Indian Journal of Orthopaedics最新文献

{"title":"Biomedical Composites for Orthopaedics Health: Innovations, Sustainable Framework and Policy Interventions.","authors":"Viralkumar B Mandaliya","doi":"10.1007/s43465-026-01825-y","DOIUrl":"https://doi.org/10.1007/s43465-026-01825-y","url":null,"abstract":"<p><strong>Background: </strong>Biomedical composites are valuable for orthopaedic in joint replacement, sports medicine, spine care and paediatrics bone care. It is essential to map technological trend in any field based on patent analysis which provide current market potential and innovation gap in a field. The present article has covered ten major categories of biomedical composites for their patent analysis.</p><p><strong>Methods: </strong>The patent data were retrieved from Patentscope, a patent database from World Intellectual Property Organization (WIPO), Geneva. The patent data was filtered through international patent classification code A61 which classify patent for medical or veterinary science, which resulted into 3,378 on biomedical composites starting from 1972.Following to that, this article mapped biomedical composites with 17 UN Sustainable Development Goals (SDGs) on a scale of 1 to 10 (lowest to highest).</p><p><strong>Results: </strong>There was patent publication from 1991-2000 with 297 records, which was rise in 2001-10 (798 records), in 2010-20 (1051 records), and exponentially rise in just fi ve years of 2021-25 (1148). This shown the market attention and importance towards patent on biomedical composites. Further, this article have elaborated recent 82 patents on various biomedical composites. Based on relevance score, biomedical composites largely aligned to SDG-3 (Good Health and Well-being) and SDG-9 (Industry Innovation and Infrastructure). At last, policy intervention comprehended on ten points for capacity building.</p><p><strong>Conclusions: </strong>In nutshell, this article covered innovative trend on ten major categories of biomedical composites, mapped 17 UN SDGs on scale of 1-10, and derived the policy intervention to attain SDGs on higher scale.</p><p><strong>Graphical abstract: </strong></p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 10","pages":"2867-2894"},"PeriodicalIF":1.3,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181678","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":"Litigation in Spine Surgery: Why Were We Sued? To What Results? What Can We Learn?","authors":"Aditya Banta, Sandeep Kumar Yadav, Rajesh Kumar Rajnish","doi":"10.1007/s43465-026-01829-8","DOIUrl":"https://doi.org/10.1007/s43465-026-01829-8","url":null,"abstract":"<p><strong>Introduction: </strong>Spine surgery is highly prone to litigation due to unpredictable functional outcomes and neurological complication risks, despite complication rates being lower than those of other orthopaedic subspecialities. Data on spine litigation dynamics in India are limited, with most studies originating from North America and China. We aimed to evaluate factors leading to litigation against spine surgeons in India, litigation outcomes, and lessons for reducing litigation risk.</p><p><strong>Materials and methods: </strong>A retrospective descriptive study was conducted by searching Indian Kanoon and confonet.nic.in for \"spine surgery\" judgements over 20 years, yielding 69 eligible cases after exclusions. Variables studied included litigant demographics, disease aetiology, surgical details, alleged deficiencies, verdicts, compensation, hospital type, and surgeon speciality. Statistical analysis was performed using SPSS with Chi-square tests for categorical data.</p><p><strong>Results: </strong>Of 69 litigations, 69.5% of plaintiffs were male, and 92.75% of cases were against private practitioners. Orthopaedic surgeons were involved in 53.6% of cases, and neurosurgeons in 43.5%. Guilty verdicts occurred in 42% of cases. Common litigation triggers included postop neural deficits (30.4%), symptom non-relief (26%), delayed diagnosis (24.6%), and infection (23.2%). Wrong-level surgery had the highest likelihood of a guilty verdict (83%). Elective, basic spine surgeries, such as lumbar discectomy (46.9%), were most frequently litigated. The average compensation awarded was ₹8.27 lakh, significantly lower than the demands.</p><p><strong>Conclusion: </strong>Recognising litigation trends and adopting comprehensive preoperative counselling, meticulous documentation, and prompt management of complications can reduce litigation risk while enhancing patient safety and care quality in spine surgery practice.