Indian Journal of Orthopaedics最新文献

{"title":"Early Functional Outcome After Anterior Cruciate Ligament Reconstruction in Patients Using Post-Operative Brace or No Brace: A Prospective Observational Case–Control Study","authors":"Nishchal Rijal, Amit Joshi, Bibek Basukala, Nagmani Singh, Rohit Bista, Rajiv Sharma, Subash Gurung, Ishor Pradhan","doi":"10.1007/s43465-024-01240-1","DOIUrl":"https://doi.org/10.1007/s43465-024-01240-1","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>The use of rehabilitative knee braces after anterior cruciate ligament reconstruction (ACLR) has been controversial. This study aimed to evaluate the early functional outcome associated with post-ACLR brace use.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>This prospective observational case–control study was conducted at AKB Center for Arthroscopy, Sports Injury, and Regenerative Medicine, B&amp;B Hospital, Lalitpur, Nepal. A total of 132 patients undergoing arthroscopic ACLR with or without a meniscal procedure were enrolled in this study, with the final analysis consisting of 66 patients in the control group (brace group) and 66 patients in the case group (no brace group). Braces were applied to the affected lower limb in the control group in the operating room immediately after surgery and were continued for 4 weeks post-operatively. The rehabilitation protocol was the same for both groups. The patients were evaluated on the 3rd post-operative day, 2 weeks, 6 weeks, and 12 weeks post-operatively in terms of Lysholm knee scores, clinical tests (Lachman and pivot shift test), range of motion (flexion and extension), VAS scores for pain, thigh girth differences, and the 12-item short-form health survey (SF-12) scores.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>There were no significant differences between the two groups regarding outcome measures, except the mental component summary of SF-12 which was significantly better in the non-braced group (<i>P</i> = 0.006).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>There was no significant difference in early functional outcome between the braced and non-braced groups following ACLR with or without a meniscal procedure. Better SF-12 mental component summary scores were seen in the nonbraced group, which indicated possible mental discomfort in patients with brace use.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217156","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":"Return to Sport After Multiligament Knee Injury: A Systematic Review of the Literature","authors":"Riccardo D’Ambrosi, Amit Meena, Nicola Ursino, Fabrizio Di Feo, Niccolò Fusari, Srinivas B. S. Kambhampati","doi":"10.1007/s43465-024-01237-w","DOIUrl":"https://doi.org/10.1007/s43465-024-01237-w","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>The objective of this study was to conduct a comprehensive assessment of MLKI outcome studies in order to ascertain the overall rates of return to sport following MLKI.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A systematic review was conducted based on the PRISMA guidelines. Quality assessment of the systematic review was performed using the MINORS Score. The following search terms were browsed in the title, abstract, and keyword fields: “multiligament knee” or “MLKI\" AND “return to sport” or “sports activity” or \"athletes\" or \"sports\" or \"sportsman\". The resulting measures extracted from the studies were the rate of RTS, level of RTS, complications, revision surgery, Tegner, International Knee Documentation Committee (IKDC) Lysholm and anterior cruciate ligament-return to sport after injury (ACL-RSI).</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>A total of 439 patients were included in the study, of whom 383 (87.2%) were male and 56 (22.8%) were female. The mean age at surgery was 28.06 ± 8.93 years. The mean time from injury to surgery was 97.68 ± 127.81 weeks, while the mean follow-up was 42.83 ± 39.22 months. Of 312 patients who completed the follow-up and reported to be sportsmen before surgery, 184 (58.97%) returned to the same or higher pre-injury level, 58 (18.58%) returned to a lower level, while 69 (22.11%) did not return to sports activity. The author analysed the Tegner score in three studies and noted a decrease compared to the pre-injury level (from 7.12 ± 0.8 pre-injury to 4.59 ± 0.57 at the final follow-up; p &lt; 0.001). At the final follow-up, 4 studies analysed IKDC with a mean value of 75.14 ± 9.6, 3 reported a mean Lysholm of 51.81 ± 27.6, and two reported a mean ACL-RSI of 64.82 ± 0.149. Among the 439 patients, a total of 90 (20.5%) complications/re-operations were reported, while a total of 29 (6.6%) failures were recorded.