Indian Journal of Orthopaedics最新文献

{"title":"Distal Femur and Proximal Tibia Morphometry in Women: Systematic Review and Meta-Analysis for Optimizing Precision in Arthroplasty and Orthopaedic Care.","authors":"Anil Regmi, Surakshya Baral, Abdus Sami, Vijay Kumar Jain","doi":"10.1007/s43465-026-01797-z","DOIUrl":"https://doi.org/10.1007/s43465-026-01797-z","url":null,"abstract":"<p><strong>Background: </strong>Morphometric differences between male and female knees play a crucial role in arthroplasty design, surgical planning, and functional outcomes. Understanding sex-based variations in distal femoral and proximal tibial anatomy is essential for improving implant fit and reducing postoperative complications.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted according to the PRISMA 2020 guidelines. PubMed, Embase, and Scopus were searched up to June 2025 for studies reporting sex-specific morphometric data of the distal femur and proximal tibia. Standardized mean differences (SMDs) were calculated for anteroposterior (AP), mediolateral (ML), and aspect ratio (AR = AP/ML) parameters using random-effects models. Heterogeneity was assessed using the I2 statistic, and publication bias with Egger's test.</p><p><strong>Results: </strong>Twenty-one studies encompassing 5,184 knees (2,889 females; 2,295 males) were included. Females had significantly smaller distal femoral and tibial dimensions across all measured parameters. Pooled SMDs showed reduced femoral AP (- 1.70; 95% CI - 2.23 to - 1.17) and ML (- 2.23; 95% CI - 2.47 to - 1.99) dimensions, with a lower femoral aspect ratio (- 0.46; 95% CI - 0.73 to - 0.20). Tibial AP (- 1.62; 95% CI - 1.83 to - 1.40) and ML (- 2.21; 95% CI - 2.56 to - 1.86) dimensions were also smaller in females, whereas tibial aspect ratio differences were nonsignificant (- 0.14; 95% CI - 0.35 to 0.07). Subgroup analyses by measurement modality and continent consistently confirmed these findings. No strong statistical evidence of publication bias was observed.</p><p><strong>Conclusion: </strong>Female knees exhibit significantly smaller distal femoral and proximal tibial dimensions, particularly in the mediolateral plane, with relatively lower femoral aspect ratios. These differences provide anatomical data that may inform implant design considerations, including sizing strategies and morphological conformity.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 9","pages":"2261-2278"},"PeriodicalIF":1.3,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108991","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":"Late but Not Too Late: Predictors of Full Neck Motion Following Surgical Correction of Congenital Muscular Torticollis in School-Going Children.","authors":"Rahul, Vivek Singh, Aditya K S Gowda, C Arjun, Sanchit Gupta, Utsav Anand","doi":"10.1007/s43465-026-01846-7","DOIUrl":"10.1007/s43465-026-01846-7","url":null,"abstract":"<p><strong>Objective: </strong>To identify predictors of full cervical range of motion (ROM) following surgical sternocleidomastoid (SCM) release in school-age children with congenital muscular torticollis (CMT).</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Tertiary referral pediatric orthopedic center.</p><p><strong>Participants: </strong>44 children older than 5 years with ultrasonography-confirmed CMT, ≥ 6 months of failed physiotherapy, and ≥ 36 months of follow-up (median age 7.6 years, 57% boys).</p><p><strong>Interventions: </strong>Standardized open surgical SCM release.</p><p><strong>Main outcome measures: </strong>Primary outcome was full ROM at 36 months, defined as active rotation and lateral flexion within 5° of age norms and absence of head tilt. Eight pre-specified variables were assessed using logistic regression.</p><p><strong>Results: </strong>Full ROM was achieved in 29 children (66, 95% CI 51-79%) at a median of 4 months postoperatively. Mean lateral bending improved from 18.2° ± 4.6° to 36.9° ± 3.8° at 36 months (<i>p</i> < 0.001), within 3° of normal. On multivariate analysis, older age reduced odds of success by 21% per year (OR 0.79, 95% CI 0.64-0.98; <i>p</i> = 0.032), each 10° increase in preoperative rotation deficit reduced odds by 30% (OR 0.70, 95% CI 0.55-0.90; <i>p</i> = 0.006), and physiotherapy compliance ≥ 80% increased odds more than five-fold (OR 5.10, 95% CI 1.60-16.2; <i>p</i> = 0.006). The model showed good performance (AUC 0.85, Hosmer-Lemeshow <i>p</i> = 0.71). Complications were minimal (one superficial infection, one revision).</p><p><strong>Conclusion: </strong>Surgical SCM release provides durable correction in most school-age children with CMT. Younger age, smaller preoperative rotation deficit, and strong physiotherapy adherence predict optimal recovery.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s43465-026-01846-7.