Indian Journal of Orthopaedics最新文献

{"title":"Indian Orthopaedics Association Guidelines for Osteoporosis.","authors":"Ramesh Sen, Shiva Shankar Jha, S S Amarnath, Jawahar T Jethwa, Jai Prakash Tiwari, Chinmoy Das, Srinivas B S Kambhampati, Murali Poduval, Bharatkumar R Dave, Ram Chaddha, Karthik Vishwanathan, S Chandrashekara, Renuka Panchagnula, Sanjay Bhadada","doi":"10.1007/s43465-025-01393-7","DOIUrl":"https://doi.org/10.1007/s43465-025-01393-7","url":null,"abstract":"<p><strong>Introduction: </strong>These guidelines provide a comprehensive and practical framework for preventing osteoporosis. They are designed for use by healthcare professionals, including orthopaedic surgeons, primary care physicians, specialists, nurses, and allied health providers, as they work with patients at risk of or already diagnosed with osteoporosis.</p><p><strong>Methodology: </strong>This iterative process involved multiple questionnaires sent to a panel of 62 osteoporosis and bone health experts. Experts, including clinicians, researchers, and academicians, were selected based on their recognised expertise and contributions to the field of osteoporosis.</p><p><strong>Observations: </strong>There were 62 medical personnel with experience. The protocol was to get consensus from experts for each round. The set of questions was divided into six rounds<b>.</b> This structured Delphi methodology ensured that the resulting osteoporosis guidelines were evidence based and reflective of expert consensus, providing a robust clinical practice framework.</p><p><strong>Results: </strong>The guidelines were put up in sections with titles as: prevention of osteoporosis, Screening for osteoporosis, diagnosing osteoporosis, calcium and vitamin D in osteoporosis, microbiome, obesity in osteoporosis, postmenopausal osteoporosis, male osteoporosis. Chronic kidney disease and osteoporosis, glucocorticoid-induced osteoporosis (GIOP), therapeutics in osteoporosis, monitoring osteoporosis therapy and osteosarcopenia. Ultimately, all the details obtained in various meetings were analysed, and responses were sought from all the participant members. All such reactions were again grouped back sequentially.</p><p><strong>Conclusions: </strong>osteoporosis is a significant problem, and many protocols exist in the literature. These guidelines were created by consensus among experts using the Delphi method. They have been developed until current knowledge is available and may be changed in the next 5-6 years, depending on the new research accumulated by that time.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 9","pages":"1279-1347"},"PeriodicalIF":1.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12496356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238608","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":"From The Editors' Desk: Towards An Inclusive Culture- Embracing Diversity, Equality and Inclusion at the IJO.","authors":"Murali Poduval, Srinivas B S Kambhampati","doi":"10.1007/s43465-025-01563-7","DOIUrl":"https://doi.org/10.1007/s43465-025-01563-7","url":null,"abstract":"","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 10","pages":"1595"},"PeriodicalIF":1.1,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12535560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336613","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":"Steel and Grace: The Women Who Shaped Indian Orthopedic Surgery.","authors":"Sanika Rapole, Nandhini Iyer, Binoti Sheth","doi":"10.1007/s43465-025-01560-w","DOIUrl":"https://doi.org/10.1007/s43465-025-01560-w","url":null,"abstract":"<p><strong>Background: </strong>Orthopedic surgery remains one of the least diverse medical specialties, historically framed as physically demanding and exclusionary. In India, despite near-parity in medical school enrolments, representation in orthopedics is disproportionately low compared to global averages. Structural barriers-including stereotypes, inequitable training pathways, and limited mentorship-have influenced workforce composition. However, evolving definitions of surgical competence, advances in technology, and advocacy initiatives have begun reshaping the specialty.</p><p><strong>Methods: </strong>A narrative review was conducted using PubMed, Scopus, and Google Scholar, supplemented by official resources (IOA, IODA), institutional archives, and Royal College records. Eligible material included workforce audits, descriptive studies, and official reports. Purposeful sampling identified key pioneers and leaders in Indian orthopedics, with contributions verified through publications, biographies, and archival sources.