Indian Journal of Orthopaedics最新文献

{"title":"Is Popliteus Tendon a Redundant Structure in Total Knee Arthroplasty?","authors":"Vikash Kapoor, Ashish Raj, Anirban Chatterjee, Kaustav Debnath","doi":"10.1007/s43465-024-01173-9","DOIUrl":"https://doi.org/10.1007/s43465-024-01173-9","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Many studies have shown that injury to the popliteus tendon has little consequence for the static stability of the knee following total knee arthroplasty (TKA). However, very few studies have evaluated the effect of intraoperative iatrogenic popliteus tendon injury on the patient-reported outcome measures (PROMs) following TKA. This study aimed to determine the incidence of iatrogenic popliteus tendon injury in our subset of the population and to find out its effect on PROMs.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>100 consecutive osteoarthritic varus knees with flexion deformities less than 20° were operated upon by a single senior experienced arthroplasty surgeon. Patients were assessed intraoperatively for any iatrogenic popliteus tendon injury, the injury site, and the amount of injury which was quantified and graded. PROMs applied for assessment at 1-year follow-up were Knee Society Score (KSS 1), Knee Function Score (KSS 2), and Western Ontario and McMaster University Osteoarthritis Index (WOMAC).</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>17% of cases had an iatrogenic popliteus tendon injury. Thirteen had grade II injuries, whereas four had grade III injuries. There was no statistical significance in post-operative knee mobility and PROMs among those with popliteus tendon injury versus non-injured patients.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>The incidence of iatrogenic popliteus tendon injury is higher than what we expected. The tendon injury remains a risk, but it is unclear how the popliteus tendon injury will affect patients after the TKA. In our series, such an injury during knee replacement does not affect the functioning of the knee in the short term; however, a long-term follow-up is warranted.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"156 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140929723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Growth Factor Concentrate (GFC) for the Management of Osteoarthritis of the Knee: A Systematic Review","authors":"Ashim Gupta, Nicola Maffulli","doi":"10.1007/s43465-024-01172-w","DOIUrl":"https://doi.org/10.1007/s43465-024-01172-w","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>The knee is the most commonly affected joint in osteoarthritis (OA), affecting millions of people worldwide. Knee OA significantly impacts the activities of daily living (ADL) along with affecting overall quality of life of patients (QoL), thereby leading to substantial socio-economic burden. Conservative therapies are prioritized, resorting to surgery only when needed. However, these traditional approaches have limitations. Regenerative medicine, involving the use of orthobiologics, including autologous peripheral blood-derived orthobiologics such as growth factor concentrate (GFC), has evolved and shown potential for managing knee OA. The primary goal of this review is to summarize the results of in vitro, preclinical and clinical studies involving GFC for the management of knee OA.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Multiple databases (PubMed, Scopus, Google Scholar, Web of Science and Embase) were searched applying terms for the intervention ‘GFC’ and treatment ‘knee OA’ for the studies published in the English language to March 10, 2024.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Only three clinical studies met our pre-defined criteria and were included in this review.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Intra-articular administration of GFC is safe and potentially efficacious to manage OA of the knee. More, adequately powered, multi-center, prospective, RCTs are warranted to demonstrate the long-term effectiveness of GFC in patients suffering from mild-to-moderate knee OA and to justify its routine clinical use. Further studies evaluating the efficacy of GFC compared to other orthobiologics are also required to allow physicians/surgeons to choose the optimal orthobiologic for the treatment of OA of the knee.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"29 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140929756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone Marrow Aspirate Concentrate for Treatment of Primary Knee Osteoarthritis: A Prospective, Single-Center, Non-randomized Study with 2-Year Follow-Up","authors":"Madhan Jeyaraman, Naveen Jeyaraman, Swaminathan Ramasubramanian, Rajni Ranjan, Saurabh Kumar Jha, Ashim Gupta","doi":"10.1007/s43465-024-01168-6","DOIUrl":"https://doi.org/10.1007/s43465-024-01168-6","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>Knee osteoarthritis (OA) is a widespread, disabling condition with no intervention to fully restore cartilage or halt progression. Bone marrow aspirate concentrate (BMAC), an autologous product from bone marrow aspiration, has shown promise as a regenerative therapy due to its cell composition and chondrogenic effects. Our study aims to assess the functional outcomes, including pain, function, satisfaction, and complications post-BMAC injection in knee OA patients.