Indian Journal of Orthopaedics最新文献

{"title":"Paediatric Flexible Flatfeet: A Narrative Review of Conflicting Perspectives in Clinical Practice.","authors":"Saraswati Viswanathan, Nirali Mehta, Prapurna Pothukuchi","doi":"10.1007/s43465-026-01769-3","DOIUrl":"https://doi.org/10.1007/s43465-026-01769-3","url":null,"abstract":"<p><strong>Background: </strong>Paediatric flexible flatfoot (PFF), though common, lacks universally accepted diagnostic and management protocols. There is ongoing debate regarding whether it represents a pathological condition or a physiological variant. Whilst many children remain asymptomatic, evidence suggests that even those without overt symptoms may experience reduced functional capacity.</p><p><strong>Objective: </strong>This narrative review aims to summarise the current understanding of paediatric flexible flatfoot, focusing on factors influencing arch development and the various clinical approaches used in managing symptomatic children.</p><p><strong>Review of literature: </strong>Many treatment strategies have been described in literature for symptomatic children, including non-operative measures such as orthotic support and functional re-education, as well as surgical procedures such as lateral column lengthening and subtalar arthroereisis (SA).Obesity has been identified as a significant contributing factor to paediatric flexible flatfoot. With the expected rise in childhood obesity, the prevalence of flatfoot is likely to increase, highlighting the need for clear and standardised management guidelines.</p><p><strong>Conclusion: </strong>Paediatric flexible flatfoot remains a debated condition with no clear consensus regarding its clinical significance or optimal management. While most children remain asymptomatic, symptomatic cases should initially be managed with activity modification and functional re-education. Surgical procedures such as subtalar arthroereisis show promising short-term outcomes in selected patients, though further long-term studies are required to establish clear treatment guidelines.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 4","pages":"846-853"},"PeriodicalIF":1.1,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770241","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":"Preserving Our Legacy: Call for a National Series on the Evolution of Orthopaedics from Individual States of India.","authors":"Srinivas B S Kambhampati, Murali Poduval, Navin Thakkar, Lalit Maini, R H Govardhan, Rajeev Raman","doi":"10.1007/s43465-026-01753-x","DOIUrl":"https://doi.org/10.1007/s43465-026-01753-x","url":null,"abstract":"","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 4","pages":"807-808"},"PeriodicalIF":1.1,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770213","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":"Medial Patellofemoral Ligament Reconstruction: A Non-implant Technique.","authors":"Claudia Arias, César Carreño, Ronald Sánchez, Margarita Chonate, Yenny Astacio, S Samundeeswari, Saseendar Shanmugasundaram","doi":"10.1007/s43465-026-01740-2","DOIUrl":"https://doi.org/10.1007/s43465-026-01740-2","url":null,"abstract":"<p><p>Medial patellofemoral ligament (MPFL) reconstruction is a widely performed procedure for patellofemoral instability. However, there is no consensus on the optimal graft choice, fixation method, or surgical technique. Most described techniques require implants such as anchors or interference screws, which increase stiffness and cost. In many developing countries, the high cost of implants limits access to surgery. We describe a reproducible, effective, and low-cost MPFL reconstruction technique that avoids implants, using a semitendinosus autograft, a modified Fithian technique for patellar fixation, and an adductor tendon loop (\"adductor sling\") for femoral fixation. The technique was developed to minimize complications related to implant use and reduce costs, while maintaining anatomical graft placement and dynamic stability assessment. This implant-free MPFL reconstruction technique offers a safe and affordable surgical option for the management of patellofemoral instability, particularly in resource-limited settings. Socioeconomic factors should be considered when selecting a reconstruction method.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 4","pages":"893-900"},"PeriodicalIF":1.1,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769766","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":"The End of the First Quarter, A Second Part of a Very Special Issue, and Launching Curated Collections.","authors":"Murali Poduval, Srinivas B S Kambhampati, Rujuta Mehta","doi":"10.1007/s43465-026-01747-9","DOIUrl":"https://doi.org/10.1007/s43465-026-01747-9","url":null,"abstract":"","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 4","pages":"809-810"},"PeriodicalIF":1.1,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770225","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":"Functional Outcome of Single Bundle ACL Reconstruction with Superficial Quadriceps Tendon Graft in an Indian Cohort: A 3-Year Study.","authors":"Rajeev Raman, Sunit Hazra, Udeepto Lodh, Debayan Sinha Roy","doi":"10.1007/s43465-026-01750-0","DOIUrl":"https://doi.org/10.1007/s43465-026-01750-0","url":null,"abstract":"<p><strong>Background: </strong>There are only a few studies on the functional outcome of anterior cruciate ligament reconstruction using quadriceps tendon (QT) autograft. The available evidence highlights many advantages of this technique. The graft is thicker and stronger with less donor site morbidity and there is much less kneeling pain as compared to patellar tendon grafts. It is very versatile and allows harvesting as an all-soft tissue or bone-tendon graft, thereby making it suitable for various groups of patients and various surgical techniques.