Catherine J Fedorka

Drexel University, Filadelfia, Pennsylvania, United States

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Publications (10)19.58 Total impact

  • Catherine J Fedorka · Mary K Mulcahey
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    ABSTRACT: Abstract The shoulder is the most common joint to dislocate in the human body, with the dislocation often occurring in the anterior direction. This injury frequently results in soft tissue injury (eg, labral tear, capsular stretching) or bone injury (eg, glenoid or humeral head bone loss), which commonly leads to persistent deficits of shoulder function and a high risk of subsequent instability episodes in young, active patients. Patients with a significant degree of glenoid bone loss (> 25%) may require surgical intervention using the Latarjet procedure, which is an open bony augmentation of the glenoid. This procedure involves transferring the tip of the coracoid to the anteroinferior glenoid, creating a bony block and musculotendinous sling to prevent instability. Rehabilitation after the procedure is a slow progression over 4 to 6 months to regain range of motion and strength, while protecting the bony augmentation. Recent reports have shown success with the Latarjet procedure, as indicated by patient satisfaction scores and a low rate of recurrent instability.
    No preview · Article · Jan 2015 · The Physician and sportsmedicine
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    ABSTRACT: The incidence of patella baja in total knee arthroplasty (TKA) revisions for aseptic and septic causes is not well defined. We retrospectively reviewed 101 mobile-bearing TKA revisions performed between 2003 and 2009. Aseptic (n = 67) and septic (n = 34) revisions were compared for patella baja. A nonarticulating spacer was used as the initial treatment for infected cases. The Insall-Salvati ratio was radiographically measured before surgery (preexplant for septic revisions) and at latest follow-up (postreplant for septic revisions). Mean (SD) Insall-Salvati ratio did not differ between groups before surgery, 1.00 (0.25) for aseptic and 0.96 (0.22) for septic, but differed significantly after surgery, 0.99 (0.23) for aseptic and 0.77 (0.24) for septic. After correcting for preoperative patellar height, there was a statistically significant postoperative difference between aseptic cases, 1.09 (0.19), and septic cases, 0.82 (0.21). There was also a significant difference in mean (SD) postoperative range of motion (ROM) between aseptic cases, 108.0° (20.7°), and septic cases, 92.2° (34.6°), and decreased ROM between cases with patella baja, 95.1° (31.6°) and cases without patella baja, 106.8° (23.6°). TKA revisions done for septic causes using a nonarticulating spacer resulted in a higher incidence of patella baja and decreased ROM.
    No preview · Article · Dec 2014 · American journal of orthopedics (Belle Mead, N.J.)
  • Antonia F. Chen · Catherine J. Fedorka · Brian A. Klatt
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    ABSTRACT: Above-the-knee amputation (AKA) is a last-resort surgical option for the treatment of periprosthetic joint infection (PJI) with resistant organisms or with recurrent infections. Certain circumstances are unique to performing AKAs after total knee arthroplasty (TKA). When performing an AKA, the factors that require special attention include the indications for surgery, presentation and comorbidities, level of amputation, possible prosthesis removal, and potential complications. This chapter includes a discussion of the surgical techniques, postoperative stump care, options for prostheses, functional status, and long term follow up after AKA. This chapter provides comprehensive and relevant information for assessing, performing, and treating AKA patients after infected TKAs. © 2014 Springer Science+Business Media New York. All rights are reserved.
    No preview · Chapter · Sep 2014
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    ABSTRACT: A private payer database was used to examine the incidence and rates of knee arthroscopy in patients less than 65years of age and the subsequent risk of knee arthroplasty. Time to event analysis was performed using the Kaplan-Meier method; also, Cox regression analysis was used to evaluate the relative risk of subsequent knee arthroplasty for arthroscopic patients. Overall, 247,034 knee arthroscopies, done for injury or arthropathy, were identified between 2004 and 2009. Within 1-year of arthroscopy, 2.2% of arthropathy patients and 0.9% of injury patients underwent a knee arthroplasty. These increased to 5.2% and 2.4% at 5-years, respectively. The risk of arthroplasty following arthroscopy increased significantly with age. Further study is warranted to examine the benefit of arthroscopy in younger patients with OA.
    No preview · Article · Jun 2013 · The Journal of arthroplasty
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    ABSTRACT: Survival after solid organ transplants in the United States is increasing, and there is a need to understand the complications in knee arthroplasty patients who underwent organ transplantation. A retrospective study was conducted from 1993-2008 on 19 patients (23 knee arthroplasties) with previous successful solid organ transplants. Eleven knee arthroplasties were performed after renal transplantation, and 12 after nonrenal solid organ transplant (seven liver, four heart, one lung). Complications occurred in 9/23 patients (39.1%) and infections occurred in 4/23 patients (17.3%). Of the infected knees, two had MRSA, one had MSSA, and one Escherichia coli. Noninfectious complications (5/24, 21.7%) include aseptic loosening, quadriceps rupture, femoral fracture, hemarthrosis, and arthrofibrosis. All patients with complications were on immunosuppressant medications at the time of arthroplasty. There was a significantly higher rate of infection in the renal group compared to the non-renal group (P = 0.022). There was also a higher overall complication rate in the renal group however this did not reach significance.
