Jordan L Smith

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Journals/Publications

• Doane, C. J., Figueroa, G., Gonzales, D. A., Margolis, D. S., Smith, J. L., Szivek, J. A., & Villalobos, E. B. (2022). A Large Segmental Mid-Diaphyseal Femoral Defect Sheep Model: Surgical Technique. Journal of Investigative Surgery. doi:10.1080/08941939.2022.2045393
• Gonzales, D. A., Martinez, M. A., Smith, J. L., Szivek, J. A., & Wojtanowski, A. M. (2019). Mesenchymal stem cell seeded, biomimetic 3D printed scaffolds induce complete bridging of femoral critical sized defects.. Journal of biomedical materials research. Part B, Applied biomaterials, 107(2), 242-252. doi:10.1002/jbm.b.34115
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  No current clinical treatments provide an ideal long-term solution for repair of long bone segment defects. Incomplete healing prevents patients from returning to preinjury activity and ultimately requires additional surgery to induce healing. Obtaining autologous graft material is costly, incurs morbidity, requires surgical time, and quality material is finite. In this pilot study, 3D printed biomimetic scaffolds were used to facilitate rapid bone bridging in critical sized defects in a sheep model. An inverse trabecular pattern based on micro-CT scans of sheep trabecular bone was printed in polybutylene terephthalate. Scaffolds were coated with micron-sized tricalcium phosphate particles to induce osteoconductivity. Mesenchymal stem cells (MSCs) were isolated from sheep inguinal and tail fat, in one group of sheep and scaffolds were infiltrated with MSCs in a bioreactor. Controls did not undergo surgery for cell extraction. Scaffolds were implanted into two experimental and two control adult sheep, and followed for either 3 or 6 months. Monthly radiographs and post explant micro-CT scanning demonstrated bone formation on the lateral, anterior, medial, and posterior-medial aspects along the entire length of the defect. Bone formation was absent on the posterior-lateral aspect where a muscle is generally attached to the bone. The 3-month time point showed 15.5% more cortical bone deposition around the scaffold circumference while the 6-month time point showed 40.9% more bone deposition within scaffold pores. Control sheep failed to unite. Serum collagen type-1C-terminus telopeptides (CTX-1) showed time-dependent levels of bone resorption, and calcein labeling demonstrated an increase in bone formation rate in treated animals compared with controls. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 107B: 242-252, 2019.
• Hannallah, J. R., Roettges, P. S., Ruth, J. T., & Smith, J. L. (2018). Predictability of Pelvic Tilt During Total Hip Arthroplasty Using a Traction Table.. The Journal of arthroplasty, 33(8), 2556-2559. doi:10.1016/j.arth.2018.03.018
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  Pelvic positioning during total hip arthroplasty (THA) affects functional position of the acetabular component. We sought to evaluate whether preoperative pelvic tilt correlated with intraoperative pelvic tilt while positioned on a traction table for direct anterior THA and furthermore to evaluate whether there was a consistent and predictable effect on pelvic tilt while positioned for surgery..We evaluated the sagittal spinopelvic preoperative standing and supine pelvic tilt radiographic measurements as compared with intraoperative measurements of 25 patients. Changes in pelvic tilt were analyzed for statistical significance and interobserver reliability..The mean standing pelvic tilt was 13.5° ± 5.7°. The mean supine pelvic tilt was 13.3° ± 6.1°. There was no statistically significant difference between standing and supine pelvic tilt (P = .866). The mean intraoperative pelvic tilt was 3.0° ± 6.2°. There was a statistically significant decrease in pelvic tilt between both standing to intraoperative comparison and supine to intraoperative comparison (P < .0001 for both). Difference in mean between these comparisons was 10.5° ± 4.6° (95% confidence interval, 8.7°-12.3°) and 10.3° ± 6.3° (95% confidence interval, 7.8°-12.8°), respectively..Patient positioning on a traction table for direct anterior THA has a reliable effect on pelvic tilt in the magnitude of approximately 10° decreased pelvic tilt. This effect on pelvic tilt correlates to approximately 7.4° and 3° altered anteversion and inclination, respectively. Taking into account this change in pelvic tilt at the time of surgery will allow the hip arthroplasty surgeon to more accurately place acetabular components in the desired functional position.
• Smith, J. L., Burk, D. R., & Wild, J. R. (2017). Prothrombin Complex Concentrates: An Alternative to Fresh Frozen Plasma.. Orthopedics, 40(2), e367-e369. doi:10.3928/01477447-20161202-02
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  Insufficiency fractures are a common cause of morbidity among geriatric patients worldwide. Improved outcomes are known to result from decreased delay to definitive operative fixation and mobilization. Use of warfarin is an important potential cause of delay. The ideal mode of warfarin reversal is currently unknown. Prothrombin complex concentrates (PCCs) offer rapid correction with small infusion volume, both of which are important for elderly patients with multiple comorbidities. The authors present 2 cases of insufficiency fractures occurring in geriatric patients receiving warfarin therapy reversed with a 3-factor PCC. Both patients were independent, community ambulators without significant functional disability and returned to their prior level of functioning. There were no significant bleeding or venous thromboembolic complications. To the authors' knowledge, no previous reports have described the use of PCC in geriatric patients with fractures. Nonetheless, its potential is well documented in emergency and trauma surgery literature. The use of PCC could potentially allow surgeons and hospitals to avoid complications related to immobility and the associated costs of treatment, extended hospital stay, and readmission. The authors' limited experience suggests 3-factor PCC preparations may provide adequate correction to allow expeditious surgical treatment. [Orthopedics. 2017; 40(2):e367-e369.].