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 10","pages":"2698-2705"},"PeriodicalIF":1.3,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181312","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":"Type V Osteogenesis Imperfecta in an Indian Cohort: Phenotypic Variability and Radiological Insights in <i>IFITM5</i>-Related Bone Fragility.","authors":"Agnes Selina, Madhavi Kandagaddala, Vrisha Madhuri","doi":"10.1007/s43465-026-01811-4","DOIUrl":"10.1007/s43465-026-01811-4","url":null,"abstract":"<p><strong>Background: </strong>Osteogenesis imperfecta type V is a rare autosomal dominant form of osteogenesis imperfecta caused by the recurrent c.-14C>T mutation in the IFITM5 gene. This mutation affects osteoblast function and mineralization, leading to distinctive skeletal manifestations that differ from classical collagen-related OI. This study describes the clinical, radiological, and genetic characteristics of Indian children with OI type V, and assesses phenotypic variability and treatment outcomes.</p><p><strong>Methods: </strong>A retrospective observational study was conducted in six Indian children with genetically confirmed OI type V. Clinical data, fracture history, radiological findings, and treatment response to intravenous pamidronate were analyzed.</p><p><strong>Results: </strong>All six patients harbored the recurrent IFITM5 c.-14C>T variant. The age at first fracture ranged from birth to three years, with variable fracture frequency and progressive skeletal deformities. Hallmark features such as hyperplastic callus formation, ossification of interosseous membranes, and radial head dislocation were consistently observed. Wormian bones were present in five patients. Progressive spinal deformities, including scoliosis and kyphosis, developed in older children. Notably, none of the patients exhibited blue sclerae or dentinogenesis imperfecta. Familial transmission across three generations was observed in one case. All patients received intravenous pamidronate therapy, which resulted in initial improvement in bone mineral density; however, it did not prevent long-term skeletal complications in some individuals.</p><p><strong>Conclusion: </strong>This first Indian cohort highlights significant phenotypic variability in OI type V despite a uniform underlying mutation. Recognition of its distinctive clinical and radiological features is critical for accurate diagnosis, appropriate genetic counselling, and optimized management strategies.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 8","pages":"2033-2041"},"PeriodicalIF":1.3,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13438063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678408","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":"Treatment of Displaced Fracture Neck of Femur by Conventional Parallel Screws (CFIX) and Biplane Double-Supported Screws (BDSF) in Adults: A Prospective Study.","authors":"Jishnu Prakash Baruah, Abhinab Gogoi, Kumar Madhurya Pratim","doi":"10.1007/s43465-026-01830-1","DOIUrl":"https://doi.org/10.1007/s43465-026-01830-1","url":null,"abstract":"<p><strong>Introduction: </strong>Intracapsular fracture neck of femur has been a challenge to orthopedic surgeons and internal fixation with conventional technique is often associated with poor outcomes. The BDSF technique introduced by Filipov has shown encouraging clinical outcomes and reduced fixation failure rates in published series. However, comparative data between BDSF and conventional cancellous screw fixation (CFIX) remain limited. This study aimed to compare the clinical and radiological outcomes of both fixation modalities.</p><p><strong>Methodology: </strong>A prospective comparative study was conducted for 2 years including 60 patients, treated with either BDSF (Group A, <i>n</i> = 30) was compared with CFIX method (Group B, <i>n</i> = 30) in displaced fracture neck of femur. Functional outcomes were assessed using Modified Harris Hip scoring system (HHS) and radiological outcome was assessed by serial hip X-ray.</p><p><strong>Results: </strong>93.33% cases united post-operatively in group A and 90% cases in Group B but it was not statistically significant. All the failure cases had Garden IV fractures & posterior comminution. Average union time in BDSF method was 12.55 weeks compared to 14.68 weeks in CFIX (<i>p</i> < 0.05). Significantly superior functional outcomes at 1 month and 3 months in BDSF group (mean HHS 85.28 and 87.80) compared to CFIX group (mean HHS 72.20 and 82.07) (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>The BDSF technique demonstrated earlier union and better early functional outcomes compared with CFIX, with comparable overall union and complication rates. These findings suggest that BDSF may be a promising alternative fixation option for displaced intracapsular neck of femur fractures.