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Return to sport after MLKI occurs in approximately 75% of surgically treated patients, though return to high-level sport is about 60% of the patients. Furthermore, one in five patients report complications, while the failure rate is relatively low (&lt; 7%).</p><h3 data-test=\"abstract-sub-heading\">Level of Evidence</h3><p>Systematic review of level 4.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217158","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":"Arthroscopic Versus Open Bone Grafting and Internal Fixation of Scaphoid Nonunion—A Systematic Review","authors":"John Ashutosh Santoshi, Puneet Kumar Acharya, Prateek Behera, Karthick Rangasamy","doi":"10.1007/s43465-024-01233-0","DOIUrl":"https://doi.org/10.1007/s43465-024-01233-0","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Scaphoid nonunion often requires surgical management involving the combination of a bone graft and internal fixation to restore the carpal alignment and length. While traditionally, the scaphoid waist nonunions have been treated with open bone grafts, with the advent of arthroscopy, bone graft reconstruction can now be carried out as an arthroscopic assisted minimally invasive procedure. We aimed to compare outcomes between open and arthroscopic bone grafting in the treatment of scaphoid nonunion.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A review protocol was established according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. PubMed/Medline, Cochrane, Embase, and Google Scholar were searched for articles on open and arthroscopic bone grafting for scaphoid nonunion with a minimum 12 month follow-up. The primary outcome was union rates in the two techniques. Secondary outcomes were changes in pain scores, complications, functional outcomes using different scoring systems, grip strength, range of motion at the wrist, and radiological parameters for restoring normal carpal alignment.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Forty studies reporting on 1534 wrists were included (1152 open, 382 arthroscopic). The union rate was 93.4% and 93.2% with open and arthroscopic techniques, respectively. The functional scores were comparable between the two techniques. All patients had a reduction in their pain scores. The radiological outcome parameters were not reported by any of the studies in the arthroscopic group.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>While bone grafting with both open and arthroscopic techniques for scaphoid nonunion showed comparable union rates and functional scores, further research is needed to assess the radiological outcomes of the arthroscopic technique.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217160","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":"Treatment of Diaphyseal Tibial Non-unions After Open Fracture: A Retrospective Observational Study on Characteristics and Outcomes","authors":"R. Strain, P. J. Harwood, N. K. Kanakaris, P. V. Giannoudis","doi":"10.1007/s43465-024-01235-y","DOIUrl":"https://doi.org/10.1007/s43465-024-01235-y","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Non-union is a significant complication following open diaphyseal tibia fractures. Management can be complex and unpredictable. Several principles must be addressed often in combination to achieve union. The aim of this study is to report on the characteristics, management and eventual outcome of non-united open tibial fractures over a 12-year period from a level I trauma centre.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>This is a retrospective observational study of all adults (age 18 years and older) presenting to a level 1 trauma centre with a diaphyseal tibia fracture. Non-union was diagnosed using the standard FDA definition of incomplete union by 9 months or no progress to union in the preceding 3 months. Injury and patient demographics in addition to all interventions and complications were recorded for each patient.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Forty three cases of diaphyseal non-union were identified from 2008 to 2019. Only the presence of peripheral vascular disease demonstrated a statistically significant association with the development of non-union. In 44% of cases, more than one additional operation was required to achieve union. Successful union was achieved in 90% of cases with 74% of patients returning to full pre-injury function without complication.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Management of non-union is a complex problem which requires a multifaceted and bespoke approach. We have included an algorithm to help guide decision making based on our institutional experience. A satisfactory result is achievable in the majority of patients.