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 8","pages":"2000-2007"},"PeriodicalIF":1.3,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13437834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678000","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":"Total Hip Arthroplasty Using Direct Anterior Approach in Obese Patients: A Systematic Review and Meta-analysis.","authors":"Andrzej Bałoniak, Tomasz Markiewicz, Waldemar Woźniak, Paweł Chodór, Łukasz Łapaj","doi":"10.1007/s43465-026-01838-7","DOIUrl":"https://doi.org/10.1007/s43465-026-01838-7","url":null,"abstract":"<p><strong>Purpose: </strong>Obesity is a major global health concern, and a significant number of patients undergo total hip arthroplasty (THA). The direct anterior approach (DAA) is one of the most used minimally invasive surgical techniques for THA worldwide. However, no study has quantitatively synthesized the outcomes of obese patients treated with this approach.</p><p><strong>Methods: </strong> We searched the PubMed, Embase, and Cochrane Library databases. Outcomes (complications, revision rates, cup inclination/anteversion, leg-length discrepancy, operative time, length of stay, and functional outcomes) were pooled using random-effects models. Risk of bias was assessed using the Newcastle-Ottawa Scale/Risk of Bias 2 tool.</p><p><strong>Results: </strong>Seventeen studies (one prospective and sixteen retrospective) comprising 16,258 patients and 16,889 hips were included in the analysis. Obesity was associated with higher periprosthetic joint infection rates (0.9 vs. 0.24%), (<i>P</i> < .001; RR, 4.23; 95% CI 2.32-7.72; <i>I</i> ² = 0%), wound complications (3.72 vs. 1.03%), (<i>P</i> < .001; RR, 3.12; 95% CI 1.92-5.06; <i>I</i> ² = 20.6%), and revision rates (2.96 vs. 1.19%), (<i>P</i> = .008; RR, 2.42; 95% CI 1.35-4.34; <i>I</i> ² = 33.0%). No statistically or clinically significant differences were observed in dislocation, fracture, leg-length discrepancy, cup anteversion, or length of hospital stay.</p><p><strong>Conclusion: </strong>Current evidence indicates that DAA is a viable option for obese patients with generally low complication rates. However, obesity is associated with an increased risk of periprosthetic joint infections, wound complications, and revision rates.</p><p><strong>Prospero registration number: </strong>CRD420251031606.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at https://doi.org/10.1007/s43465-026-01838-7.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 9","pages":"2209-2220"},"PeriodicalIF":1.3,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109067","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":"MicroRNA-652-3p Drives Chondrocyte Dysfunction in Post-Traumatic Osteoarthritis by Targeting γ-Glutamyl Carboxylase (GGCX).","authors":"Qinghai Han, Suyi Wei, Hong Wang, Wei He, Shenlong Ma","doi":"10.1007/s43465-026-01833-y","DOIUrl":"https://doi.org/10.1007/s43465-026-01833-y","url":null,"abstract":"<p><strong>Background: </strong>Post-traumatic osteoarthritis (PTOA) is a degenerative joint disorder initiated by trauma, with chondrocyte dysfunction and extracellular matrix (ECM) degradation as key pathological features. MicroRNA-652-3p (miR-652-3p) has been linked to osteoarthritis progression, but its role in PTOA remains unclear.</p><p><strong>Objective: </strong>This study sought to examine the predictive significance of miR-652-3p in PTOA development and elucidate its mechanistic role via targeting γ-glutamyl carboxylase (GGCX).</p><p><strong>Methods: </strong>Circulating miR-652-3p concentrations were measured in 100 PTOA cases and 70 healthy individuals using qRT-PCR. Diagnostic performance was evaluated by ROC analysis. Functional assays and rescue experiments were performed in IL-1β-stimulated C-28/12 chondrocytes. Direct targeting of GGCX by miR-652-3p was demonstrated through luciferase reporter assay.</p><p><strong>Results: </strong>Elevated miR-652-3p expression was significantly associated with PTOA (<i>P</i> < 0.001), demonstrating high diagnostic performance (AUC = 0.891). Logistic analysis identified its independent prognostic value for poor PTOA outcomes (OR = 4.789, <i>P</i> = 0.006). MiR-652-3p overexpression suppressed chondrocyte proliferation/migration, promoted apoptosis, and disrupted ECM homeostasis. Experimental validation identified GGCX as a direct downstream target of miR-652-3p, where GGCX silencing abolished the beneficial effects of miR-652-3p suppression.</p><p><strong>Conclusion: </strong>Our findings demonstrated that miR-652-3p drives PTOA pathogenesis by suppressing GGCX, highlighting its clinical potential as a combined biomarker and therapeutic candidate.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at https://doi.org/10.1007/s43465-026-01833-y.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 10","pages":"2901-2911"},"PeriodicalIF":1.3,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181413","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":"Predictive Value of Serum NLRP3 for Delayed Radiographic Progression After PFNA Fixation in Patients with Intertrochanteric Femoral Fractures.","authors":"Fei Wang, Liqin Wang, Tingting Liu, Qi Zhang, Gongxi Fang, Zhaohong Gao","doi":"10.1007/s43465-026-01782-6","DOIUrl":"https://doi.org/10.1007/s43465-026-01782-6","url":null,"abstract":"<p><strong>Background: </strong>Delayed fracture healing is a clinically significant complication following proximal femoral nail antirotation (PFNA) fixation in older adults with intertrochanteric femoral fractures. Early identification of patients at risk remains challenging. This prospective observational study investigated whether early postoperative serum NLRP3 levels are associated with delayed radiographic progression.