About

O. Folorunsho Edobor-Osula, MD, MPH, is a board-certified pediatric orthopaedic surgeon at Rutgers North Jersey Orthopaedic Institute and an associate professor in the Department of Orthopaedics at Rutgers New Jersey Medical School. She serves as an attending physician at multiple medical centers including University Hospital in Newark, Saint Barnabas Medical Center in Livingston, St. Joseph's Medical Center in Patterson, and Newark Beth Israel Medical Center. Dr. Osula completed a clinical fellowship in pediatric orthopaedic surgery at the Hospital for Special Surgery in New York City and completed her orthopaedic residency at Northwell Health - Hofstra School of Medicine. She earned her medical degree from Weill Cornell Medical College, graduating with honors, and received the Sandra Lee Shaw Memorial award for her commitment to medical research. Additionally, she holds a Master's in Public Health from the University of Albany, where she was awarded the Axelrod Scholarship, and a Bachelor's degree in Public Health/Natural Sciences from Johns Hopkins University, where she also played varsity women's basketball. Her research interests include limb lengthening and deformity, hip disorders, cerebral palsy, pediatric trauma, sports medicine, and disorders of the foot and ankle. Dr. Osula has authored numerous peer-reviewed publications, book chapters, and abstracts, and actively mentors students through programs such as the Summer Medical and Dental Education Program. She is the Director of Diversity, Equity, and Inclusion for the Department of Orthopaedic Surgery at NJMS and is a member of professional organizations including the American Academy of Orthopaedic Surgeons and the Pediatric Orthopaedic Society of North America.

Selected publications

• Who is at Risk for Implant Irritation After Fixation of a Tibial Tubercle Fracture? A Multicenter Study

  Journal of Pediatric Orthopaedics · 2025-02-21 · 3 citations

  article

  BACKGROUND: Tibial tubercle fractures are typically treated surgically with screws. Implant irritation is the most common complication. However, detailed investigation of this problem is challenging, since most research is limited to small, single-center studies. Understanding who is at the highest risk may improve patient counseling and potentially guide surgical techniques. The purpose of this study is to identify risk factors for implant irritation in patients undergoing fixation of tibial tubercle fractures. METHODS: This retrospective cohort study included tibial tubercle fractures fixed with screws at 7 tertiary children's hospitals in the Tibial Tubercle Study (TITUS) Group. Exclusion criteria included age 18 years or older, primary fixation with nonscrew implants, or <6 months of follow-up. Demographic, perioperative, and postoperative data was collected. The primary outcome of interest was postoperative implant irritation. Univariable analysis was followed by multivariable regression to adjust for confounders. Odds ratios (OR) are reported with 95% CIs. RESULTS: Of the 475 patients included, implant irritation was reported in 12.8% while 10.7% subsequently underwent unplanned removal. Patients weighing <70 kg reported more irritation than those weighing 70 kg or more (17.3% vs. 9.4%, P =0.01). However, in patients weighing <70 kg, there was no difference in the rate of symptomatic implants when stratifying by screw size. White patients reported more irritation than nonwhite patients (24.8% vs. 9.6%, P <0.001). Significant institutional variation in implant irritation rates was reported, ranging from 0% to 29% ( P =0.004). Screw number, size, configuration, washer use, or pre-existing Osgood-Schlatter syndrome were not associated with symptomatic implants. When adjusting for confounders in multivariable analysis, white patients (OR: 3.2, 95% CI: 1.5-6.6; P =0.002) and those weighing <70 kg (OR: 2.2, 95% CI: 1.2-4.2; P =0.02) had higher odds of experiencing implant irritation. One of the 7 study sites was also independently associated with increased odds of symptomatic screws (OR: 7.8, 95% CI: 1.1-54.9; P =0.04). CONCLUSIONS: Implant irritation was reported by 12.8% of patients following screw fixation of a tibial tubercle fracture. Even when accounting for institutional variability, white patients and those weighing <70 kg had higher odds of symptomatic screws. This information can be used to enhance patient counseling and potentially adjust surgical techniques in some patients. LEVEL OF EVIDENCE: Level III.