</p><p><strong>Results: </strong>Historical barriers limited entry and progression within orthopedics, reinforcing perceptions of physicality over precision. Notable pioneers established new benchmarks in pediatric orthopedics, hand surgery, scoliosis care, limb reconstruction, and arthroplasty. The establishment of WOICE in 2016 provided a platform for mentorship, advocacy, and leadership development. Despite progress, underrepresentation persists in subspecialties such as spine and arthroplasty, alongside systemic challenges including limited institutional support and inconsistent mentorship.</p><p><strong>Conclusion: </strong>The evolution of orthopedics in India highlights gradual but meaningful change. Continued progress requires structural reforms in training, equitable leadership opportunities, and inclusive professional policies. Advancing diversity is not only a matter of equity but also central to clinical excellence and improved patient outcomes.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 10","pages":"1599-1608"},"PeriodicalIF":1.1,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12535550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336809","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":"Women in Orthopaedics: Substance and Strength.","authors":"Rujuta Mehta","doi":"10.1007/s43465-025-01558-4","DOIUrl":"https://doi.org/10.1007/s43465-025-01558-4","url":null,"abstract":"","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 10","pages":"1596-1598"},"PeriodicalIF":1.1,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12535549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336894","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":"Comparison of Open and Percutaneous Treatment in Trigger Finger: A Retrospective Analysis of Functional Results and Cost-Effectiveness.","authors":"Oğuzhan Gökalp, Gökhan İlyas, Fikri Burak İpçi","doi":"10.1007/s43465-025-01532-0","DOIUrl":"https://doi.org/10.1007/s43465-025-01532-0","url":null,"abstract":"<p><strong>Introduction: </strong>Trigger finger, a common condition caused by flexor tendon compression in adults, often requires surgical release when conservative treatment fails. This study retrospectively compared the outcomes and costs of percutaneous needle release and traditional open release to treat trigger fingers.Article title is mismatch between Job sheet and author provided manuscript. Kindly check and confirm.Thank you for pointing this out. The correct form of the title is:\"Comparison of Open and Percutaneous Treatment in Trigger Finger: A Retrospective Analysis of Functional Results and Cost-Effectiveness.\"Please use \"Cost-Effectiveness\" with a capital E.</p><p><strong>Methods: </strong>A retrospective analysis of patients over 18 undergoing trigger finger surgery was conducted (<i>n</i> = 92). The patients were divided into two groups: open surgery (<i>n</i> = 43) and percutaneous release (<i>n</i> = 49). Treatment outcomes were assessed using the Gilbert questionnaire (failure, complications, and satisfaction), and functional outcomes were measured using the Quick Disabilities of the Arm, Shoulder, and Hand scores. The cost analysis was based on social security billing.</p><p><strong>Results: </strong>The mean quick disabilities of the arm, shoulder, and hand scores are 10 ± 5.7 for the percutaneous group and 10.4 ± 5.7 for the open surgery group (<i>p</i> = 0.69). Finger stiffness was reported in 2% of the percutaneous group and 30% of the open surgery group (<i>p</i> = 0.03), whereas scarring was observed in 0% of the percutaneous group and 23% of the open surgery group (<i>p</i> < 0.01). Returning to daily work was faster in the percutaneous group, with 67% resuming within a week compared to 0% in the open group (<i>p</i> < 0.01). The procedure costs averaged 156.3 ± 6.6 United States dollars for the percutaneous group and 182.9 ± 24.2 USD (United States dollars) for the open surgery group (<i>p</i> < 0.01).</p><p><strong>Conclusion: </strong>Percutaneous needle release appears to be a more cost-effective alternative to traditional open surgery for the trigger finger, with similar functional outcomes, faster recovery, fewer complications, and lower costs.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 9","pages":"1530-1536"},"PeriodicalIF":1.1,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12496306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238455","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":"Leading by Example: Strategies that Have Helped Inclusivity in the UK-A Personal Memoir.","authors":"Deborah M Eastwood","doi":"10.1007/s43465-025-01518-y","DOIUrl":"https://doi.org/10.1007/s43465-025-01518-y","url":null,"abstract":"<p><p>This article describes the progress that the BOA (British Orthopaedic Association) has made in tackling equity and diversity issues over the last 5 years. Gender diversity is the most obvious characteristic but others are equally important. We must recognise the problems that exist to change them. The working environment needs to be fair to all and the service we deliver also needs to be fair to our patients. The changes made by the BOA include concerns regarding sexual harassment in the workplace and the adequate provision of PPE (personal protective equipment) when using radiation and promoting a sustainable change in workplace behaviour.