Adnan Saithna

Arizona State University, Orthopedic Surgery, Faculty Member

Nottingham Trent University, School of Science & Technology, Honorary Professor

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Dr Saithna is a Sports Injury Knee and Shoulder Surgeon at AZBSC Orthopedics, Scottsdale, Arizona, USA. He is Professor of Orthopedic Surgery, Adjunct Clinical Faculty, Kansas City University, Honorary Professor at Nottingham Trent University, King James IV Professor, Royal College of Surgeons, Edinburgh

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Papers by Adnan Saithna

A comparison of complications requiring return to theatre in hip and knee arthroplasty patients taking enoxaparin versus rivaroxaban for thromboprophylaxis

by Adnan Saithna, Gurdip Chahal, and Julian Gilbody

Ortopedia, traumatologia, rehabilitacja

There is no consensus on the optimal form of venous thromboembolic prophylaxis treatment in hip a... more There is no consensus on the optimal form of venous thromboembolic prophylaxis treatment in hip and knee arthroplasty patients, or on the safety and complication profile of the available chemical prophylaxis modalities. In this study we aimed to measure the return to theatre rate for any cause related to wound complications in patients undergoing total hip replacement and total knee replacement, and compare these rates between patients on oral Rivaroxaban 10mg OD and subcutaneous Enoxaparin 40mg OD in our department. There were a total of 387 patients included in the study; 227 patients in group 1, who received Enoxaparin 40mg OD, and 160 patients in group 2, who received Rivaroxaban 10mg OD. The primary outcome measure was re-operation rate due to wound complications. Secondary outcome measures were infection rate, incidence of deep vein thrombosis, pulmonary emboli, duration of hospital stay, change in haemoglobin and haematocrit and blood transfusion rate. In this retrospective c...

Treatment of deformational plagiocephaly and torticollis using a weight distribution ring

by Edward Gee, Adnan Saithna, and Christopher Hill

Journal of Pediatric Orthopaedics B, 2013

Plagiocephaly, from the Greek &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;am... more Plagiocephaly, from the Greek &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;plagios&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; (slanting) and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;kephale&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; (head), refers to a condition of an infant&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s head deformation by forces acting upon a malleable cranium. Marked plagiocephaly causes distress and stigma towards the baby and their family and has knock-on effects with craniofacial abnormalities, visual-field defects and delay in motor skills, and may also cause developmental difficulties. Current treatment methods have multiple drawbacks. This small, illustrated case series presents a novel, cost-effective, practical first-line treatment using a horseshoe-shaped gel head ring to redistribute pressure, allowing uniform growth and reshaping. Our early experience suggests that this method represents an effective treatment option with promising results so far.

Surgical Outcomes of soft tissue reattachment surgery - Is tantalum an appropriate biomaterial?

by Adnan Saithna and Edward Gee

European Surgical Research

ABSTRACT

Does External Rotation Bracing for Anterior Shoulder Dislocation Actually Result in Reduction of the Labrum? A Systematic Review

by Jason Old and Adnan Saithna

The American journal of sports medicine, Jan 3, 2014

External rotation (ER) bracing has been shown to improve labral reduction in cadaveric studies, b... more External rotation (ER) bracing has been shown to improve labral reduction in cadaveric studies, but this has not translated to universal improvement in re-dislocation rates in clinical series. To systematically review and critically appraise the literature that investigates how well the labrum is actually reduced by ER in patients who have had an anterior shoulder dislocation. Systematic review. We conducted a systematic review of the literature using the online databases Medline, EMBASE, and the Cochrane Controlled Trial Register. Studies were included if they reported on the difference in labral reduction after ER and internal rotation bracing in patients who had a traumatic anterior shoulder dislocation. Of the 6 studies included, 5 assessed labral reduction on magnetic resonance imaging and 1 arthroscopically. Each study reported an overall improvement in labral reduction with ER, but anatomic reduction was not commonly achieved. This was despite the use of extreme positions tha...

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The effect of stimulators of differentiation on 5HT3 and muscarinic receptor expression in NG108-15 cells

British Journal of Pharmacology

Repeat injection is not the next course of action

BMJ British medical journal

ABSTRACT

Reverse Shoulder Arthroplasty in Rheumatoid Arthritis: A Systematic Review

by Adnan Saithna and Edward Gee

The Open Orthopaedics Journal, 2015

Background: Anatomical shoulder replacement for rheumatoid arthritis (RA) is complicated by high ... more Background: Anatomical shoulder replacement for rheumatoid arthritis (RA) is complicated by high incidences of rotator cuff tears and glenoid erosion. This can lead to poor function and early failure; reverse shoulder arthroplasty (RSA) has gained popularity as an alternative. This systematic review attempts to further define the role of RSA in RA.

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Improving theatre efficiency and utilisation through early identification of trauma patients and enhanced communication between teams

BMJ Quality Improvement Reports, 2015

Surgical departments are increasingly put under pressure to improve services, cut waiting lists, ... more Surgical departments are increasingly put under pressure to improve services, cut waiting lists, increase efficiency and save money. At a district general hospital in the west-midlands we approached the challenge of improving efficiency and optimising the services available in our orthopaedic theatres.