  PublisherDOI

• Risk Factors for Stiffness After Fixation of Tibial Tubercle Fractures: A Multicenter Study From the TITUS Group

  JBJS Open Access · 2025-07-01

  articleOpen access

  Background: Persistent stiffness after operative treatment of tibial tubercle fractures (TTFs) can inhibit functional recovery and interfere with activities of daily living. Given the rare nature of this fracture, little data exist to help identify risk factors for this complication. The purpose of this multicenter study was to identify risk factors for stiffness after fixation of TTFs. Methods: Operatively managed TTFs at 7 tertiary children's hospitals in patients younger than 18 years were included in this retrospective comparative study. Fractures with <3 months of documented postoperative range of motion and those fixed with nonscrew implants were excluded. Demographic, clinical, and radiographic data were reviewed. Persistent stiffness was defined as lacking ≥20° of flexion compared with the contralateral knee at 3 months after surgery. Univariable analysis was followed by multivariate regression to adjust for confounders. Results: The incidence of prolonged stiffness among the 369 included patients was 3.0%. The median time between initial presentation and surgery was longer in those who developed stiffness (24 versus 14 hours, p = 0.002). Furthermore, those who had surgery >24 hours after presentation developed stiffness more often than those who underwent fixation within 24 hours (12.7% versus 1.6%, p < 0.001). The median duration of postoperative immobilization was longer in patients who developed stiffness (45 versus 28 days, p = 0.006). Children immobilized >4 weeks after surgery developed stiffness more frequently than those who initiated mobilization within 4 weeks (5.7% versus 0.6%, p = 0.009). When adjusting for confounders such as age and fracture classification, fixation >24 hours after presentation was associated with 9.7 times higher odds of stiffness (95% CI 2.0-46.5, p = 0.004) and postoperative immobilization >4 weeks had 10.3 times higher odds of stiffness (95% CI 1.1-95.0, p = 0.04). Conclusions: Persistent stiffness after surgical fixation of TTFs occurs in 3.0% of children. Prolonged postoperative immobilization (>4 weeks) and delayed surgical fixation (>24 hours) are associated with higher odds of a persistent flexion deficit 3 months after surgery. Surgeons should consider this information when determining timing of treatment and postoperative protocols. Level of Evidence: Level III, retrospective comparative study. See Instructions for Authors for a complete description of levels of evidence.

  PublisherDOI

• Are Routine Post–Cast Removal Radiographs and a Second Follow-up Appointment Necessary in the Management of Nondisplaced or Minimally Displaced Distal Radius Fractures?

  Journal of the Pediatric Orthopaedic Society of North America · 2025-03-08 · 2 citations

  articleOpen accessSenior author

  Background: The effectiveness of routine follow-up radiographs and appointments after cast removal when managing minimally displaced pediatric distal radius fractures has not been conclusively proven. This study aims to assess how often follow-up appointments and radiographs taken after cast removal alter management of patients with minimally displaced distal radius fractures. Methods: A single-center retrospective chart review was conducted on patients under 18 years of age with minimally displaced distal radius fractures between 2017 and 2023. Demographic information, fracture characteristics, time to follow-up, and each appointment outcome were recorded. A change in patient management following post-cast removal radiographs was defined as a need for closed reduction, operative intervention, or prolonged immobilization. The second follow-up appointment was considered to modify management if it necessitated a physical therapy referral or an additional office visit. Unscheduled appointments and any changes in fracture alignment during follow-up visits were also noted. Results: Ninety-three patients met the inclusion criteria; 1.1% (1 of 93) of patients had their management changed following their post-cast removal radiographs according to our criteria. One patient was indicated for prolonged immobilization for a visible fracture line; no patients were indicated for surgery or closed reduction. Thirty-eight patients who underwent cast removal attended their 2nd follow-up appointment; 2.6% (1 of 38) of patients had their management changed according to our criteria. One patient required an additional follow-up appointment for a physeal check; no patient required a physical therapy referral. Two patients had an unscheduled appointment after discharge of care, due to parental desire of recovery confirmation before returning to gym play. No changes in fracture alignment were observed during any follow-up radiographs. Conclusions: This study suggests that post-cast removal radiographs and second follow-up appointments rarely alter management of minimally displaced distal radius fractures. Limiting unnecessary visits and imaging could reduce costs and ease the burden on patients and families. Key Concepts: 1) Post-cast removal radiographs rarely altered management for minimally displaced pediatric distal radius fractures.2) Only 1.1% of patients required prolonged immobilization, with no cases needing surgery or closed reduction.3) Second follow-up appointments infrequently changed management, with only 2.6% of patients requiring an additional visit.4) Unscheduled visits were primarily driven by parental concerns rather than clinical necessity.5) No changes in fracture alignment were observed in any follow-up radiographs. Level of Evidence: Level IV - case series.