</p><p><strong>Methods: </strong>A total of 157 patients undergoing PFNA fixation were enrolled. Serum NLRP3, IL-6, IL-1β, TNF-α, and C-reactive protein were measured on postoperative day 1. Clinical, perioperative, and radiographic data were collected. Fracture healing at 4 months was assessed based on radiographic callus formation. Group comparisons, Spearman correlation analysis, receiver operating characteristic (ROC) curves, and multivariate logistic regression were used to evaluate the predictive value of NLRP3.</p><p><strong>Results: </strong>Among the 157 patients included, 123 (78.3%) achieved fracture healing and 34 (21.7%) experienced delayed radiographic progression at 4 months. Serum levels of NLRP3, IL-6, and IL-1β were significantly higher in the delayed group compared with the healing group. Spearman correlation analysis revealed that serum NLRP3 levels were positively correlated with IL-6 and IL-1β, and negatively correlated with serum albumin. ROC curve analysis demonstrated that NLRP3 exhibited the highest diagnostic performance for delayed radiographic progression, with an area under the curve of 0.831 (95% CI 0.744-0.917). In multivariate logistic regression analysis, higher serum NLRP3 levels, higher IL-6 levels, longer time from injury to surgery, and absence of prefracture independent mobility were independently associated with delayed radiographic progression.</p><p><strong>Conclusion: </strong>Early postoperative serum NLRP3 levels were associated with delayed radiographic progression in older adults following PFNA fixation. NLRP3 demonstrated better discriminatory ability than conventional inflammatory markers and remained an independent predictor after adjustment for clinical and perioperative variables. These findings suggest that serum NLRP3 may serve as a useful early indicator to identify patients at risk of delayed radiographic progression.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 10","pages":"2840-2848"},"PeriodicalIF":1.3,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181505","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":"Orthopaedic Patient Data Management and Analysis Using Clinical Registries.","authors":"Shivanshu Dixit, Pradeep Singh, Y J Naga Malleswari Turlapati, Ushasukhanya S, Udendran R, Muralidharan C","doi":"10.1007/s43465-026-01837-8","DOIUrl":"https://doi.org/10.1007/s43465-026-01837-8","url":null,"abstract":"<p><strong>Background: </strong>Conventional orthopaedics patient data management are often fragmented across multiple platforms which adversely impact effective interoperability, data storage, retrieval, and clinical decision-making. The goal of this study is to design and implement an integrated and extensible Orthopaedic Patient Data Management and Analysis System using structured clinical registries that improve clinical workflows, patient care, and research readiness.</p><p><strong>Methods: </strong>A web-based clinical registry system was developed using MERN (MongoDB, Express.js, React, Node.js) stack. The system supports configurable orthopaedic-specific clinical registries, flexible data entry full CRUD (Create, Read, Update, Delete) operations, role-based access control for data security, and multi-criteria filtering included for quick patient searches. Future versions will include data visualization tools and predictive analytics for better decision-making.</p><p><strong>Results: </strong>The implemented system provides improved data accessibility, reduces task duplication, and improves and enhances structured record keeping across orthopaedic subspecialties with multi-criteria filtering algorithms. Although advanced analytics and visualization are not currently deployed, the system architecture supports future integration of AI-driven predictive models and Power BI dashboards.</p><p><strong>Conclusion: </strong>The developed Orthopaedic Patient Data Management and Analysis System is robust, secure, scalable, and extensible, enhancing administrative efficiency and enabling longitudinal outcome tracking. It also contributes to medical research via outcome tracking and trend analysis. The system acts as a fundamental step toward intelligent data-driven orthopaedic care through future predictive analytics and clinical decision support.