</p><h3 data-test=\"abstract-sub-heading\">Materials and Methods</h3><p>In this prospective, single-center study, 63 patients with grade II–III knee OA (Kellgren–Lawrence (K–L) scale) unresponsive to conservative management underwent BMAC injection. The procedure involved bone marrow aspiration from the anterior iliac crest, processing to obtain a concentrate, followed by intra-articular injection. Patients were followed for 24 months, assessing outcomes using the Visual Analog Scale (VAS), International Knee Documentation Committee (IKDC) score, and MOCART 2.0 score.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The cohort, with a slight female predominance and predominantly aged 41–50 years, majorly comprised K–L grade III OA patients. BMAC treatment resulted in significant improvements in VAS pain scores, IKDC functional scores, and MOCART 2.0 scores over the 24-month follow-up.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>BMAC injection provides significant improvement in both pain and functional outcomes at mid-term follow-up in patients with mild-to-moderate OA of the knee. Further high-quality, adequately powered, multi-center, prospective, double-blinded, randomized controlled trials with longer follow-up are necessary to justify the routine clinical use of BMAC for treatment of patients suffering with knee OA.</p><h3 data-test=\"abstract-sub-heading\">Graphical Abstract</h3>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"16 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140929724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Intraoperative Platelet-Rich Plasma After Meniscal Repair: Systematic Review and Meta-analysis","authors":"Muhammad Thahir, Iffath Misbah, Jagadeesh Bhaskaran, Nazmul Huda Syed, Munis Ashraf, Navin Balasubramanian","doi":"10.1007/s43465-024-01155-x","DOIUrl":"https://doi.org/10.1007/s43465-024-01155-x","url":null,"abstract":"&lt;h3 data-test=\"abstract-sub-heading\"&gt;Background&lt;/h3&gt;&lt;p&gt;Meniscal injuries frequently require surgical intervention to restore knee joint function and stability. Intraoperative platelet-rich plasma (PRP) injection has emerged as a potential adjunctive therapy to enhance tissue healing post-meniscal repair. This systematic review and meta-analysis aimed to evaluate the efficacy of PRP in terms of pain relief, functional recovery, and overall success rates in patients undergoing meniscal repair procedures&lt;b&gt;.&lt;/b&gt;&lt;/p&gt;&lt;h3 data-test=\"abstract-sub-heading\"&gt;Methods&lt;/h3&gt;&lt;p&gt;A comprehensive search strategy was employed to identify relevant studies across Scopus, PubMed, Embase, and the Cochrane Library databases. The inclusion criteria encompassed human studies, including randomized controlled trials (RCTs), cohorts, and case–control studies, focusing on intraoperative platelet-rich plasma (PRP) use post-meniscal repair and reporting outcomes related to pain, functionality, and cure rates. Exclusion criteria comprised animal studies, non-English publications, studies lacking relevant outcome measures, and those with insufficient data. Two reviewers independently screened titles and abstracts, resolving disagreements through consensus or consultation with a third reviewer, followed by a full-text assessment for potentially eligible studies. Data extraction was conducted independently by two reviewers using a standardized form. The reliability of observational studies was evaluated using the Newcastle–Ottawa Scale. Subgroup analyses and pooled effect estimates for main outcomes were computed using RevMan 5.3, a meta-analysis tool.&lt;/p&gt;&lt;h3 data-test=\"abstract-sub-heading\"&gt;Results&lt;/h3&gt;&lt;p&gt;The demographic analysis revealed that the PRP group had an average age of 41.39 years, while the control group had an average age of 42.1 years. In terms of gender distribution, the PRP group consisted of 61 men and 29 women, while the control group had 62 men and 34 women. Pain ratings showed a preference for PRP with a mean difference of 4.83 (&lt;i&gt;p&lt;/i&gt; = 0.13). However, there was no significant difference in Lysholm scores (mean difference: − 0.44, p = 0.91) or IKDC scores (mean difference: 2.80, &lt;i&gt;p&lt;/i&gt; = 0.14) between the PRP and control groups. Similarly, ROM measures did not show a statistically significant difference, with a mean difference of 2.80 (&lt;i&gt;p&lt;/i&gt; = 0.18). Additionally, there was no significant distinction in failure rates between the PRP and control groups, as indicated by a weighted mean difference of 0.71 (&lt;i&gt;p&lt;/i&gt; = 0.52). These findings suggest that while PRP may offer some benefits in pain relief, its impact on functional recovery, range of motion, and failure rates following meniscal repair procedures is inconclusive.