  PublisherDOI

• Multiple Diagnoses of Nutritional Rickets in An Inner-City Pediatric Population: A Case Series

  Journal of Orthopedics and Orthopedic Surgery · 2024-01-19 · 4 citations

  articleOpen accessSenior author

  This case series details seven pediatric cases of nutritional rickets in an inner-city population of New Jersey. Eighty six percent of these patients were exclusively breast fed, and all self-identified as black or African American. Patients ranged in age from 8 months to 3 years at the time of initial diagnosis. All seven patients were male. Five patients were presented in an office setting, while two were found to have nutritional rickets in an emergency setting. Patients demonstrated classic pathognomonic findings of rickets, including three patients with rachitic rosary. The aim of this case series is to emphasize the importance of surveillance and high clinical suspicion for nutritional rickets, particularly in children with darker skin complexions and who were exclusively breast-fed during infancy. Rapid diagnosis and intervention may delay or negate the need for orthopedic surgical intervention.

  PublisherOA PDFDOI

• Hemiplateau Elevation for Early-Onset Blount Disease

  2024-01-01

  book-chapter1st authorCorresponding
  PublisherDOI

• Evaluating the Readability of Patient Education Materials for Anterior Vertebral Body Tethering, Distraction-Based Methods, and Posterior Spinal Fusion for the Treatment of Pediatric Spinal Deformity

  The International Journal of Spine Surgery · 2024-04-01 · 3 citations

  articleOpen access

  <h3>Background</h3> The Internet is an important source of information for patients, but its effectiveness relies on the readability of its content. Patient education materials (PEMs) should be written at or below a sixth-grade reading level as outlined by agencies such as the American Medical Association. This study assessed PEMs’ readability for the novel anterior vertebral body tethering (AVBT), distraction-based methods, and posterior spinal fusion (PSF) in treating pediatric spinal deformity. <h3>Methods</h3> An online search identified PEMs using the terms “anterior vertebral body tethering,” “growing rods scoliosis,” and “posterior spinal fusion pediatric scoliosis.” We selected the first 20 general medical websites (GMWs) and 10 academic health institution websites (AHIWs) discussing each treatment (90 websites total). Readability tests for each webpage were conducted using Readability Studio software. Reading grade levels (RGLs), which correspond to the US grade at which one is expected to comprehend the text, were calculated for sources and independent <i>t</i> tests compared with RGLs between treatment types. <h3>Results</h3> The mean RGL was 12.1 ± 2.0. No articles were below a sixth-grade reading level, with only 2.2% at the sixth-grade reading level. AVBT articles had a higher RGL than distraction-based methods (12.7 ± 1.6 vs 11.9 ± 1.9, <i>P</i> = 0.082) and PSF (12.7 ± 1.6 vs 11.6 ± 2.3, <i>P</i> = 0.032). Materials for distraction-based methods and PSF were comparable (11.9 ± 1.9 vs 11.6 ± 2.3, <i>P</i> = 0.566). Among GMWs, AVBT materials had a higher RGL than distraction-based methods (12.9 ± 1.4 vs 12.1 ± 1.8, <i>P</i> = 0.133) and PSF (12.9 ± 1.4 vs 11.4 ± 2.4, <i>P</i> = 0.016). <h3>Clinical Relevance</h3> Patients’ health literacy is important for shared decision-making. Assessing the readability of scoliosis treatment PEMs guides physicians when sharing resources and discussing treatment with patients. <h3>Conclusion</h3> Both GMWs and AHIWs exceed recommended RGLs, which may limit patient and parent understanding. Within GMWs, AVBT materials are written at a higher RGL than other treatments, which may hinder informed decision-making and patient outcomes. Efforts should be made to create online resources at the appropriate RGL. At the very least, patients and parents may be directed toward AHIWs; RGLs are more consistent. <h3>Level of Evidence</h3> 3.

  PublisherOA PDFDOI

• What is the Utilization and Impact of Advanced Imaging for Tibial Tubercle Fractures? An Analysis of 598 Patients From the Tibial Tubercle Study (TITUS) Group