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217159","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":"Orthopedic or Surgical Treatment in Gartland Type II Supracondylar Humerus Fractures: A Systematic Review","authors":"Isabel Barber-Vidal, Ignacio Miranda, Francisco J. Miranda","doi":"10.1007/s43465-024-01227-y","DOIUrl":"https://doi.org/10.1007/s43465-024-01227-y","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>There is a broad consensus among orthopedic surgeons in the treatment of Gartland type I supracondylar humerus fractures (conservative) and Gartland type III (surgical) fractures, but there is controversy regarding the treatment of choice for Gartland type II fractures. The aim was to analyze the existing current evidence on the choice of surgical or conservative treatment of Gartland type II supracondylar humerus fractures.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A systematic review was carried out following the PRISMA guidelines. The search was conducted on May 24, 2023, in PubMed and Cochrane Central, introducing the terms (“humerus” AND “supracondylar”) AND (“Gartland II” OR “Gartland 2”). The selected studies were evaluated with the JBI checklist for quasi-experimental studies.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>5 retrospective comparative studies were included (evidence level III). Radiological and functional results were good with both treatments. Only one study obtained a better result with surgical treatment (with <i>n</i> = 4 in the conservative group); the other four studies did not find significant differences between the two types of treatment. There are risks of bias in all studies.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Both types of treatment (conservative and surgical) are valid for type II Gartland supracondylar humerus fractures, and provide good results, both functional and radiological. There is not enough scientific evidence to be able to affirm that one of the two treatments (surgical or conservative) is superior to the other for the treatment of these fractures. Findings on the initial radiograph, such as rotational deformity, coronal malalignment, or a severely angulated distal humeral fragment, can assist in the decision-making process.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217208","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":"A Radiological Comparison of Robotic-Assisted Versus Manual Techniques in Total Hip Arthroplasty","authors":"Adarsh Annapareddy, Praharsha Mulpur, Tarun Jayakumar, Chethan Shinde, Vemaganti Badri Narayana Prasad, A. V. Gurava Reddy","doi":"10.1007/s43465-024-01232-1","DOIUrl":"https://doi.org/10.1007/s43465-024-01232-1","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>This study investigates the radiological outcomes of robotic-assisted total hip arthroplasty (RATHA) compared to manual total hip arthroplasty (mTHA), addressing the ongoing debate on the effectiveness of RATHA in achieving superior implant positioning accuracy.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A prospective cohort of 212 patients (103 robotic, 109 manual) underwent THA and were evaluated for postoperative radiological outcomes, focusing on the inclination and anteversion angles of the acetabular cup. Outlier prevalence was assessed based on angles outside the defined Lewinnek safe zones. All post-operative measurements were made using the BoneNinja application.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>High inter-observer and intra-observer reliabilities were observed, validating the measurement accuracy. The mean anteversion and inclination angles in the RATHA cohort were 40.5 ± 1.5 and 24.5 ± 3.1° respectively; and the mTHA cohort were 42.1 ± 4.9 and 24.9 ± 4.5°. There was a statistically significant difference in inclination angles between the two cohorts whereas the anteversion angles showed no difference. Majority of the conventional THRs (<i>N</i> = 72, 55.4%) were placed outside the safe zone for anteversion. The inclination angles revealed a highly significant difference between the cohorts (<i>p</i> &lt; 0.0001), with all the robotic THRs (<i>N</i> = 121, 100%) being placed within the safe zone for inclination, whereas only 70% (<i>N</i> = 91) of the conventional THRs were within the safe zone. 97.5% of RA-THRs were within 3° of the proposed plan, demonstrating high accuracy.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>RATHA significantly outperforms MTHA in radiological accuracy, achieving precise acetabular cup positioning with minimal outliers. These results advocate for RATHA's adoption in THA to enhance outcome predictability and affirm its reliability and safety over manual methods.