&lt;/p&gt;&lt;h3 data-test=\"abstract-sub-heading\"&gt;Conclusion&lt;/h3&gt;&lt;p&gt;The current evidence regarding the effect of intraoperative platelet-rich plasma (PRP) injection on patients undergoing meniscal repair remains inconclusive. While some studies sugg","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140929760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolomics in Osteoarthritis Knee: A Systematic Review of Literature","authors":"Akhilesh Arjun, Girinivasan Chellamuthu, Naveen Jeyaraman, Madhan Jeyaraman, Manish Khanna","doi":"10.1007/s43465-024-01169-5","DOIUrl":"https://doi.org/10.1007/s43465-024-01169-5","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>Osteoarthritis (OA) is a common degenerative disorder of the synovial joints and is usually an age-related disease that occurs due to continuous wear and tear of the cartilage in the joints. Presently, there is no proven medical management to halt the progression of the disease in the early stages. The purpose of our systematic review is to analyze the possible metabolites and metabolic pathways that are specifically involved in OA pathogenesis and early treatment of the disease.</p><h3 data-test=\"abstract-sub-heading\">Materials and Methods</h3><p>The articles were collected from PubMed, Cochrane, Google Scholar, Embase, and Scopus databases. “Knee”, “Osteoarthritis”, “Proteomics”, “Lipidomics”, “Metabolomics”, “Metabolic Methods”, and metabolic* were employed for finding the articles. Only original articles with human or animal OA models with healthy controls were included.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>From the initial screening, a total of 458 articles were identified from the 5 research databases. From these, 297 articles were selected in the end for screening, of which 53 papers were selected for full-text screening. Finally, 50 articles were taken for the review based on body fluid: 6 urine studies, 15 plasma studies, 16 synovial fluid studies, 11 serum studies, 4 joint tissue studies, and 1 fecal study. Many metabolites were found to be elevated in OA. Some of these metabolites can be used to stage the OA Three pathways that were found to be commonly involved are the TCA cycle, the glycolytic pathway, and the lipid metabolism.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>All these studies showed a vast array of metabolites and metabolic pathways associated with OA. Metabolites like lysophospholipids, phospholipids, arginine, BCCA, and histidine were identified as potential biomarkers of OA but a definite association was not identified, Three pathways (glycolytic pathway, TCA cycle, and lipid metabolic pathways) have been found as highly significant in OA pathogenesis. These metabolic pathways could provide novel therapeutic targets for the prevention and progression of the disease.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140929722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Spontaneous Osteonecrosis of the Knee with Ipsilateral Meniscus and Posterior Root Tear: Systematic Review and Meta-analysis","authors":"Yuhua Feng, Jiaju Yang, Min Zhang, Haohao Wang, Gang Xi","doi":"10.1007/s43465-024-01140-4","DOIUrl":"https://doi.org/10.1007/s43465-024-01140-4","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Objective</h3><p>The relationship between spontaneous osteonecrosis of the knee (SONK) and ipsilateral meniscus tear remains to be established, and the possible causes are clarified and summarized.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We conducted a search in Pubmed, Web of Science, Embase, and the Cochrane Library to include all English articles published from the establishment of the database until April 2023. The odds ratio (OR) and 95% confidence interval (CI) were calculated to evaluate the relationship between SONK and ipsilateral meniscus lesions.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>A total of 405 patients were included in eight articles, including 157 males and 248 females, with an average age of 63.94 years and an average BMI of 26.36 kg/m². In patients with medial SONK, the prevalence of ipsilateral meniscus tear was 0.8982, 95% CI (0.7389, 0.9648), and the prevalence of ipsilateral posterior root tear was 0.6198, 95% CI (0.5169, 0.7118). The prevalence of ipsilateral meniscus tears in patients with lateral SONK was 0.2188, 95% CI (0.1150, 0.3711), and the prevalence of ipsilateral posterior root tears was 0.1667, 95% CI (0.1071, 0.2424).</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>SONK is significantly associated with meniscus or root tears, which limit meniscus function and lead to changes in the stress environment between the knee and the tibiofemur, increasing the chance of incomplete fracture. We suggest that the expression of SONK can be replaced with subchondral insufficiency fracture of the knee.