs). The presence of a bony substrate may facilitate integration upon implantation. These efforts will provide an underlying framework from which a functional tissue-engineering approach, as described by Butler and coworkers (2000), may be applied to general cell-scaffold systems adopted for cartilage tissue engineering.

Lisfranc fracture-dislocations: current management.

Abstract: It is essential to know and understand the anatomy of the tarsometatarsal (TMT) joint (Lisfranc joint) to achieve a correct diagnosis and proper treatment of the injuries that occur at that level. ...

3D Bioprinting: New Directions in Articular Cartilage Tissue Engineering

Abstract: Bioprinting is a growing field with significant potential for developing engineered tissues with compositional and mechanical properties that recapitulate healthy native tissue. Much of the current research in tissue and organ bioprinting has focused on complex tissues that require vascularization. Cartilage tissue engineering has been successful in developing de novo tissues using homogeneous scaffolds. However, as research moves toward clinical application, engineered cartilage will need to maintain homogeneous nutrient diffusion in larger scaffolds and integrate with surrounding tissues. Bioprinting techniques have provided promising results to address these challenges in cartilage tissue engineering. The purpose of this review was to evaluate 3D extrusion-based bioprinting research for developing engineered cartilage. Specifically, we reviewed the potential impact of 3D bioprinting on nutrient diffusion in larger scaffolds, development of scaffolds with spatial variation in cell distribution or mechanical properties, and cultivation of more complex tissues using multiple materials. Finally, we discuss current limitations and challenges in using 3D bioprinting for cartilage tissue engineering and regeneration.