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 9","pages":"2411-2420"},"PeriodicalIF":1.3,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109032","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":"Wrist Ganglion Cyst Localization in Relation to Cyst Size and Associated Injuries: An MRI-Based Retrospective Study.","authors":"Salih Kaya, Mehmet Ali Dursun","doi":"10.1007/s43465-026-01823-0","DOIUrl":"https://doi.org/10.1007/s43465-026-01823-0","url":null,"abstract":"<p><strong>Background: </strong>Wrist ganglion cysts (GCs) are frequently identified on magnetic resonance imaging (MRI); however, the relationship between cyst localization, cyst size, and associated MRI-detected pathologies remains unclear. This study aimed to evaluate whether the anatomical localization of wrist GCs is associated with cyst size and the presence of accompanying pathologies.</p><p><strong>Methods: </strong>This retrospective cross-sectional study included adult patients who underwent wrist MRI between 2023 and 2024 and were diagnosed with a GC. Cyst localization was classified as dorsal or volar. Cyst size was assessed by calculating cyst volume (mm³) based on the maximum diameters measured in three orthogonal planes on MRI. Accompanying pathologies, including distal radioulnar joint (DRUJ) injury, triangular fibrocartilage complex (TFCC) injury, bone cysts, tenosynovitis, and bone marrow edema, were recorded as binary variables. Cyst size was compared between dorsal and volar localizations using the Mann-Whitney <i>U</i> test. Associations between localization and accompanying pathologies were evaluated using Chi-square test. A multivariable logistic regression analysis was performed to evaluate the association between cyst localization and TFCC injury after adjustment for age and sex. Effect sizes were reported with corresponding 95% confidence intervals, including odds ratios and Cliff's delta where appropriate.</p><p><strong>Results: </strong>A total of 226 wrist GCs were analyzed, including 155 (68.6%) female and 71 (31.4%) male patients. Of these, 138 (61.1%) were located dorsally and 88 (38.9%) in the volar wrist. The median cyst volume did not differ significantly between dorsal and volar locations (<i>p</i> = 0.163), with a negligible effect size (Cliff's <i>δ</i> = 0.10). Volar GCs were observed in older patients and significantly associated with accompanying pathologies (<i>p</i> = 0.007), although the effect size remained small (Cliff's <i>δ</i> = 0.17). Among individual pathologies, the association between volar localization and TFCC injury did not retain significance after correction for multiple comparisons (<i>p</i> = 0.067). In multivariable logistic regression adjusted for age and sex, volar localization remained independently associated with TFCC injury (OR 2.12, 95% CI 1.02-4.43, <i>p</i> = 0.045).</p><p><strong>Conclusion: </strong>Wrist GC localization was not significantly associated with cyst size. Although volar GCs showed a higher frequency of accompanying pathologies-particularly TFCC injury-this finding should be interpreted as an observed trend rather than a definitive association.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 10","pages":"2859-2866"},"PeriodicalIF":1.3,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181520","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":"Results of Transverse Acetabular Fracture Fixation with Both Column Screws Only Versus Plate and Column Screw Combination: A Comparative Analysis for Choosing the Best Method.","authors":"Sunit Hazra, Sourav Ghosh, Mainak Chandra, Aakash Basu, Sanjay Kumar, Soham Mondal, Sumanta Pal","doi":"10.1007/s43465-026-01818-x","DOIUrl":"https://doi.org/10.1007/s43465-026-01818-x","url":null,"abstract":"<p><strong>Introduction: </strong>There has always been a debate regarding the fixation strategy of transverse acetabular fractures. We hypothesized that fixation strength of both column screws would be sufficient to withstand the physiological load across hip joint, resulting in similar functional and radiological outcomes with lower morbidity than plate and column screw combinations in transverse acetabular fractures.