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"162 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140929802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GOLDIC Therapy Holds Promise as an Orthobiologic Agent: A Systematic Review of the Literature","authors":"Madhan Jeyaraman, RP Packkyarathinam, Thamizhmathi Thangaraju, Naveen Jeyaraman, Girinivasan Chellamuthu, Manish Khanna","doi":"10.1007/s43465-024-01167-7","DOIUrl":"https://doi.org/10.1007/s43465-024-01167-7","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>Orthobiologic agents play a significant role in regenerative medicine. The quest for newer and more effective Orthobiologic agents is never-ending, leading to the evolution of more reformed products. GOLDIC (GOLD Induced cytokine) is a recently evolving Orthobiologic agent developed by conditioning autologous serum with gold particles. We aim to collate the available evidence on GOLDIC and provide a systematic literature review.</p><h3 data-test=\"abstract-sub-heading\">Materials and methods</h3><p>Using Cochrane and PRISMA guidelines literature search was done for GOLDIC. After duplicate removal and exclusions, 62 articles were scrutinized, of which 8 articles qualified for full-text review. A risk-of-bias assessment of the included studies was done.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>All articles showed standardized preparation methods of GOLDIC and uniformity in the number of doses administered, except one study. Reproducible results were noted like an increase in plasma gelsolin and improved KOOS, WOMAC, and VAS scores.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>GOLDIC has the potential to be a significant Orthobiologic modality considering its standardized preparation techniques, method of administration, and uniformly reproducible outcome measures. However, further high-quality evidence is needed to analyze the clinical efficiency and safety profile of GOLDIC.</p><h3 data-test=\"abstract-sub-heading\">Systematic review registration</h3><p>INPLASY202350027 [https://doi.org/10.37766/inplasy2023.5.0027].</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"22 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140929945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening and Analysis of Core Genes for Osteoporosis Based on Bioinformatics Analysis and Machine Learning Algorithms","authors":"Yongxia Lu, Wei Wang, Baiyuan Yang, Gui Cao, Yue Du, JingYu Liu","doi":"10.1007/s43465-024-01152-0","DOIUrl":"https://doi.org/10.1007/s43465-024-01152-0","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Objective</h3><p>This study aimed to identify osteoporosis-related core genes using bioinformatics analysis and machine learning algorithms.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>mRNA expression profiles of osteoporosis patients were obtained from the Gene Expression Profiles (GEO) database, with GEO35958 and GEO84500 used as training sets, and GEO35957 and GSE56116 as validation sets. Differential gene expression analysis was performed using the R software “limma” package. A weighted gene co-expression network analysis (WGCNA) was conducted to identify key modules and modular genes of osteoporosis. Kyoto Gene and Genome Encyclopedia (KEGG), Gene Ontology (GO), and gene set enrichment analysis (GSEA) were performed on the differentially expressed genes. LASSO, SVM-RFE, and RF machine learning algorithms were used to screen for core genes, which were subsequently validated in the validation set. Predicted microRNAs (miRNAs) from the core genes were also analyzed, and differential miRNAs were validated using quantitative real-time PCR (qPCR) experiments.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>A total of 1280 differentially expressed genes were identified. A disease key module and 215 module key genes were identified by WGCNA. Three core genes (ADAMTS5, COL10A1, KIAA0040) were screened by machine learning algorithms, and COL10A1 had high diagnostic value for osteoporosis. Four core miRNAs (has-miR-148a-3p, has-miR-195-3p, has-miR-148b-3p, has-miR-4531) were found by intersecting predicted miRNAs with differential miRNAs from the dataset (GSE64433, GSE74209). The qPCR experiments validated that the expression of has-miR-195-3p, has-miR-148b-3p, and has-miR-4531 was significantly increased in osteoporosis patients.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>This study demonstrated the utility of bioinformatics analysis and machine learning algorithms in identifying core genes associated with osteoporosis.