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217161","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":"Does Proprioception-Based Rehabilitation Enhance Functional Outcome in Total Knee Arthroplasty? A Prospective Randomised Study","authors":"Yuvarajan Palanisamy, Arjun R. Prasad, Karthik Seetharaman, K. Ganesan, M. Kavitha, David V. Rajan","doi":"10.1007/s43465-024-01218-z","DOIUrl":"https://doi.org/10.1007/s43465-024-01218-z","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>Rehabilitation after Total Knee Arthroplasty (TKA) often includes proprioceptive exercises to prevent falls, but studies on proprioceptive training have yielded conflicting findings. This study aims to explore impact of proprioceptive training on functional performance after TKA.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Eighty patients who underwent unilateral TKA were randomly assigned to a proprioceptive exercise (PE) group or a routine exercises (RE) group. The PE group received proprioceptive exercises in addition to routine physiotherapy. Osteoarthritis Research Society Internal (OARSI) recommended tests and Oxford Knee Score (OKS) were used to assess performance and outcome at 3 and 6 months.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>In the 30-s chair sits test, the PE group outperformed the RE group at 3 months (13.69 vs. 9.17) and 6 months (21.07 vs. 18.63) (<i>p</i> &lt; 0.001 and <i>p</i> = 0.030). Stair climbing favoured PE group at 3 months (8.86 vs. 16.66, <i>p</i> = 0.037) and 6 months (0.556 vs. 1.133, p = 0.001). At 6 months in the 40-m fast-paced walk test, the PE group had a significantly shorter time (0.308 min vs. 0.557 min, <i>p</i> &lt; 0.001). Timed up and go test at 6 months favoured PE group (0.204 min vs. 0.377 min). In the 6-min walk test, the PE group covered significantly greater distances than the RE group at 3 months (589.59 vs. 346.53 m, <i>p</i> &lt; 0.001) and 6 months (649.60 vs. 448.32 m, <i>p</i> &lt; 0.001). OKS at 3 months was 38 ± 2.0 for PE group and 38 ± 4 for RE group (<i>p</i> = 1). OKS at 6 months was 42 ± 4 for PE group and 40 ± 2 for RE group (<i>p</i> = 0.94).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>This study highlights the importance of proprioception-based rehabilitation in improving functional performance for TKA patients, surpassing traditional rehabilitation programmes.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141934720","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":"Successful Management of a Pediatric Patient with Humeral Lateral Condyle Non-union, Elbow Valgus Deformity and Ulnar Neuropathy","authors":"İdris Çoban, Mustafa Karakaplan, Emre Ergen, Okan Aslantürk, Muhammed Köroğlu, Kadir Ertem","doi":"10.1007/s43465-024-01222-3","DOIUrl":"https://doi.org/10.1007/s43465-024-01222-3","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Humeral lateral condyle fracture is the most common elbow fracture in children after supracondylar fractures. Non-union of these fractures may cause ulnar nerve deficit, deformity and loss of joint motion, which are difficult to manage. Treatment of lateral condyle non-union can be done in two stages or one stage. However, despite all types of treatment, the chance of success is very variable. Many complications such as avascular necrosis, loss of motion, non-union, chronic pain, and heterotopic ossification have been reported as a result of surgeries performed for lateral condyle pseudoarthrosis.</p><h3 data-test=\"abstract-sub-heading\">Objective</h3><p>In this article, we applied two-stage surgical treatment to a pediatric patient who developed ulnar neuropathy and elbow valgus deformity as a result of lateral condyle non-union.</p><h3 data-test=\"abstract-sub-heading\">Case report</h3><p>A 8-year-old boy with lateral condyle nonunion presented to our clinic with pain and deformity. After initial examination, two-stage surgical treatment was planned to achieve union and deformity correction. In the first stage, we performed pseudoarthrosis surgery and ulnar nerve anterior transposition, and in the second stage, we performed elbow valgus deformity correction surgery. In three year follow-up, the range of elbow was 130/5/0 flexion/extension, with full supnation and pronation. Carrying angle was same with the opposite side.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Pediatric humeral lateral condyle nonunions cause deformity, pain, loss of motion, instability and neuropathy. Surgical treatment of nonunions with a careful planning provide excellent clinical and functional results.