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 10","pages":"1763-1768"},"PeriodicalIF":1.1,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12535566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336637","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":"Calcaneal Osteomyelitis: A Treatment Protocol.","authors":"Madhura Sujay Kulkarni","doi":"10.1007/s43465-025-01457-8","DOIUrl":"https://doi.org/10.1007/s43465-025-01457-8","url":null,"abstract":"<p><strong>Introduction: </strong>Calcaneal osteomyelitis poses a problem as any other chronic osteomyelitis in the body. Correct diagnosis and prompt treatment are essential to avoid limb-threatening amputation surgery. In this retrospective study, we describe the 4 golden principles of treatment of such cases through extended debridement, dead space management, soft tissue coverage and post-operative orthosis.</p><p><strong>Materials and methods: </strong>We have studied 14 calcaneal osteomyelitis in 13 patients. Six of them were due to neuropathy. All the patients underwent debridement and sequestrectomy. Eight patients had instillation of calcium sulfate antibiotic granules in them. Silo technique was used in 10 patients. Total calcanectomy was performed in one case. Most of the patients were offloaded till their ulcers healed and were given custom orthosis to prevent recurrences.</p><p><strong>Results: </strong>13 cases had a successful result (P-value = 0.00092). One diabetic patient required a below-knee amputation. There were three cases of complications of re-ulceration, but it was not associated with calcaneal infection. The ulcers healed in 1.75 months (15 days-4 months). Insoles or ankle foot orthosis with hindfoot offloading were given to eight patients, while one patient required a silicon heel insole.</p><p><strong>Conclusion: </strong>Thorough debridement, dead space management and prevent of recurrences by offloading orthosis is necessary for limb salvage in calcaneal osteomyelitis.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 10","pages":"1705-1711"},"PeriodicalIF":1.1,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12535548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336857","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 Uses of Banked Bone Allograft for Non-oncological Orthopaedic Surgeries: A Preliminary Report of the First 28 Cases in Nigeria.","authors":"Kehinde Adesola Alatishe, Oluwaseyi Kayode Idowu, Mustapha Alimi","doi":"10.1007/s43465-025-01460-z","DOIUrl":"10.1007/s43465-025-01460-z","url":null,"abstract":"<p><strong>Background: </strong>The use of bone allograft in Orthopaedics is a novel practice but the detailed information about the indications and outcomes is yet to be reported in Nigeria.</p><p><strong>Objective: </strong>To highlight the non-oncological indications and early outcomes of the uses of irradiated frozen bone allografts for orthopaedic procedures in Nigeria.</p><p><strong>Materials and methods: </strong>This was a prospective study of patients who had bone allograft implanted between 1st September 2020 and 31st August 2022 for various non-oncological orthopaedic conditions at our tertiary center. The donors were selected based on American Association of Tissue Bank (AATB) guidelines. The bone allografts were prepared, irradiated, and stored in a freezer at - 80 °C. Ethical clearance was obtained from the institutional ethics committee and written informed consent was signed by patients. They all had implantation of banked femoral head allograft. The details on demographics, indications, and early outcomes were documented in a questionnaire and analyzed with SPSS software version 20.</p><p><strong>Results: </strong>A total of 28 patients with follow-up results were included in the study. The follow-up duration was a minimum of 1 year. The male-to-female ratio was 2.5: 1 with mean age of 51.0 ± 9.8 years. The indications were acetabular reconstruction in complex primary and revision total hip replacement (67.9%), non-union fractures (14.3%), tibial plateau fractures (10.7%), and spinal fusion surgery (7.1%). Most of the grafts were implanted as structural grafts (57.9%) while others were used as either morselized (26.3%) or composite grafts (15.8%). The mean incorporation time of 6.2 ± 0.7 months was recorded. Most of the patients (92.9%) had satisfactory osteo-integration of the graft (Oswestry's ≥ 2). There was no incidence of infection in this early report.</p><p><strong>Conclusion: </strong>The use of deep frozen and irradiated bone allografts in the management of non-oncological orthopaedic conditions is a new development in Nigeria. This preliminary report is encouraging and we hope to arrive at a definite conclusion after a long-term follow-up.