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"32 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140929726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Injective Treatments for Sacroiliac Joint Pain: A Systematic Review and Meta-analysis","authors":"A. Ruffilli, T. Cerasoli, F. Barile, M. Manzetti, G. Viroli, M. Traversari, G. Filardo, C. Faldini","doi":"10.1007/s43465-024-01164-w","DOIUrl":"https://doi.org/10.1007/s43465-024-01164-w","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>The most effective injective treatment approach for sacroiliac joint (SIJ) pain remains unclear. Aim of this study was to quantify the safety and effectiveness of the available injective strategies to address SIJ pain.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A systematic review and meta-analysis of the literature was conducted on PubMed, Scopus, and Embase databases from inception until January 2023. Inclusion criteria were studies written in English, comparative and non-comparative studies regardless of the minimum follow-up, and case series on SIJ injections. Safety and efficacy of the different injection therapies for the SIJ were quantified. A meta-analysis was conducted on the available data of the documented injective therapies. The “Checklist for Measuring Quality” by Downs and Black was used to assess the risk of bias and the quality of papers.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The literature search retrieved 43 papers (2431 patients): 16 retrospective case series, 2 retrospective comparative studies, 17 prospective case series, 3 prospective comparative studies, and 5 randomized controlled trials. Of the selected studies, 63% examined the effect of steroid injections, 16% of PRP injections, while 21% reported other heterogeneous treatments. The failure rate was 26% in steroid injections and 14% in PRP injections. The meta-analysis showed a statistically significant reduction in pain with the VAS score for both steroids and PRP: steroids improvement at mid-term 3.4 points (<i>p</i> &lt; 0.05), at long-term 3.0 (<i>p</i> &lt; 0.05), PRP improvement at mid-term 2.2 (<i>p</i> = 0.007), at long-term 2.3 points of the VAS pain scale (<i>p</i> = 0.02).</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Steroids are the most documented injective approach, with studies showing an overall safety and effectiveness. Still, the high number of failures underlined by some studies suggest the need for alternative procedures. Early PRP data showed promise, but the limitations of the current literature do not allow to clearly define the most suitable injective approach, and further studies are needed to identify the best injective treatment for SIJ patients.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"41 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140929829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower Extremity Muscle Tendon Interaction Around Knee During Gait Among Adolescent Children with Cerebral Palsy with Varying Crouch Angle","authors":"Triveni Shetty, Rajani Mullerpatan, Sailakshmi Ganesan, Ashok N. Johari","doi":"10.1007/s43465-024-01165-9","DOIUrl":"https://doi.org/10.1007/s43465-024-01165-9","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Optimal management and surgical planning of severe bony deformities and muscle tendon unit contractures demands comprehensive evaluation of all structures including the dynamic muscle tendon length of all muscles around the joint during gait.</p><h3 data-test=\"abstract-sub-heading\">Objectives</h3><p>Present study aimed to explore dynamic muscle–tendon length for all muscles around the knee joint along with pelvis, hip, and ankle joint kinematics among adolescent children with varying crouch angle.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Muscle–tendon length of 29 adolescent children with cerebral palsy with varying crouch angles was computed using a full-body musculo-skeletal model and expressed as a percentage of muscle–tendon length during walking compared to resting condition.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Children with knee flexion angle greater than 25° demonstrated lower anterior pelvic tilt and 11% greater muscle–tendon length of semimembranosus and biceps femoris during stance phase of gait compared to children with knee flexion angle less than 25° and typically developing children (<i>p</i> &lt; 0.01).</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>The findings of present study reported that routine bedside clinical evaluation in adolescent children with knee flexion angle greater than 25° revealed moderate shortening of hamstring muscle in supine position. Whereas instrumented objective evaluation of gait demonstrated lengthened hamstring muscle and reduced hip extension and relatively lower anterior pelvic tilt. Therefore, it may be valuable to add objective assessment of dynamic muscle–tendon length to kinematics of all lower-extremity joint motion during gait, in order to understand the muscle–joint interactions; particularly in children with severe crouch and plan specific, tailor-made surgical and non-surgical interventions.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"209 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140930169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}