Indian Journal of Orthopaedics最新文献

{"title":"Half-Yearly Reflections from the IJO Editorial Office.","authors":"Srinivas B S Kambhampati, Murali Poduval","doi":"10.1007/s43465-025-01450-1","DOIUrl":"https://doi.org/10.1007/s43465-025-01450-1","url":null,"abstract":"","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 7","pages":"861-862"},"PeriodicalIF":1.1,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Case of Vertebral Intraosseous Arteriovenous Fistula with Large Epidural Venous Varices and Vertebral Collapse: Multimodal Imaging and Treatment Options.","authors":"Nitish Gupta, B T Pushpa, Ajoy Prasad Shetty, Shanmuganathan Rajasekaran, Bhupendar Singh","doi":"10.1007/s43465-025-01403-8","DOIUrl":"https://doi.org/10.1007/s43465-025-01403-8","url":null,"abstract":"<p><p>Spinal arteriovenous fistulas (AVF) are uncommon spinal pathologies and the presence of exclusive intraosseous vertebral AVF is a rarity. Only a handful of cases are documented in the literature. We present a case of large vertebral intraosseous spinal AVF causing vertebral collapse with associated large epidural venous pouches causing compression and congestion of cauda equina nerve roots. We highlight the clinico-radiological features of this entity and the importance of endovascular embolization before surgery in the management of vertebral intraosseous AVF. A 22-year lady presented with complaints of low back ache that had radiation to the right lower limb. MRI and contrast enhanced CT of lumbosacral spine showed areas of L5 vertebral destruction with large vascular channels. These channels were in contiguity with multiple venous pouches present in the anterior epidural spaces. Catheter angiography showed these venous pouches draining into the paravertebral venous plexus. The intraosseous AVF was completely occluded by the techniques of transarterial embolization with glue. The symptoms showed significant reduction after embolization. Although extremely rare, spinal intraosseous AVFs can develop and cause symptoms like back ache, congestive myelopathy and compressive myelopathy. Endovascular embolization is useful for the cases of spinal intraosseous AVFs as the primary treatment method and can be used presurgery in patients requiring vertebral instrumentation for stabilisation of the spine.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 7","pages":"1007-1011"},"PeriodicalIF":1.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calcific Myonecrosis: Case Report of a Rare Clinical Presentation and Literature Review.","authors":"Vikas Maheshwari, Danish V, Vikas Olkha, Mohit Dhingra, Cury Sharma, Anil Regmi","doi":"10.1007/s43465-025-01428-z","DOIUrl":"https://doi.org/10.1007/s43465-025-01428-z","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Calcific myonecrosis is a rare entity characterized by coagulative and liquefactive necrosis with calcifications of the entire muscle mass of the involved compartment secondary to post-traumatic compartment syndrome. There is limited literature on the rare disease with technical difficulties and pitfalls of operative procedures in these patients.</p><p><strong>Presentation of case: </strong>A 52-year-old male presented with complaints of swelling over his right leg with discharging sinus over the past 2 years following a surgical intervention. He was diagnosed as a case of calcific myonecrosis based on history and clinico-radio-histological correlation and was managed successfully with en bloc excision with vacuum-assisted closure (VAC) of wound.</p><p><strong>Clinical discussion: </strong>A rare musculoskeletal condition is characterized by muscle necrosis and extensive calcification within a limb compartment, typically following post-traumatic compartment syndrome involving muscle and neurovascular structures. Diagnosis relies heavily on radiological findings, such as calcifications and adjacent bone erosions, while histopathology is crucial to exclude malignancy. A high index of clinical suspicion is essential for timely identification.</p><p><strong>Conclusion: </strong>Calcific myonecrosis requires a multi-factorial approach to reach to a diagnosis, with ruling out the differentials and proper preoperative plan are the key to success. If un-infected, it is a \"Touch me not disease\"; however, through debridement or en-mass excision of compartment with VAC therapy should be considered for infected cases.