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 9","pages":"2279-2288"},"PeriodicalIF":1.3,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108418","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 Pivot Total Knee Arthroplasty: Replicating Native Knee Kinematics and Early Clinical Outcomes.","authors":"Shaheer Shahul Hameed, Rakesh Rajput, P Uwais, Aakash Basu, Sayak Setua, Nilay Saha","doi":"10.1007/s43465-026-01832-z","DOIUrl":"https://doi.org/10.1007/s43465-026-01832-z","url":null,"abstract":"<p><strong>Background: </strong>Despite advances in total knee arthroplasty (TKA), up to 20% of patients remain dissatisfied, often due to non-physiological knee kinematics associated with conventional cruciate-retaining and posterior-stabilized designs. Medial pivot TKA systems aim to replicate native knee biomechanics by providing a stable medial compartment with controlled lateral femoral rollback.</p><p><strong>Objectives: </strong>To evaluate early clinical, functional, and radiological outcomes of primary TKA using a medial pivot knee system in patients with advanced knee osteoarthritis.</p><p><strong>Methods: </strong>This prospective single-center study included 73 patients (82 knees) undergoing primary TKA with a medial pivot knee system between August 2023 and December 2024. Patients with severe deformities or prior knee osteotomies were excluded. All surgeries were performed by a single surgeon using a standardized technique. Clinical outcomes were assessed using the Oxford Knee Score (OKS), WOMAC score, Forgotten Joint Score (FJS), and range of motion (ROM) preoperatively and at 6 weeks, 3 months, and 1 year postoperatively. Radiographs were evaluated for component positioning, loosening, and osteolysis. Patient satisfaction and complications were recorded.</p><p><strong>Results: </strong>At one year, significant improvements were observed in all outcome measures. Mean OKS improved from 11.3 to 45.1, WOMAC from 29.6 to 88.4, and FJS reached 87.4. Mean ROM increased from 118.4° preoperatively to 121.5°. Excellent or good satisfaction was reported by 97.3% of patients. No radiological loosening or osteolysis was observed. Complications were minimal and successfully managed.</p><p><strong>Conclusion: </strong>Medial pivot TKA demonstrated excellent short-term functional outcomes, high patient satisfaction, and stable radiological results, suggesting that replication of native knee kinematics may enhance early clinical performance.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 9","pages":"2322-2329"},"PeriodicalIF":1.3,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109037","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":"Conversion Unicondylar Knee Arthroplasty in the Indian Patient: What Can You Expect?","authors":"Adit R Maniar, Rajesh N Maniar, Muhammad Naqvi, Nishant Sanghavi","doi":"10.1007/s43465-026-01831-0","DOIUrl":"https://doi.org/10.1007/s43465-026-01831-0","url":null,"abstract":"<p><strong>Introduction: </strong>Our aim was to compare the clinical outcomes of conversion unicompartmental knee arthroplasty (UKA) with (a) primary total knee arthroplasty (TKA) and (b) revision TKA.</p><p><strong>Methods: </strong>We retrospectively identified 17 patients undergoing conversion of UKA to TKA by a single surgeon with a minimum 1 year follow-up. These patients were matched 1:1 to patients undergoing primary TKA and revision TKA based on age, sex, BMI and time to final follow-up forming three groups: conversion UKA group (C-UKA), primary TKA group (P-TKA) and revision TKA group (R-TKA). Clinical outcomes were compared using New Knee Society Score (NKSS) and Forgotten Joint Score (FJS). The level of significance was set at 0.05.</p><p><strong>Results: </strong>The average time to surgery in the C-UKA group was 7.2 years (range 2.5-17.2), with 82.5% being less than 10 years from index UKA. The mean follow-up was 3.7 years in the C-UKA group. All patients required more than a primary component on the tibial side. Flexion (<i>p</i> = 0.03), symptom (<i>p</i> < 0.001) and function (<i>p</i> < 0.001) subcomponent as well as total NKSS (<i>p</i> = 0.001) were significantly lower in the C-UKA group as compared to the P-TKA group. The flexion (<i>p</i> = 0.67), FJS (<i>p</i> = 0.71) as well as the NKSS and its subcomponents were comparable (<i>p</i> > 0.05) between the C-UKA and R-TKA groups.</p><p><strong>Conclusion: </strong>When performing conversion of a medial UKA in the Indian population, a revision component is required in all patients on the tibial side. The clinical outcomes of conversion UKA were poorer than a primary TKA and more comparable to a revision TKA. Surgeons should keep this in consideration when performing a medial UKA, especially in cases with extended indications.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 9","pages":"2340-2346"},"PeriodicalIF":1.