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Surgical Outcomes of soft tissue reattachment surgery - Is tantalum an appropriate biomaterial?

European Surgical Research

ABSTRACT

RETROSPECTIVE ANALYSIS OF SYMPTOM DURATION IN PATIENTS WITH SOFT TISSUE SARCOMA: DOES A DELAY IN DIAGNOSIS AFFECT OUTCOME?

The Bone & Joint Journal

ABSTRACT

The internet as a tool for direct marketing of hip resurfacing

BMJ British medical journal

ABSTRACT

SUCCESSFUL RESULTS FOLLOWING CARTILAGE REPAIR IN THE KNEE USING A NOVEL SYNTHETIC OSTEOCHONDRAL SCAFFOLD

The Bone & Joint Journal

ABSTRACT

BONE MARROW STIMULATION CARTILAGE REPAIR SURGERY IN THE KNEE WITHOUT PROLONGED NON WEIGHTBEARING – IT’S NOW A LOT EASIER

The Bone & Joint Journal

ABSTRACT

OPENING WEDGE DISTAL FEMORAL VARUS OSTEOTOMY. IS IT GOOD ENOUGH?

The Bone & Joint Journal

ABSTRACT

BILATERAL SIMULTANEOUS ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: A SAFE OPTION

The Bone & Joint Journal

ACCURACY OF ABDUCTION‐EXTERNAL ROTATION (ABER) VERSUS STANDARD MAGNETIC RESONANCE ARTHROGRAPHY IN THE DIAGNOSIS OF INTRA-ARTICULAR SHOULDER PATHOLOGY

Shoulder & Elbow

The goal of this study was to compare the accuracy of abduction-external rotation magnetic resona... more The goal of this study was to compare the accuracy of abduction-external rotation magnetic resonance arthrography (ABERMRA) with standard MRA in the diagnosis of intra-articular shoulder pathology. One hundred three consecutive patients undergoing preoperative direct MRA and subsequent arthroscopic examination were included in the study. Seventy-eight patients underwent standard MRA and 25 underwent ABERMRA. Specialist-trained musculoskeletal radiologists reported all scans, and attending shoulder surgeons performed all arthroscopies. Arthroscopic assessment revealed 11 partial-thickness rotator cuff tears, 3 full-thickness tears, 64 labral lesions (48 soft tissue and 16 significant bony), and 17 superior labrum anterior-posterior (SLAP) tears. The sensitivity/specificity for standard MRA was 0.56/0.99 for partial-thickness rotator cuff tears, 1.00/1.00 for full-thickness rotator cuff tears, 0.75/0.91 for soft tissue labral tears, 0.58/1.00 for significant bony glenoid lesions, and ...

An analysis of the biomechanics of interference screw fixation and sheathed devices for biceps tenodesis

by Martyn Snow and Adnan Saithna

Clinical Biomechanics, 2015

This study aimed to evaluate the differences in biomechanical properties of biceps tenodesis when... more This study aimed to evaluate the differences in biomechanical properties of biceps tenodesis when performed with sheathed versus unsheathed screws and also to investigate the effect of altering the pre-tension. Tenodesis was performed in an in vitro model using biomechanical test blocks and ovine tendons. Blocks were allocated to 1 of 5 groups which varied by method of tenodesis and cyclical loading protocol: Group A, Biosure PK screw (10-100N), Group B: 7-8mm Biosure Sync and Biosure PK screw (10-100N), Group C: Biosure PK screw (10-70N), Group D: Biosure PK (20-100N), and Group E: custom sheath and Biosure PK screw (10-100N). If tenodeses remained intact after 500cycles maximum load to failure testing was performed. 30% of tenodeses in Group A failed prior to 500cycles whereas none failed in the sheathed device groups (P=0.02). Using a sheathed device prevented mal-rotation. However, tenodeses in Group B were more likely to fail immediately distal to the tenodesis at a load below the anticipated maximum load to failure suggesting tendon damage during fixation. Using the custom sheath, which did not have sharp edges, resulted in a statistically significant increased maximum load to failure in Group E (348N) when compared to Group A (228N, mean difference 120N, P=0.01) and Group B (253N, mean difference 95N, P=0.0007). Sheathed devices prevent mal-rotation and increase stiffness and maximum load to failure. This is further improved by reducing tendon damage at the time of tenodesis.

DOES ACL RECONSTRUCTION WITH ACCELERATED REHABILITATION INFLUENCE THE OUTCOME OF CONCOMITANT MENISCAL REPAIR?