</p><p><strong>Objectives: </strong>To evaluate the functional outcome associated with anterior cruciate ligament reconstruction using quadriceps tendon autograft.</p><p><strong>Methods: </strong>A prospective study was conducted over a period of 3 years in a Tertiary Care Orthopedics department. The study included male and female patients aged between 20 and 50 years with symptomatic isolated ACL tears and a BMI below 40 kg/m². Patients were excluded if they had associated meniscal, cartilage, or posterior cruciate ligament injuries, bilateral or multiple knee ligament injuries, ipsilateral ankle injuries, prior knee or ankle surgery, osteoarthritic changes, active infection or restricted knee motion, or fractures involving the knee. These patients underwent ACLR with QT autograft. Functional outcomes were assessed with standardized scoring systems (Lysholm Knee Score, Subjective IKDC, Tegner Activity Scale) pre-operatively, at 1 and 3 years post-operatively.</p><p><strong>Results: </strong>The study included 50 patients with ACL injuries, most of whom were aged between 20 and 30 years and predominantly male. Nearly half of them had a healthy BMI, with the remainder being overweight or obese. Injuries were commonly caused by road traffic accidents and sports activities, and the right knee was more frequently affected. Following ACL reconstruction with a quadriceps tendon autograft, significant improvement in clinical outcomes was observed. Most of the patients experienced no post-operative complications, while a small number developed superficial infection, anterior knee pain, or knee stiffness.</p><p><strong>Conclusion: </strong>Even though the use of QT for ACL reconstruction has become popular in recent times, only a few surgeons are using it as the preferred primary graft option. Several clinical studies have shown that ACL reconstruction using the quadriceps tendon autograft offers comparable, and, in some cases, superior functional outcomes to hamstring and patellar tendon grafts. In our study, ACLR using QT autograft provided satisfactory clinical results and functional outcomes with relatively low rates of complications. Given its consistent results and adaptability for both primary and revision procedures, the quadriceps tendon autograft should be considered as a preferred graft choice for ACL reconstruction surgeries.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 3","pages":"570-577"},"PeriodicalIF":1.1,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13031598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147573784","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":"Guest Editorial-Special Issue on Global Collaboration in Arthroscopy and Sports Medicine.","authors":"Sivaraman Arumugam, Thomas Werner Patt","doi":"10.1007/s43465-026-01697-2","DOIUrl":"https://doi.org/10.1007/s43465-026-01697-2","url":null,"abstract":"","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 3","pages":"529-530"},"PeriodicalIF":1.1,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13031476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147573802","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 Review of Lumbar Spine Kinematics During Field Hockey Drag Flick Stroke.","authors":"S Arumugam, K A Thiagarajan, M M Shishir, Sai Aditya Raman, S S Nimishaanth","doi":"10.1007/s43465-026-01713-5","DOIUrl":"https://doi.org/10.1007/s43465-026-01713-5","url":null,"abstract":"<p><strong>Introduction: </strong>In field hockey, the drag flick stroke is mainly used during penalty corner for scoring opportunities. This review article investigates the biomechanics involved in the drag flick and its implications on injury risk.</p><p><strong>Methods: </strong>Key elements analyzed include trunk flexion-extension, axial and lateral rotation, inter-lumbar rotational motion, and lower limb mechanics during the preparatory, execution, and follow-through phases of the drag flick. A review of literature indicates the occurrence of greater lumbar flexion, coupled flexion-rotation, and higher shear forces during the drag flick when compared with the hit stroke during penalty corners.</p><p><strong>Results: </strong>Technical features described among Indian players-such as deeper lunges, prolonged drag phases, increased forward trunk inclination, and rapid pelvic-trunk rotation-may further accentuate these loading patterns, potentially leading to a greater injury risk.</p><p><strong>Summary: </strong>The cumulative exposure to end-range lumbar movements under high rotational velocities may predispose drag flick specialists to overuse injuries of the lumbar spine and hip. The paper highlights the need for technique refinement, structured conditioning, and workload regulation to support performance while minimizing injury risk.