</p><p><strong>Material and methods: </strong>A total of 44 transverse acetabular fracture patients without significant comminution were divided them into three groups based on the type of treatment received, viz., group A which underwent fixation with anterior and posterior column screw (19 patients), group B which underwent fixation with anterior column screw and posterior column plate (15 patients), and group C which underwent fixation with anterior column plate and posterior column screw (10 patients). Radiological adequacy of fixation was determined by comparing the fracture gap or step as per Matta radiological accuracy at immediate post-op and 8 weeks, as well as comparison of horizontal and vertical displacement of the centre of rotation of the femur head at immediate post-op and at 12 weeks. Operative morbidity was also assessed in terms of blood loss and surgical time. Intraoperative radiation exposure was also determined.</p><p><strong>Results: </strong>All three groups showed satisfactory outcomes in terms of fixation. There was no statistically significant difference between the three groups in terms of loss of reduction assessed by an increase in gap or step or increase in horizontal and vertical distance of the centre of rotation of the femur head at predefined time intervals after surgery. Radiation exposure was also comparable in the three groups. However, group A showed a significantly lesser blood loss and operative time in comparison to groups B and C.</p><p><strong>Conclusion: </strong>In comparison to other methods of fixation for transverse acetabular fractures, both column screw fixation offers an adequate fixation strength along with the added benefit of decreased operative morbidity.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 9","pages":"2395-2401"},"PeriodicalIF":1.3,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108916","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":"Percutaneous Endoscopic Lumbar Discectomy With or Without Platelet-Rich Plasma: A Meta-Analysis.","authors":"Guy Awad, Marc Boutros, Jean-Pierre Saad, Zina Smadi, Jad Bou Monsef","doi":"10.1007/s43465-026-01819-w","DOIUrl":"https://doi.org/10.1007/s43465-026-01819-w","url":null,"abstract":"<p><strong>Background: </strong>Platelet-rich plasma (PRP) is increasingly used in orthopedic and spine surgery for its regenerative and anti-inflammatory effects, yet its clinical efficacy as an adjunct to percutaneous endoscopic lumbar discectomy (PELD) remains uncertain.</p><p><strong>Methods: </strong>A systematic search was performed in PubMed, Scopus, Cochrane Library, and Google Scholar through September 2025. Five comparative studies involving 479 patients met the inclusion criteria. Extracted outcomes included postoperative pain (VAS for low back and leg pain), functional recovery (ODI and JOA scores), MRI-based structural measurements obtained both preoperatively and postoperatively (Pfirrmann grading, intervertebral disc height, and spinal canal cross-sectional area), as well as recurrence rates.</p><p><strong>Results: </strong>PRP demonstrated significant benefits in early postoperative pain control, with lower VAS scores for low back pain (<i>p</i> < 0.001) and leg pain (<i>p</i> < 0.001) at 3 months. Improvements in low back pain persisted at 6 months (<i>p</i> = 0.003), while leg pain became borderline and no longer statistically significant (<i>p</i> = 0.05). Functional recovery also favored PRP, with higher clinician-assessed JOA scores at 3 and 6 months (<i>p</i> = 0.02 and <i>p</i> < 0.001) and improved patient-reported ODI scores at both time points (<i>p</i> < 0.001). MRI-based outcomes indicated greater postoperative spinal canal expansion (<i>p</i> < 0.001), better preservation of intervertebral disc height (<i>p</i> = 0.002), and less progression in Pfirrmann degenerative grading (<i>p</i> < 0.001). PRP was additionally associated with a significantly reduced rate of recurrent lumbar disc herniation (<i>p</i> = 0.007).</p><p><strong>Conclusions: </strong>PRP appears to enhance both clinical and structural outcomes when used as an adjunct to PELD, contributing to improved pain relief, functional recovery, and postoperative disc integrity. While promising, these findings highlight the need for larger high-quality studies to refine PRP protocols and confirm long-term effectiveness.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at https://doi.org/10.1007/s43465-026-01819-w.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 9","pages":"2192-2208"},"PeriodicalIF":1.3,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108794","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":"Comparative Outcomes of Total Knee Arthroplasty in Patients With Osteoarthritis vs With Rheumatoid Arthritis: A Meta-Analysis.","authors":"Guy Awad, Jean-Pierre Saad, Josef Lattouf, Marc Boutros","doi":"10.1007/s43465-026-01803-4","DOIUrl":"https://doi.org/10.1007/s43465-026-01803-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Total knee arthroplasty (TKA) is a well-established treatment for end-stage knee disease secondary to osteoarthritis (OA) or rheumatoid arthritis (RA). Although both conditions benefit from surgical intervention, they represent distinct patient phenotypes with differences in systemic inflammation, immunosuppression, comorbidity burden, and medical therapy, which may influence postoperative outcomes. This meta-analysis aimed to compare functional outcomes, implant-related complications, systemic adverse events, and infections between OA and RA patients following TKA.