    Full-text · Article · Apr 2013 · The Journal of arthroplasty
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    ABSTRACT: Traditionally, periprosthetic joint infections (PJIs) due to gram-negative organisms are considered more difficult to manage; however, little literature exists with regard to outcome of PJI caused by gram-negative organisms. We identified 277 patients with 282 culture-positive PJI receiving surgical treatment. Thirty-one joints were treated for gram-negative PJI. The gram-negative group was then compared with the gram-positive and polymicrobial PJI. A single debridement and retention of prosthesis were successful in 70% (7/10) of isolated gram negative compared with 33.3% (13/39) of methicillin-sensitive gram positive, 48.9% (23/47) of methicillin-resistant gram positive, and 57.1% (4/7) of polymicrobial. Of those patients undergoing a planned 2-stage exchange, a successful reimplantation was performed in 52% (12/23) of gram-negative, 51% (52/103) of methicillin-resistant gram-positive, 69% (65/94) of methicillin-sensitive gram-positive, and 0% (0/8) of polymicrobial PJI cases. These results indicate that PJI due to gram-negative pathogens, although less common, is difficult to treat and is associated with limited success.
    Full-text · Article · Jun 2011 · The Journal of arthroplasty
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    ABSTRACT: This is a survey study designed to evaluate agreement among spine surgeons regarding treatment options for six clinical scenarios involving degenerative conditions of the cervical and lumbar spine. The purpose was to evaluate whether or not surgeons agree on which cases require operative intervention and what type of surgery should be performed. Agreement between spine surgeons on when to operate and what procedure to perform is a subject that has received increasing attention. This is an important question in the field of spine surgery, where "gold standards" that are based on large clinical trials are relatively sparse. Six clinical vignettes were presented to 19 members of the Degenerative Spine Study Group. Each vignette was accompanied by a series of radiographs and/or magnetic resonance imagings, followed by treatment options in multiple-choice format. Two months later, the same vignettes were sent out with identical instructions except that they were now told they were treating a close family member. More than 76% of surgeons agreed on whether or not to recommend surgical intervention for the following four cases: lumbar degenerative spondylolisthesis with stenosis, cervical herniated nucleus pulposus, lumbar spondylosis, and lumbar herniated nucleus pulposus. Two scenarios had approximately 50% surgeon agreement: cervical stenosis and lumbar spondylolysis. However, despite good inter-rater agreement about who needed surgery, there was poor agreement regarding what procedure to perform if surgery was recommended. When repeating the survey in the setting of operating on a family member, only 17 (17.7%) of 96 recommendations were changed. Spine surgeons in this survey generally agreed on when to operate but failed to agree on what type of procedures to perform.
    No preview · Article · Feb 2011 · Spine
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    ABSTRACT: Prosthetic joint infection is an uncommon but serious complication of total knee arthroplasty (TKA). Control of infection after TKA is not always possible, and the resolution of infection may require an above-knee amputation (AKA). The purpose of this study was to determine the etiology of AKA and the functional outcomes of AKA after infected TKA. We retrospectively reviewed 35 patients who underwent AKA after an infected TKA. The amputations were performed an average of 6 years (range, 21 days to 24 years) after primary TKA. There were 19 females and 16 males with a mean age of 62 years (range, 26-88 years). Patient demographic information, comorbidities, surgical treatments, cultures, and culture sensitivities were recorded. Complications and functional status, including SF-12 and activities of daily living questionnaires, after AKA were also studied. The minimum followup was 7 months (mean, 39 months; range, 7-96 months). Two patients died secondary to cardiac arrest and 13 more died during the followup period of unrelated causes. Nine patients required irrigation and débridement for nonhealing wounds after AKA and two patients had repeat AKA for bony overgrowth. Of the 14 patients fitted for prostheses, eight were functionally independent outside of the home. Patients fitted with a prosthesis had higher mean activities of daily living scores (58 versus 38) and also tended to be younger with fewer comorbidities than those who were not fitted with a prosthesis. We found low functional status in living patients with an AKA after infection with only half of the patients walking after AKA. Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
    Full-text · Article · Oct 2010 · Clinical Orthopaedics and Related Research
  • Garen Steele · Catherine J. Fedorka · Alvaro Sanchez-Ortiy · Alma Heyl · Brian A. Klatt