• Thai, J. N., Pacheco, J. A., Margolis, D. S., Swartz, T., Massey, B. Z., Guisto, J. A., Smith, J. L., & Sheppard, J. E. (2015). Evidence-based Comprehensive Approach to Forearm Arterial Laceration. The western journal of emergency medicine, 16(7), 1127-34.
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  Penetrating injury to the forearm may cause an isolated radial or ulnar artery injury, or a complex injury involving other structures including veins, tendons and nerves. The management of forearm laceration with arterial injury involves both operative and nonoperative strategies. An evolution in management has emerged especially at urban trauma centers, where the multidisciplinary resource of trauma and hand subspecialties may invoke controversy pertaining to the optimal management of such injuries. The objective of this review was to provide an evidence-based, systematic, operative and nonoperative approach to the management of isolated and complex forearm lacerations. A comprehensive search of MedLine, Cochrane Library, Embase and the National Guideline Clearinghouse did not yield evidence-based management guidelines for forearm arterial laceration injury. No professional or societal consensus guidelines or best practice guidelines exist to our knowledge.
• Dezfuli, B., & Smith, J. L. (2012). Level of billing as a function of resident documentation and orthopedic subspecialty at an academic multispecialty orthopedic surgery practice. Orthopedics, 35(11), e1655-8.
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  Documentation, coding, and billing for physician-patient encounters have evolved over time and have significant variability. Appropriate and complete documentation of these encounters can contribute to the financial viability of private and academic medical centers. The objectives of this study were to assess the financial effect of documentation on billing and to compare the authors' institution's distribution of billing level compared with Medicare normative data. Four orthopedic surgery subspecialty clinics were evaluated at a university outpatient clinic over a 1-year period. A single full-day clinic per week was used for each subspecialty. Residents dictated the majority of the reports. All reports were transcribed by medical transcriptionists and coded by certified professional coders. The sports medicine subspecialty generated the highest volume of patient clinic visits, followed by foot and ankle, trauma, and spine (P
• Melvin, J. S., Smith, J. L., Sims, S. H., & Patt, J. C. (2012). The use of an interference fit retrograde nail as an adjunct to plate fixation of a complex Vancouver B1 periprosthetic femoral fracture. Injury, 43(10), 1779-82.
• Smith, J. L., Goorman, S. D., Baron, J. M., Curtin, S. L., & Lewandrowski, K. U. (2006). Three-level bilateral pediculolysis following osteoporotic lumbar compression fracture. The spine journal : official journal of the North American Spine Society, 6(5), 539-43.
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  Osteoporotic compression fractures frequently occur at the thoracolumbar junction as a result of anterior column failure. Fractures of the pedicles are much less common and are not known to be associated with a prior compression fracture. Bilateral pedicle fractures over several consecutive lumbar levels in an osteoporotic elderly patient have not been previously reported.
• Smith, J. L., Bolson, E. L., Wong, S. P., Hubka, M., & Sheehan, F. H. (2003). Three-dimensional assessment of two-dimensional technique for evaluation of right ventricular function by tricuspid annulus motion. The international journal of cardiovascular imaging, 19(3), 189-97.
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  Measurement of tricuspid annulus motion (TAM) is an easy way to estimate right ventricular ejection fraction (RVEF). However the accuracy of two-dimensional (2-D) methods for analyzing the three-dimensional (3-D) structure of the tricuspid annulus has not been evaluated.
• Marusich, M. F., Robinson, B. H., Taanman, J. W., Kim, S. J., Schillace, R., Smith, J. L., & Capaldi, R. A. (1997). Expression of mtDNA and nDNA encoded respiratory chain proteins in chemically and genetically-derived Rho0 human fibroblasts: a comparison of subunit proteins in normal fibroblasts treated with ethidium bromide and fibroblasts from a patient with mtDNA depletion syndrome. Biochimica et biophysica acta, 1362(2-3), 145-59.
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  Although much progress has been made in identifying genetic defects associated with mitochondrial diseases, the protein expression patterns of most disorders are poorly understood. Here we use immunochemical techniques to describe subunit expression patterns of respiratory chain enzyme complexes II (succinate dehydrogenase: SD) and IV (cytochrome c oxidase: COX) in cultured cells lacking mtDNA (Rho0 cells) derived either chemically by exposure of normal cells to ethidium bromide, or genetically in cells derived from a patient with mtDNA depletion syndrome. Both control cells and early passage patient-derived cells express a normal complement of SD and COX subunit proteins. Ethidium bromide treatment of normal cells and in vitro cell proliferation of patient-derived cells caused both populations to acquire identical Rho0 phenotypes. As expected, they lack mtDNA-encoded subunits COX-I and COX-II. In contrast, nDNA-encoded subunits are affected differentially, with some (COX-VIc) lacking and others (COX-IV, COX-Va, SD 30 and SD 70) maintained at somewhat reduced levels. We suggest that the differential stability of nDNA-encoded subunits in the absence of intact enzyme complexes is due to the ability of some, but not all, subunits to associate as partial complexes in the absence of mtDNA-encoded subunits.