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108969","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":"An Experience of Orthopedic Implant-Related Adverse Events at a Regional Training Center in Central India.","authors":"Ahmad Najmi, Shilpa N Kaore, Rehan-Ul-Haq, Manish Dwivedi, S Balakrishnan, Mohammad Faizan Khan, Chirag Agrawal","doi":"10.1007/s43465-026-01817-y","DOIUrl":"https://doi.org/10.1007/s43465-026-01817-y","url":null,"abstract":"<p><strong>Background: </strong>Orthopedic implant-associated adverse events (OIAEs) pose a significant challenge to patient safety. Infections, implant failures, allergic reactions, and the need for revision surgeries are among the most frequently reported complications. This study aimed to evaluate the nature and pattern of medical device adverse events (MDAEs) related to orthopedic implants at a Regional Training Center under the Materiovigilance Program of India.</p><p><strong>Methods: </strong>A retrospective, observational study was conducted using spontaneously reported MDAEs at the Medical Device Monitoring Center (MDMC), at a tertiary care center in Central India, between July 2019 and September 2022. Reports were submitted by healthcare professionals, patients, or their caregivers. Data were collected using the Indian Pharmacopeia Commission (IPC) recommended MDAE reporting form and analyzed using Microsoft Excel and SPSS v1.0.0.1406. Causality was assessed using WHO-UMC criteria. Descriptive statistics (frequency, percentages) were used for analysis.</p><p><strong>Results: </strong>A total of 92 MDAEs were reported, of which 88% were serious. Infections were the leading cause (73%), followed by dislocation (11%), allergic reactions (7%), implant loosening (5%), and metallosis or bent nails (2% each). Revision surgery was required in 76% of cases. The most frequently implicated devices included interlocking nails and tibia locking plates. Causality assessment categorized 58% as probable, 25% as possible, and the remainder as unlikely, unassessable, or not related.</p><p><strong>Conclusion: </strong>This study highlights infections as the predominant OIAE, requiring revision surgeries in most cases. A robust materiovigilance system and increased awareness among healthcare providers are essential for timely detection and reporting of OIAEs to improve patient safety.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 10","pages":"2895-2900"},"PeriodicalIF":1.3,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181533","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":"Reliability of Clinical Features in Identifying Atypical Club Foot.","authors":"Saurabh Jain, Anand Ajmera, Arunangshu Mukherjee","doi":"10.1007/s43465-026-01824-z","DOIUrl":"10.1007/s43465-026-01824-z","url":null,"abstract":"<p><strong>Background: </strong>Atypical clubfeet, which is often refractory to the classical Ponseti manipulations have special clinical features. It is important to identify these atypical club feet from these clinical features, so as to modify the manipulation technique, for optimal results. In this study, we assessed the presence of the different clinical features in diagnosing atypical clubfeet and its influence on subsequent management protocol, using modified Ponseti technique.</p><p><strong>Methods: </strong>Fifty two atypical club feet with a mean age of 3.3 months were assessed for the presence of different clinical features and subsequently treated by modified Ponseti casting. Mean of the number of casts required to correct the deformity were correlated with the various clinical features present.</p><p><strong>Results: </strong>Short hyperextended great toe, which was smaller than the 2nd toe was the most consistent finding seen in all of the cases. This was followed by the presence of deep plantar crease (plantaris) and short swollen chubby foot as seen in more than 90 per cent of cases. Deep posterior crease; tight, wide and long heel cord; rigid equinus and history of slippage of casts were observed in 35 (67.3%), 25 (48.07%), 33 (63.4%) and 12 (23%) cases, respectively. Presences of all the seven clinical features were seen only in 12 (23%) feet. Mean number of casts required to correct the deformity were 8.8 (range 7 to 12). When atypical club foot was associated with presence of any other additional clinical feature, mean casts required to correct deformity was 9.4. When two or more additional clinical features were present mean number of casts required was 9.9.</p><p><strong>Conclusions: </strong>In this study, short hyperextended great toe, great toe smaller than 2nd toe, short swollen chubby foot and deep plantar crease (plantaris) with severe plantar flexion of all metatarsals were the most reliable clinical features of atypical clubfeet. We noted that the mean number of casts required to correct atypical club foot was higher when compared with idiopathic clubfoot correction, as reported in literature. Furthermore, the number of casts required for correction, increases with the presence of each additional clinical feature(s), i.e., more the clinical features out of seven, noted above, more casts required for correction.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s43465-026-01824-z.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 8","pages":"2028-2032"},"PeriodicalIF":1.3,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13437845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678289","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}