    No preview · Article · Apr 2010 · The Journal of Arthroplasty
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    Dann J Laudermilch · Catherine J Fedorka · Alma Heyl · Nalini Rao · Richard L McGough
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    ABSTRACT: The incidence of infection by methicillin-resistant Staphylococcus aureus (MRSA) in total knee arthroplasty (TKA) is becoming a more frequent concern, as increased morbidity following TKA has been reported for infections by resistant organisms. This study investigates whether MRSA infections are associated with decreased functional scores. We therefore compared the functional scores, operative times, and rates of reinfection of revision TKA following MRSA infection versus other indications for revision. We retrospectively reviewed charts of 101 patients (103 knees) who underwent mobile bearing TKA revision from January 2003 to September 2006, with a minimum clinical followup of 2 years in 45 knees (44%). We obtained the following indices: WOMAC, Activities of Daily Living Score (ADLS), SF-36, and Knee Society scores (KSS). Three groups of revisions were compared: MRSA infection (n = 6), non-MRSA infection (n = 9), and aseptic failure (n = 30). The three groups were similar in demographics and comorbidities. The MRSA (166 minutes) and non-MRSA groups (149 minutes) had longer operative times than the aseptic group (121 minutes). With numbers available, there were no differences in ROM, WOMAC, ADLS, KSS, and SF-36, with MRSA separate or combined with all infections. Infection recurrence between MRSA-infected knees and non-MRSA-infected knees was similar. While our study was underpowered to detect functional differences between MRSA-infected knees and non-MRSA-infected knees it does add data to the literature. Knees revised for infection have longer operative times and more frequent infection after revision. The reason for increased operative times is unclear. Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
    Full-text · Article · Mar 2010 · Clinical Orthopaedics and Related Research

Publication Stats

90 Citations
19.58 Total Impact Points


  • 2013-2015
    • Drexel University
      • Department of Orthopaedic Surgery
      Filadelfia, Pennsylvania, United States
    • Hospital of the University of Pennsylvania
      Philadelphia, Pennsylvania, United States
  • 2011
    • Thomas Jefferson University Hospitals
      Filadelfia, Pennsylvania, United States
  • 2010-2011
    • Thomas Jefferson University
      Filadelfia, Pennsylvania, United States