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 7","pages":"1000-1006"},"PeriodicalIF":1.1,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial IOA Special Edition.","authors":"Ashish Babhulkar, Saseendar Shanmugsundaram, Nitesh Gahlot","doi":"10.1007/s43465-025-01397-3","DOIUrl":"https://doi.org/10.1007/s43465-025-01397-3","url":null,"abstract":"","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 6","pages":"709"},"PeriodicalIF":1.1,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Intermittent Teriparatide Facilitate Supraphysiological-Rate Distraction Osteogenesis? A Feasibility Study in the Rabbit Tibial Lengthening Model.","authors":"Siddhartha Sharma, John Khing, Navin Kumar, Ram Naresh, Pravir Sihota, Mandeep S Dhillon, Sameer Aggarwal, Pebam Sudesh","doi":"10.1007/s43465-025-01420-7","DOIUrl":"https://doi.org/10.1007/s43465-025-01420-7","url":null,"abstract":"<p><strong>Background: </strong>Intermittent teriparatide administration is known to accelerate and promote bone healing. We wanted to investigate if intermittent teriparatide administration could facilitate supraphysiological-rate distraction osteogenesis (DO) in the rabbit tibial lengthening model without compromising on the regenerate quality.</p><p><strong>Methods: </strong>24 New Zealand white rabbits underwent tibial lengthening of 10 mm by distraction osteogenesis and were divided into two groups. Group A (<i>n</i> = 12) underwent DO at the physiological (standard) rate of 0.75 mm per day and Group B (<i>n</i> = 12) underwent DO at the supraphysiological (accelerated) rate of 1.5 mm per day. Subgroups A1 and B1 received intermittent teriparatide, whereas subgroups A2 and B2 received saline as the vector control. The latency period (7 days) was equal in both groups. The consolidation phase was 2.5 times the distraction phase. Outcome parameters included mortality, number of failures of DO, regenerate volume, bone mineral density and strength of the regenerate as determined by the three-point bending test parameters (stiffness, work to failure and ultimate load to failure).</p><p><strong>Results: </strong>There was one mortality in each group. Failure of distraction osteogenesis was noted in one animal in groups A1, A2 and B1, and four animals in Group B2. Kaplan-Meir survival analysis revealed significantly higher failures in Group B2 (log-rank test <i>P</i> value = 0.02). ANOVA revealed significant difference in regenerate stiffness (<i>P</i> = 0.04) among the four groups. However, the total volume, bone mineral density, work to failure and ultimate load to failure parameters were not significantly different among the four groups.</p><p><strong>Conclusion: </strong>This feasibility study provides proof of concept of using teriparatide to accelerate distraction osteogenesis to supraphysiological levels, without compromising on the regenerate quality.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 7","pages":"982-989"},"PeriodicalIF":1.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Autologous Platelet-Rich Plasma for the Treatment of Ankle Sprain: A Systematic Review of Literature with Limited Meta-Analysis.","authors":"Sumit Banerjee, Shalini Mishra, Rajesh Kumar Rajnish, Sandeep Kumar Yadav, Saurabh Gupta, Abhay Elhence","doi":"10.1007/s43465-025-01418-1","DOIUrl":"https://doi.org/10.1007/s43465-025-01418-1","url":null,"abstract":"<p><strong>Background: </strong>Lateral ankle sprains are common among active individuals and, if not managed properly, can result in recurrent sprains, chronic instability, and post-traumatic ankle osteoarthritis. Standard treatment includes physical therapy and a brief period of rest, followed by early functional rehabilitation. Autologous platelet-rich plasma, which is rich in growth factors, has demonstrated promising healing responses in acute ankle sprains. This systematic review assessed the current evidence regarding the efficacy and adverse events associated with autologous PRP injection in acute ankle sprain injuries.</p><p><strong>Method: </strong>This systematic review adhered to PRISMA guidelines. An electronic search was performed across PubMed, Embase, Scopus, and Cochrane Library using specific keywords. Eligible studies comprised prospective or retrospective comparisons of autologous PRP injection versus control for acute ankle sprain injuries reported in English.</p><p><strong>Results: </strong>Three randomized controlled trials and one prospective comparative study met the inclusion criteria, involving 85 ankle injuries in 84 autologous PRP injection groups and 57 ankle injuries in 56 patients in the control group. Autologous PRP injection provided superior short-term pain relief, functional outcomes, and an earlier return to activity and sports, as well as improved radiological outcomes compared to the control group. However, during the follow-up period, both groups exhibited comparable results in terms of Visual Analog Scale (VAS) scores and functional outcomes, with no reported adverse events. A meta-analysis of limited data for VAS and American Orthopaedic Foot and Ankle Society scores demonstrated comparable outcomes between the two groups.