  Journal of Pediatric Orthopaedics · 2024-07-09 · 3 citations

  article

  BACKGROUND: Given the rare nature of tibial tubercle fractures, previous studies are mostly limited to small, single-center series. This results in practice variation. Previous research has shown poor surgeon agreement on utilization of advanced imaging, but improved evidence-based indications may help balance clinical utility with resource utilization. The purpose of this study is to quantify diagnostic practices for tibial tubercle fractures in a large, multicenter cohort, with attention to the usage and impact of advanced imaging. METHODS: This is a retrospective series of pediatric tibial tubercle fractures from 7 centers between 2007 and 2022. Exclusion criteria were age above 18 years, missing demographic and pretreatment data, closed proximal tibial physis and tubercle apophysis, or a proximal tibia fracture not involving the tubercle. Demographic and injury data were collected. Fracture classifications were derived from radiographic evaluation. The utilization of advanced imaging was recorded as well as the presence of findings not identified on radiographs. Standard descriptive statistics were reported, and χ 2 tests were performed (means reported±SD). RESULTS: A total of 598 patients satisfied the inclusion criteria, of which 88.6% (530/598) were male with a mean age of 13.8±1.9 years. Internal oblique x-rays were obtained in 267 patients (44.6%), computed tomography (CT) in 158 (26.4%), and magnetic resonance imaging (MRI) in 64 (10.7%). There were significant differences in the frequency at which CT (7.2% to 79.4%, P <0.001) and MRI were obtained (1.5% to 54.8%, P <0.001). CT was obtained most frequently for Ogden type IV fractures (50/99, 50.5%), and resulted in novel findings that were not visualized on radiographs in a total of 37/158 patients (23.4%). The most common finding on CT was intra-articular fracture extension (25/37). MRI was obtained most frequently for Ogden type V fractures (13/35, 37.1%), and resulted in novel findings in a total of 31/64 patients (48.4%). The most common finding was patellar tendon injury (11/64), but only 3 of these patients required tendon repair. CONCLUSIONS: Substantial variation exists in the diagnostic evaluation of tibial tubercle fractures. CT was most helpful in clarifying intra-articular involvement, while MRI can identify patellar tendon injury, periosteal sleeve avulsion, or a nondisplaced fracture. This study quantifies variation in diagnostic practices for tibial tubercle fractures, highlighting the need for evidence-based indications for advanced imaging. LEVEL OF EVIDENCE: Level III.

  PublisherDOI

• 13 Year Old with Unilateral Late-Onset Blount Disease

  2024-01-01

  book-chapter1st authorCorresponding
  PublisherDOI

• My radius is broken – do I need a cast or is a splint enough?

  Current Opinion in Pediatrics · 2023-10-26

  articleSenior author

  PURPOSE OF REVIEW: The treatment of many distal radius fractures has shifted from casting to splinting or the application of a soft dressing. This review includes a review of the types of pediatric distal radius fractures and the most recent literature on the management of these injuries. RECENT FINDINGS: Many nondisplaced distal radius fractures may be treated with removable splints or bandages. This mitigates complications with cast immobilization. Additionally, many of these injuries do not require follow-up treatment and thereby reduce healthcare costs. SUMMARY: This update on distal radius fractures in the pediatric population highlights changes in the treatment paradigm and demonstrates an opportunity to diminish healthcare costs.

  PublisherDOI

• Surgical prophylaxis in pediatric orthopedic patients with penicillin allergy: a multicentered retrospective prognostic study

  Journal of Pediatric Orthopaedics B · 2023-09-11 · 1 citations

  articleSenior author

  Up to 20% of orthopedic surgeons still avoid the use of cephalosporins in patients with penicillin allergies despite its reported safety in the adult and general surgery pediatric population. The primary objective is to determine the incidence of adverse effects and allergic reactions when using cephalosporins in pediatric orthopedic patients labeled as penicillin-allergic as compared to those without previously reported penicillin allergy. A multicenter retrospective chart review was performed across three level 1 trauma centers from January 2013 to February 2020 to identify penicillin-allergic as well as non-penicillin-allergic pediatric patients treated for orthopedic injuries. Data were collected regarding patient demographics, antibiotic administered, timing of antibiotic administration, reported drug allergy, and described allergic reaction. Postoperative or intraoperative allergic reactions to antibiotics, surgical site infections, and complications were recorded. A total of 2289 surgeries performed by four fellowship-trained surgeons were evaluated. Eighty-five patients diagnosed with penicillin allergy were identified and underwent 95 surgeries and 95 patients without previously reported penicillin allergy underwent 95 surgeries. One patient, with a documented history of anaphylaxis to cefazolin, sustained an anaphylactic reaction intraoperatively to cefazolin. There were no other reported reactions, surgical site infections, or complications. There was no statistically significant difference in rate of allergic reaction in patients with previously reported penicillin allergy treated with cefazolin and those with no previous reported reaction ( P > 0.05). Prophylaxis with cephalosporins is not associated with increased risk for allergic reaction. Cephalosporins can be safely administered to pediatric patients with penicillin allergy undergoing orthopedic intervention. Level of evidence: Level II, Multicenter Retrospective Prognostic Study.

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Labs

• Rutgers North Jersey Orthopaedic Institute (RNJOI)PI

Awards & honors

• Sandra Lee Shaw Memorial award
• Axelrod Scholarship from the University of Albany School of…