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A comprehensive literature search was conducted in PubMed, Scopus, Cochrane Library, and Google Scholar from database inception through September 2025. Eligible studies included randomized controlled trials, prospective and retrospective cohort studies, and registry-based analyses directly comparing outcomes of TKA in OA versus RA patients. Subgroup analyses included sex-matched and registry-based analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Thirty-five studies including over 7.0 million OA and 220,000 RA patients were analyzed. Functional outcomes (Knee Society Score (KSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Hospital for Special Surgery (HSS) Expectation score, and visual analogue scale (VAS) pain) showed no significant differences between groups. Quality-of-life measures statistically favored OA, with higher Short Form-36 (SF-36) physical component summary (PCS) (MD = 0.46; &lt;i&gt;p&lt;/i&gt; &lt; 0.00001) and mental component summary (MCS) scores (MD = 0.32; &lt;i&gt;p&lt;/i&gt; = 0.01), although these differences were of limited clinical significance. RA patients had higher risks of periprosthetic infection (RR = 0.37; 95% CI 0.26-0.54; &lt;i&gt;p&lt;/i&gt; &lt; 0.00001), prosthetic loosening (RR = 0.29; &lt;i&gt;p&lt;/i&gt; = 0.02), wound complications (RR = 1.28; &lt;i&gt;p&lt;/i&gt; = 0.01), and chronic pain (RR = 1.91; &lt;i&gt;p&lt;/i&gt; = 0.02), whereas OA patients had higher risks of deep vein thrombosis (RR = 1.22; &lt;i&gt;p&lt;/i&gt; = 0.02), pulmonary embolism (RR = 1.21; &lt;i&gt;p&lt;/i&gt; &lt; 0.00001), respiratory (RR = 1.68; &lt;i&gt;p&lt;/i&gt; = 0.04), renal (RR = 1.27; &lt;i&gt;p&lt;/i&gt; = 0.007), and gastrointestinal complications (RR = 1.36; &lt;i&gt;p&lt;/i&gt; &lt; 0.00001). Sex-matched analyses attenuated most differences, although periprosthetic infection remained higher in RA (RR = 0.49; &lt;i&gt;p&lt;/i&gt; = 0.0001). Registry-based analyses confirmed higher risks of periprosthetic infection (RR = 0.35; &lt;i&gt;p&lt;/i&gt; = 0.007) and prosthetic loosening (RR = 0.26; &lt;i&gt;p&lt;/i&gt; = 0.05) in RA, with comparable revision rates, mortality, and functional outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;TKA provides comparable functional outcomes and implant survivorship in OA and RA patients. However, distinct complication profiles reflect disease-specific biological and comorbidity factors rather than differences in surgical efficacy. These findings support individualized perioperative risk stratification rather than expecta","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 9","pages":"2221-2260"},"PeriodicalIF":1.3,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108971","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":"Clinical Study of Modified Tibial Transverse Transport Combined with the Masquelet Technique for the Treatment of Diabetic Foot with Ulcers.","authors":"Qing Ma, Bin Liu, Jianxue Zeng, Liang Lu","doi":"10.1007/s43465-026-01806-1","DOIUrl":"10.1007/s43465-026-01806-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective and background: &lt;/strong&gt;To analyze the clinical effect of modified tibial transverse transport combined with the Masquelet technique in treating diabetic foot with ulcers (Wagner stages 2-4). This study was conducted to explore a novel combined surgical strategy for Wagner 2-4 diabetic foot ulcers that respond poorly to conventional treatments.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 46 patients with Wagner 2-4 diabetic foot ulcers were enrolled (23 per group). Both groups received standardized preoperative glycemic control and infection management. The intervention group underwent modified tibial transverse transport (10 × 1.8 cm bone window; distraction starting on day 7 at 1 mm/day for 3 weeks, followed by reverse transport) combined with the Masquelet technique (PMMA spacer implantation at stage I, followed by autologous bone grafting at 6-8 weeks). The control group received conventional treatment, including debridement, VSD, and systemic antibiotics, without bone transport or induced membrane procedures. The primary outcome was limb salvage rate at 6 months. Secondary outcomes included wound healing rate, time to wound healing, MRI-confirmed edema resolution, changes in inflammatory markers, and 6-month recurrence rate. The hierarchical testing procedure was applied with limb salvage as the first endpoint; only if significant would subsequent endpoints be formally tested.