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141739172","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":"Effect of Timing of Surgery on the Outcomes and Complications in Multi-ligament Knee Injuries: An Overview of Systematic Reviews and A Meta-analysis","authors":"Raju Vaishya, Mohit Kumar Patralekh, Abhishek Vaish, Luke V. Tollefson, Robert F. LaPrade","doi":"10.1007/s43465-024-01224-1","DOIUrl":"https://doi.org/10.1007/s43465-024-01224-1","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background and Aims</h3><p>Multi-ligament knee injuries (MLKI) are serious and challenging to manage. This study aimed to elucidate the impact of surgical timing on both early and long-term outcomes following an MLKI.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A comprehensive search strategy was employed across PubMed, Scopus, Web of Science, and the Cochrane Library. Studies were identified using a combination of relevant keywords encompassing “multi-ligament knee injury,” “knee dislocation,” “reconstruction,” “repair,” “surgery,” and “timing,” and their synonyms, along with appropriate Boolean operators. Selection of articles (systematic reviews and meta-analyses) adhered to predefined inclusion and exclusion criteria. Furthermore, a meta-analysis was conducted utilizing data extracted from primary studies.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Early surgery for MLKI demonstrated a significant advantage over delayed surgery, reflected by significantly higher Lysholm scores (Mean Difference [MD] 3.51; 95% Confidence Interval [CI] 1.79, 5.22), IKDC objective scores (Mantel–Haenszel Odds Ratio [MH-OR] 2.95; 95% CI 1.30, 6.69), Tegner activity scores (MD 0.38; 95% CI 0.08, 0.69), and Mayer’s ratings (MH-OR 5.47; 95% CI 1.27, 23.56). In addition, we found a significantly reduced risk of secondary chondral lesions (MH-OR 0.33; 95% CI 0.23, 0.48), lower instrumented anterior tibial translation in the early surgery group (MD −0.92; 95% CI −1.83, −0.01), but no significant difference was observed in the secondary meniscal tears, between the two groups. However, the early surgery group also exhibited a significantly increased risk of knee stiffness (MH-OR 2.47; 95% CI 1.22, 5.01) and a greater likelihood of requiring manipulation under anaesthesia (MH-OR 3.91; 95% CI 1.10, 13.87).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Early surgery for MLKI improves function, and stability, and reduces further articular cartilage damage, but increases the risk of stiffness.</p><h3 data-test=\"abstract-sub-heading\">Level of Evidence</h3><p>IV.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141739171","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":"Serum Sirt6 as a Potential Biomarker for Osteoarthritis and its Correlation with IL-6 Alterations","authors":"Nikhil Gupta, Anchal Arora, Navjot Kanwar, Kavin Khatri, Abhinav Kanwal","doi":"10.1007/s43465-024-01223-2","DOIUrl":"https://doi.org/10.1007/s43465-024-01223-2","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Objective</h3><p>The study aimed to assess Sirt6 levels in serum of knee osteoarthritis (OA) patients compared to healthy individuals to evaluate its correlation with OA and to understand how Sirt6 is linked with the change in IL-6 levels.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>The cross-sectional study involved 50 knee OA patients clinically diagnosed as per the American College of Rheumatology guidelines and 50 healthy controls. Radiological examination as per Kellgren–Lawrence (KL) criteria was done to determine the disease severity. Peripheral blood samples were collected from each participant, and serum Sirt6 and IL-6 levels were measured using ELISA.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The serum Sirt6 levels in knee OA patients were significantly lower as compared to healthy controls (p = 0.023). Patients with knee OA of KL grade 4 had significantly lower Sirt6 levels as compared to those with KL grade 2 OA (p = 0.031). Individuals of younger age group had higher Sirt6 levels compared to older age group. IL-6 levels in knee OA patients were significantly higher as compared to controls (p = 0.007). A negative correlation was observed between serum Sirt6 and IL-6 levels (r = − 0.407; p = 0.035).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>The study concludes that serum Sirt6 levels are inversely associated with knee OA and may serve as a potential biomarker for the disease. Moreover, a negative correlation between Sirt6 and IL-6 levels was observed in this study. Further investigations are necessary to confirm these findings and to explore the mechanisms by which Sirt6 and IL-6 are involved in OA.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141739284","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}