The Bone & Joint Journal

Purpose: To investigate the validity of previous observations that meniscal repair has a better s... more Purpose: To investigate the validity of previous observations that meniscal repair has a better success rate when associated with ACL reconstruction.Methods and Results: The case notes of 170 patients who underwent meniscal repair between May 1999 and May 2007 were analysed for causes of re-operation and relation to status of the ACL. Mean age at the time of surgery was 28 years.41 patients underwent re-operation at a mean time interval of 21 months (range 2 weeks - 87 months). 79 patients (Group A) had isolated meniscal tears. 44 patients (Group B) had meniscal repair at the same time as elective ACL reconstruction and underwent brace-free, accelerated rehabilitation. 47 patients (Group C) had meniscal repair in association with ACL disruption and underwent staged ligament reconstruction.In Group A, 23 patients underwent re-operation (Indications; meniscal symptoms 21, stiffness 1, infection 1). Nineteen repairs (23.8%) were found to have failed. In Group B, 15 patients underwent r...

Defining the Role of the Tibial Tubercle-Trochlear Groove and Tibial Tubercle-Posterior Cruciate Ligament Distances in the Work-up of Patients With Patellofemoral Disorders

by Adnan Saithna and Martyn Snow

The American Journal of Sports Medicine, 2015

The radiological work-up of patients with patellofemoral disorders continues to be debated. The i... more The radiological work-up of patients with patellofemoral disorders continues to be debated. The interchangeability of the tibial tubercle-trochlear groove (TT-TG) distance between computed tomography (CT) and magnetic resonance imaging (MRI) has recently been questioned. In addition, a new measurement-the tibial tubercle-posterior cruciate ligament (TT-PCL) distance-has shown that not all patients with a pathological TT-TG distance (&amp;amp;amp;amp;gt;20 mm) have lateralization of the tibial tubercle. Another factor to consider when looking at the position of the tibial tubercle is the knee joint rotation, defined as the angle between the femoral dorsal condylar line and the tibial dorsal condylar line. To determine, with a larger population, if the TT-TG measurements can be used interchangeably between CT and MRI and to confirm the correlation between the TT-PCL and TT-TG distances in determining tibial tubercle lateralization. Cohort study (diagnosis); Level of evidence, 2. Patients with patellofemoral disorders and MRI and CT scans of the same knee (n = 141) were identified. The TT-PCL, the knee joint rotation, and TT-TG were measured independently by 2 fellowship-trained orthopaedic surgeons. Thirty measurements were repeated on a separate occasion to allow for an assessment of the intrarater reliability. The intraclass correlation coefficient (ICC) was used to assess reliability of the measurements. The mean TT-TG was 4.16 mm less on MRI (P &amp;amp;amp;amp;lt; .05), with the mean TT-TG ± SD being 17.72 ± 5.15 mm on CT (range, 6.97-31.33 mm) and 13.56 ± 6.07 mm on MRI (range, 2-30.04 mm). The ICC for each rater comparing the 2 imaging modalities was only fair (0.54 and 0.48). The mean TT-PCL measurement was 20.32 ± 3.45 mm (range, 10.11-32.01 mm) with excellent interobserver and intraobserver reliability (&amp;amp;amp;amp;gt;0.75). Based on the TT-TG and TT-PCL measurements, 4 groups of patients can be established. When knee joint rotation is compared among groups, an increased TT-TG may result from true lateralization of the tibial tubercle, an increased knee joint rotation, or both. Based on a statistically significant mean difference (4.11 mm) and only a fair ICC (0.54 and 0.48) for raters comparing the 2 modalities, the measurements for the TT-TG cannot be used interchangeably between CT and MRI. Therefore, currently accepted values for TT-TG based on CT scans should not be applied to an MRI scan. The TT-PCL measurement is a measure of true lateralization of the tibial tubercle, while the TT-TG is an amalgamated measure of true lateralization and knee joint rotation.

Combined Posterior Cruciate Ligament and Posteromedial Reconstruction

Posterior Cruciate Ligament Injuries, 2015

ABSTRACT Injuries to the posteromedial corner (PMC) have received relatively less attention in th... more ABSTRACT Injuries to the posteromedial corner (PMC) have received relatively less attention in the literature than those to the posterolateral corner and as a consequence are often not considered when addressing the PCL injured knee. Unrecognized or inadequately treated associated injuries are reported to have an incidence of 50-90% in the PCL injured knee and this may explain why some studies have shown unfavorable outcomes at midterm follow up. Part of the reason why injuries to the PMC may go unrecognized is due to the fact that the phrase “medial sided injury” has become synonymous with MCL sprains or tears and therefore it is often assumed that medial-sided injuries will heal with non-operative management. However, unlike low-grade MCL tears, injuries to the PMC are a significantly different clinical entity biomechanically and are unlikely to heal particularly in the setting of a multi-ligament injured knee. In addition, persistent valgus or posteromedial instability can place additional strain on a reconstructed cruciate ligament and potentially cause late graft failure. Therefore, it is essential to have an appropriate index of suspicion and identify these injuries before cruciate reconstruction so that repair and/or reconstruction of the PMC and MCL can be undertaken at the same time. This chapter seeks to highlight the key features of the anatomy, biomechanics, and surgical management of combined PCL and PMC injuries.