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 3","pages":"531-537"},"PeriodicalIF":1.1,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13031470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147573752","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":"Day-Care, Awake, Distal (DAD): The New Grammar of Nerve Surgery.","authors":"J Terrence Jose Jerome","doi":"10.1007/s43465-026-01711-7","DOIUrl":"https://doi.org/10.1007/s43465-026-01711-7","url":null,"abstract":"","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 3","pages":"723-724"},"PeriodicalIF":1.1,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13031475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147573831","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":"Anterior Cruciate Ligament Injuries in Professional Soccer: Evidence from Transfermarkt-Based Studies.","authors":"Riccardo D'Ambrosi, Chiara Ursino, Fabrizio Di Feo, Luca Maria Sconfienza, Alessandro Nuara, Nicola Ursino","doi":"10.1007/s43465-026-01714-4","DOIUrl":"https://doi.org/10.1007/s43465-026-01714-4","url":null,"abstract":"<p><strong>Background: </strong>Anterior cruciate ligament (ACL) injury represents one of the most severe and career-threatening conditions in professional soccer. In recent years, several epidemiological studies have used media-based databases, particularly Transfermarkt, to investigate ACL injury patterns in elite football. To summarize and critically discuss Transfermarkt-based evidence on ACL injuries in professional soccer, focusing on epidemiology, injury distribution, recurrence, return-to-play outcomes, and long-term career impact.</p><p><strong>Methods: </strong>This study was designed as a narrative review of peer-reviewed Transfermarkt-based studies investigating anterior cruciate ligament injuries in professional soccer. A systematic literature search was performed in PubMed, Scopus, and Web of Science, and eligible studies were qualitatively synthesized focusing on epidemiology, injury distribution, recurrence, return-to-play, and career-related outcomes.</p><p><strong>Results: </strong>Across the included studies, ACL injuries occurred predominantly during matches, with a substantially higher risk compared with training. Injury distribution showed consistent seasonal clustering and position-dependent patterns, with defenders and forwards being most frequently affected. A considerable proportion of injuries represented second ACL ruptures. Although return-to-play rates were high, only a limited proportion of players returned to their preinjury competitive level. Moreover, ACL-injured players demonstrated reduced long-term performance and shorter career duration compared with matched uninjured controls.</p><p><strong>Conclusion: </strong>ACL injury in professional soccer is not only an acute traumatic event but also a condition with relevant long-term performance and career consequences. Transfermarkt-based studies provide valuable large-scale epidemiological insight into ACL injury patterns in elite football; however, their findings should be interpreted in light of inherent methodological limitations. Future research integrating medical registries with standardized reporting systems is required to optimize injury prevention strategies and long-term outcome assessment.</p><p><strong>Level of evidence: </strong>V (Narrative review of observational studies).</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 3","pages":"561-569"},"PeriodicalIF":1.1,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13031424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147573744","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":"Meniscal-Related Risk Factors for Lateral Meniscal Extrusion: A Narrative Review.","authors":"Angelo V Vasiliadis, Vasileios Giovanoulis, Dimitrios Chytas, Konstantinos Katakalos, George Paraskevas, Emmanouel Papakostas, George Noussios","doi":"10.1007/s43465-026-01715-3","DOIUrl":"https://doi.org/10.1007/s43465-026-01715-3","url":null,"abstract":"<p><strong>Background: </strong>Meniscal extrusion is an important imaging marker of meniscal dysfunction and altered knee joint biomechanics. While medial meniscal extrusion has been extensively investigated, lateral meniscal extrusion remains comparatively underexplored despite its clinical relevance, particularly in younger and athletic populations.</p><p><strong>Objective: </strong>To provide a narrative review of meniscal-related risk factors associated with lateral meniscal extrusion.</p><p><strong>Methods: </strong>A narrative literature review was performed using the PubMed database to identify studies published between January 2000 and December 2025, supplemented by additional relevant sources. Relevant peer-reviewed studies addressing meniscal-related contributors to lateral meniscal extrusion were identified. Risk factors were categorized into meniscal shape and morphology, meniscal pathology and meniscal surgical interventions.</p><p><strong>Results: </strong>Morphological variations, including discoid lateral meniscus, increased meniscus-bone angle and greater meniscal cartilage height, predispose individuals to lateral meniscal extrusion. Specific meniscal pathologies, such as posterior root tears, radial tears, complex tears and degenerative tear patterns, disrupt circumferential hoop stress and significantly increase the risk of extrusion. Lateral meniscal extrusion is also frequently observed following surgical interventions, particularly partial meniscectomy, discoid meniscus reshaping procedures and meniscal allograft transplantation. Post-operative extrusion has been associated with poorer clinical outcomes, increased cartilage degeneration and technical factors related to surgical technique and graft positioning.</p><p><strong>Conclusion: </strong>Lateral meniscal extrusion is primarily driven by structural instability rather than degenerative change. Discoid morphology, unfavorable meniscal geometry, complex tear patterns and prior meniscal surgery are major contributing factors, underscoring the clinical importance of meniscal preservation.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 3","pages":"552-560"},"PeriodicalIF":1.1,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13031568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147573818","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}