</p><p><strong>Conclusion: </strong>Autologous PRP injection appears to play a beneficial role in acute ankle sprains by reducing pain, expediting return to play, and enhancing function, with no reported adverse events.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 7","pages":"910-919"},"PeriodicalIF":1.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Removal of Metalwork After Lisfranc Fracture-Dislocation Internal Fixation: A Retrospective Study from a Major Trauma Centre with More Than 2 Years of Follow-Up.","authors":"Sherif Ahmed Kamel, Mayur Mohan, Wagih Moussa, Syed Anjum","doi":"10.1007/s43465-025-01416-3","DOIUrl":"https://doi.org/10.1007/s43465-025-01416-3","url":null,"abstract":"<p><strong>Purpose: </strong>Lisfranc injuries are considered rare but significant injuries. There are debates about the best treatment approach, and removal of metalwork is one of them. This study aims to compare the functional outcomes and complications of patients who had the removal of metalwork after Lisfranc fixation and those who retained it.</p><p><strong>Materials and methods: </strong>This study was a retrospective review of patients admitted from 01/01/2017 to 31/07/2020 at University Hospitals of Southampton NHS Foundation Trust, UK, who had internal fixation for Lisfranc injuries. Group A were patients who had retained metalwork, and group B were patients who had metalwork removed. In subgroup B1, removal of metalwork was planned, whilst this was unplanned in subgroup B2. The primary outcome was the Manchester-Oxford Foot Questionnaire (MOXFQ) at the final follow-up. The secondary outcome was the rate of complications.</p><p><strong>Results: </strong>Initial search showed 124 patients. Forty-two patients were included in the study after the exclusion. The average age was 44.6 years (range 19-77 years; SD 15.4). The average follow-up was 57 months (range 33-78 months; SD 14). Eighteen patients (43%) responded to the final telephone appointments for MOXFQ. There was no statistically significant difference in all domains and the Index of MOXFQ between both groups. Relative risks were 0.16 to 2.38 across the range of complications, but none of them was statistically significant <i>(p</i> = 0.14-0.86).</p><p><strong>Conclusion: </strong>We conclude that there was no functional difference between removal and retention of metalwork in Lisfranc fracture dislocation. We recommend removal of metalwork only if indicated. Close follow-up is necessary for the patients to assess the potential complications.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 7","pages":"973-981"},"PeriodicalIF":1.1,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-Stage Revision for Treatment of Prosthetic Joint Infection in Total Hip Arthroplasty.","authors":"H Humphries, W Wignadasan, A Fontalis, A Alsheddi, M Shaeir, F S Haddad","doi":"10.1007/s43465-025-01405-6","DOIUrl":"10.1007/s43465-025-01405-6","url":null,"abstract":"<p><p>Total hip arthroplasty (THA) is a highly successful procedure for managing hip osteoarthritis, with increasing numbers performed yearly. Prosthetic joint infection (PJI) is a devastating complication which remains one of the leading causes of implant failure and is increasing in prevalence, resulting in significant morbidity, mortality, and economic burden. Traditional management of PJI has relied on two-stage revision, but recent evidence suggests that single-stage revision may be an effective alternative for select patients. This review looks at the pathogenesis, diagnosis and classification of PJI in THA, and examines the current literature on single-stage revision for PJI in THA, including its indications, surgical technique, and clinical outcomes. Indication of the procedure is determined by the patient comorbidities and biology, and micro-organism characteristics. The surgical technique involves the removal of infected implants, thorough debridement, and reimplantation of a new prosthesis within the same procedure. Single-stage revision is associated with reduced hospital stays, lower costs, and improved patient satisfaction compared to two-stage revision. While successful eradication of infection depends on factors such as host immunity, pathogen virulence, and soft tissue viability, studies have demonstrated comparable or superior infection-free survival rates for single-stage revision. Recent advances in microbiological diagnostics, biofilm disruption techniques, and multidisciplinary perioperative management have further enhanced the efficacy of single-stage revision. Despite some contraindications, including highly resistant organisms and severe soft tissue compromise, high-volume centers have expanded their indications with promising results. As the demand for THA continues to rise, optimizing PJI treatment strategies is critical. This review highlights the growing role of single-stage revision as a viable and cost effective approach for managing PJI in carefully selected patients.