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;With a median follow-up of 6.5 months (range 3-12 months), the complete wound healing rate (defined as complete epithelialization without drainage sustained for ≥ 2 weeks, achieved without or after minor amputation) was 82.6% (19/23) versus 69.6% (16/23) (&lt;i&gt;P&lt;/i&gt; = 0.289). The limb salvage rate (avoidance of major amputation above ankle) was 100% (23/23) in both groups (&lt;i&gt;P&lt;/i&gt; = 1.000). Among the 19 healed patients in the intervention group, 15 achieved healing without amputation, and 4 achieved healing after minor amputation (toe/ray); among the 16 healed control patients, 9 achieved healing without amputation and 7 achieved healing after minor amputation. Four intervention patients and seven control patients did not achieve wound healing within the study period. Among healed patients with complete 6-month post-healing follow-up (&lt;i&gt;n&lt;/i&gt; = 19 intervention, &lt;i&gt;n&lt;/i&gt; = 16 control), recurrence rates were 15.8% (3/19) and 31.3% (5/16), respectively (&lt;i&gt;P&lt;/i&gt; = 0.113). Four intervention patients and seven control patients did not achieve wound healing or were lost to follow-up before 6 months and were excluded from recurrence analysis. Four patients in the intervention group and seven in the control group did not achieve wound healing within the study period and were excluded from recurrence analysis. Wound healing time showed a trend toward a shorter duration in the intervention group (4.2 ± 2.1 vs. 5.8 ± 2.4 months, &lt;i&gt;P&lt;/i&gt; = 0.056). Postoperative inflammatory markers (ESR, CRP), affected foot skin temperature, to","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 8","pages":"2061-2074"},"PeriodicalIF":1.3,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13438089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678596","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":"Effectiveness of High-Volume Corticosteroid Injection Diluted with Saline in Subacromial Impingement Syndrome: A Randomized Trial.","authors":"Rıdvan Yıldızhan, İsa Cüce, Enes Veziroğlu, Taha Furkan Çakır, Merve Başol Göksülük","doi":"10.1007/s43465-026-01813-2","DOIUrl":"10.1007/s43465-026-01813-2","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to determine whether the efficacy of high-volume, ultrasound-guided subacromial injection with corticosteroid (CS) diluted with normal saline is superior to that of low-volume injection in patients with subacromial impingement syndrome (SIS).</p><p><strong>Methods: </strong>This study included 70 patients diagnosed with SIS. Patients were randomized into either the high-volume CS injection group [1 mL, 40 mg triamcinolone acetonide (TA); 1 mL, 2% lidocaine; 8 mL normal saline mixture] or the low-volume CS injection group (1 mL, 40 mg TA; 1 mL, 2% lidocaine; 1 mL normal saline mixture). Additional instructions for a home exercise program were provided after the injection. Assessments were made at baseline and 4- and 12-weeks post-injection, using the following measurements: Shoulder Pain and Disability Index (primary outcome); visual analogue scale (pain); active range of motion measurements (abduction, flexion, and external and internal rotations); and Western Ontario Rotator Cuff Index.</p><p><strong>Results: </strong>There were no significant differences between the groups in terms of demographic or shoulder-pain-related data at baseline. Both groups showed significant improvements in all outcomes at 4- and 12-weeks post-injection. However, there was no significant difference between the groups for any outcome. Post-injection adverse events and drug consumption during follow-up were comparable between the groups.</p><p><strong>Conclusions: </strong>All outcome measures significantly improved in both the high- and low-volume injection groups, with no significant between-group differences. This suggests that high-volume CS injections provide no additional benefit over low-volume injections for reducing pain and improving function in patients with SIS.</p><p><strong>Graphical abstract: </strong></p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 8","pages":"1957-1966"},"PeriodicalIF":1.3,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13438094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678562","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}