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 8","pages":"1249-1254"},"PeriodicalIF":1.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952385","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":"Navigating the Efficacy and Safety Landscape of Duloxetine in Osteoarthritis Management: A Meta-Analysis of Randomized Controlled Trials.","authors":"Baibhav Bhandari, Kanchan Bisht, Gaurav Purohit, Shiwam Gupta, Girish Kumar Singh, Sonal Goyal, Pradeep Atter, Ajit Kumar, Praveen Talawar","doi":"10.1007/s43465-025-01372-y","DOIUrl":"10.1007/s43465-025-01372-y","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy and safety of duloxetine in treatment of osteoarthritis compared with placebo.</p><p><strong>Method: </strong>We conducted a comprehensive search for pertinent randomized controlled trials (RCTs) across multiple databases, including PubMed, Embase, Scopus, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov and Google scholar. These selected RCTs aimed to assess the effectiveness and safety of duloxetine versus a placebo in the management of osteoarthritis (OA). We computed the mean difference (MD) for continuous outcome measures and calculated the risk ratio (RR) for dichotomous outcome measures.</p><p><strong>Results: </strong>Data from 10 RCT including 2294 participants comparing duloxetine and placebo were pooled. Duloxetine showed improvement in BPI-S (Brief Pain Inventory-Severity)MD =  - 0.66; 95% CI, [- 0.75, - 0.57], BPI-I (Brief Pain Inventory-Interference)MD =  - 0.59; 95% CI [- 0.66, - 0.52], WOMAC (Western Ontario and McMaster Universities Arthritis Index) pain sub scale scores SMD =  - 2.56; 95% CI, [- 4.24, - 0.89] <i>P</i> = 0.003; physical function MD =  - 4.59; 95% CI, [- 5.83, - 3.34] <i>P</i> < 0.00001; SF 36 (Short Form) Physical function MD = 1.56; 95% CI, [0.14, 2.97] <i>P</i> = 0.03 and patients global impressions scores SMD =  - 0.47; 95% CI, [- 0.62, - 0.32]. Duloxetine resulted in higher number of treatment emergent adverse events RR = 1.34; 95% CI, [1.12,1.61] <i>P</i> = 0.002; and discontinuations RR = 2.54; 95%, CI, [1.89, 3.42] <i>P</i> < 0.00001. However duloxetine was no different from placebo in improving stiffness and in terms of incidence of serious adverse effects.</p><p><strong>Conclusion: </strong>Duloxetine demonstrates effectiveness in addressing chronic pain and mitigating the decline in physical function associated with knee osteoarthritis (OA), while maintaining a reasonable level of tolerable adverse events. However, it does not offer a distinct advantage in alleviating joint stiffness.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s43465-025-01372-y.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 8","pages":"1123-1136"},"PeriodicalIF":1.1,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952299","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":"Fragility Fracture of the Neck of Femur in the Young Elderly.","authors":"Vishal Kumar, Tharun Teja Aduri, Sachin Yashwant Kale, Akhilesh Kumar, S S Amarnath","doi":"10.1007/s43465-025-01370-0","DOIUrl":"10.1007/s43465-025-01370-0","url":null,"abstract":"<p><strong>Background: </strong>Fragility fractures of the femoral neck (NOF) are a growing concern in the \"young elderly\" (aged 65-84), a group experiencing the intersection of aging and active lifestyles. These fractures occur with minimal trauma due to weakened bones, primarily from osteoporosis. The management of such fractures in this population presents distinct challenges, requiring a balance between rapid recovery and the limitations imposed by aging physiology.</p><p><strong>Management: </strong>The rising incidence of femoral neck fractures is linked to age-related bone loss and comorbidities like osteoporosis, sarcopenia, and chronic diseases. Women, due to post-menopausal bone loss, are disproportionately affected. Early surgical intervention (internal fixation, hemiarthroplasty, or total hip arthroplasty) is crucial for restoring mobility. Surgical complications such as avascular necrosis, fixation failure, and dislocation remain significant concerns. Rehabilitation involving early mobilization and osteoporosis management is essential for optimal recovery, though the risk of mortality and permanent disability remains elevated.</p><p><strong>Conclusion: </strong>Fragility fractures in the young elderly require a multidisciplinary approach that combines prompt surgical intervention, targeted rehabilitation, and long-term osteoporosis management. Preventive strategies focused on bone health and fall prevention will be critical in reducing the incidence and improving outcomes for this population.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 8","pages":"1014-1025"},"PeriodicalIF":1.1,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952353","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}