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 7","pages":"901-909"},"PeriodicalIF":1.1,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suprapectoral Biceps Tenodesis for Isolated SLAP Tears in Competitive Athletes Yields High Return to Sport Rates: Prospective Cohort Study of 50 Athletes.","authors":"Manit Arora, Jay Shah, Smit Prajapati","doi":"10.1007/s43465-025-01387-5","DOIUrl":"10.1007/s43465-025-01387-5","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical treatment of isolated SLAP tears has traditionally been SLAP repair, however, persistent pain, low return to sport rates and biological healing issues have led to newer treatment options. Biceps tenodesis has recently shown lower post-operative pain scores, higher return to sport and better functional outcome scores compared to SLAP repairs. The purpose of the present study was to assess the functional outcomes and return to sport for athletes undergoing suprapectoral biceps tenodesis.</p><p><strong>Methods: </strong>Institutional ethics approval was obtained from the institutional ethics review board prior to initiation of the study. Athletes presenting to the shoulder clinic with clinical and radiological evidence of isolated SLAP tears were recruited for the study prospectively between January 2023 and October 2023. Patients were assessed using functional outcome measures (UCLA and Constant scores) and pain measure (VAS score) for six months duration. Return to sport and return to sport at pre-injury level were also assessed.</p><p><strong>Results: </strong>Pain and functional outcome scores improved significantly over the study duration with maximal improvement in the first three months post-surgery approaching near maximum scores. Between the third and six-month follow-up a plateau phase is described. All patients returned to sport after surgery with average RTS at 5.2 ± 1.1 months post-surgery with 82% returning to sport at a pre-injury level.</p><p><strong>Conclusion: </strong>Biceps tenodesis is a safe and reproducible procedure for the treatment of isolated SLAP tears in athletes. The present study, the first of its kind for Indian athletes, shows that biceps tenodesis has excellent functional outcomes and a high rate of return to sport.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 6","pages":"833-839"},"PeriodicalIF":1.1,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Sexual and Functional Outcomes After Direct Anterior Approach Total Hip Arthroplasty: Insights from a Retrospective Study.","authors":"Supreet Bajwa, Ravi Teja Rudraraju, Kunal Aneja, Ponnanna Karineravanda Machaiah, Nitin Dawre","doi":"10.1007/s43465-025-01399-1","DOIUrl":"https://doi.org/10.1007/s43465-025-01399-1","url":null,"abstract":"<p><strong>Purpose of the study: </strong>The direct anterior approach (DAA) is favored for its muscle-sparing benefits and rapid recovery after total hip arthroplasty (THA). While functional outcomes are well-documented, the impact of DAA THA on sexual health remains underexplored. This study evaluates the resumption of sexual activity and functional recovery in male patients following DAA THA.</p><p><strong>Methods: </strong>A retrospective review of male patients who underwent DAA THA (January 2023 and December 2023) was assessed pre- and post-operatively (2 weeks, 12 weeks, and 1-year) for sexual function using the Sexual Health Inventory for Men (SHIM) and hip functionality through the Harris Hip Score (HHS). Statistical significance was set at <i>p</i> < 0.05.</p><p><strong>Results: </strong>Among 64 patients (mean age: 31.4 ± 4.9 years), 73.5% resumed sexual activity within 2 weeks, rising to 95% by 12 weeks. Of those sexually active within 2 weeks, 93% reported a SHIM score of ≥ 20. By 1 year, all patients resumed sexual activity with a mean SHIM score of 23.5. Functional recovery showed a significant improvement in HHS from 39.3 ± 1.4 pre-operatively to 98.9 ± 0.9 at 1 year (<i>p</i> < 0.05). Minor complications, including superficial wound dehiscence (<i>n</i> = 2), were conservatively managed, with no dislocations or major complications reported.</p><p><strong>Conclusion: </strong>DAA THA improves hip function and early resumption to sexual activity, an essential yet overlooked aspect in younger male patients. With 95% resuming sexual activity within 12 weeks and full functional restoration by 1 year, DAA THA proves as a safe and effective approach, making it an ideal choice for active, young individuals seeking physical and personal well-being after surgery.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 7","pages":"967-972"},"PeriodicalIF":1.1,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}