Indian Journal of Orthopaedics最新文献

{"title":"Autologous Growth Factor-Rich Concentrate (GFC) Injection in Non-union of Fractures: A Quasi-experimental Study.","authors":"Karun Jain, Madhan Jeyaraman, Naveen Jeyaraman, Ashim Gupta","doi":"10.1007/s43465-024-01278-1","DOIUrl":"10.1007/s43465-024-01278-1","url":null,"abstract":"<p><strong>Introduction: </strong>Non-union fractures represent a significant challenge in orthopedic practice, contributing to considerable morbidity and socioeconomic burden. Traditional treatments, such as autologous bone grafting, are effective but have limitations, including donor-site morbidity and limited tissue availability. Autologous peripheral blood-derived orthobiologics, including growth factor-rich concentrate (GFC), have emerged as a minimally invasive alternative, leveraging the body's natural healing mechanisms by concentrating and applying growth factors directly to the fracture site. This study evaluates the safety and efficacy of GFC injections in the treatment of non-union fractures.</p><p><strong>Materials and methods: </strong>This quasi-experimental study included 17 patients with non-union fractures of various long bones, treated under fluoroscopic guidance with three doses of 5 mL GFC injections, administered 2 weeks apart at the non-union site. Demographic data, injury characteristics, and comorbid conditions were recorded. Growth factor levels were quantified via enzyme-linked immunosorbent assay (ELISA), and statistical analyses were conducted to explore associations between the amount of growth factors and treatment outcomes. Radiographic assessments and bony callus appearance were evaluated at the baseline and at 1-, 3-, and 6-month follow-up post-last injection.</p><p><strong>Results: </strong>No adverse effects were reported throughout the duration of the study. The majority of patients (82.4%) showed significant improvement, evidenced by enhanced bony callus formation and reduced non-union signs. No significant correlation was found between the specific growth factor levels and the clinical outcomes of non-union of fractures. However, the presence of comorbid conditions significantly influenced treatment efficacy, underscoring the importance of patient selection in clinical practice.</p><p><strong>Conclusion: </strong>Administration of GFC injection is safe and potentially efficacious for the treatment of non-union fractures, offering an alternative to traditional surgical interventions. These results laid the foundation for prospective, adequately powered, randomized and non-randomized clinical studies with longer follow-up to further establish the efficacy of GFC in patients with non-union fractures. Moreover, formulation protocols need to be optimized while considering patient-specific variables, to ensure reproducibility and repeatability of outcomes from these studies.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s43465-024-01278-1.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"58 12","pages":"1833-1843"},"PeriodicalIF":1.1,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11628475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813088","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":"Effect of Approach Based Lumbar Interbody Fusion on Sagittal Spinopelvic Parameters and Functional Outcomes: Comparison between Oblique Lumbar Interbody Fusion (OLIF) and Transforaminal Lumbar Interbody Fusion (TLIF).","authors":"Mantu Jain, Siddharth S Sethy, Auroshish Sahoo, Shahnawaz Khan, Sujit Tripathy, Mathan Kumar Ramasubbu","doi":"10.1007/s43465-024-01229-w","DOIUrl":"10.1007/s43465-024-01229-w","url":null,"abstract":"<p><strong>Purpose: </strong>Transforaminal lumbar interbody fusion (TLIF) and oblique lumbar interbody fusion (OLIF) are the most commonly conducted operations for interbody fusions. In addition to fusion, the restoration of proper spinal alignment has become crucial for achieving favorable functional outcomes. There is a lack of agreement on which lumbar interbody fusion technique provides the most effective correction for sagittal spinopelvic parameters (SSPs). This study aims to investigate the functional outcome in terms of SSPs in patients undergoing single level OLIF and TLIF for lumbar degenerative disc disease.</p><p><strong>Methodology: </strong>Retrospective analysis of single level OLIF or TLIF was done. The patients' index and follow-up data until 6 months of surgery were collected. Radiographic parameters analysis included disc height (DH), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), pelvic index, lumbar lordosis (LL), segmental lordosis (SL). Clinical outcomes were recorded using visual analogue scale (VAS) and Oswestry Disability Index (ODI).</p><p><strong>Results: </strong>In a total of 38 patients (19 in each group) mean age was 51.52 ± 12.67 years in OLIF and 52.17 ± 9.73 years in TLIF. Improvement in DH was more in OLIF but not statistically significant (p = 0.075). Significant improvements were seen in PT, and SL post-TLIF. Change in SSPs among groups shown no significant differences. Both VAS and ODI shown improvements in both the groups but no significant difference was noted while comparing the two groups.</p><p><strong>Conclusion: </strong>The study showed better restoration of SSPs by TLIF in terms of PT and SL although functional outcomes appear similar in both procedures. Increase in DH is the important determinant for resulting good outcome. Patients with maintained spinopelvic balance can be treated satisfactorily with less-invasive OLIF.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 1","pages":"40-46"},"PeriodicalIF":1.1,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11680536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902977","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":"Correction: A Radiological Comparison of Robotic-Assisted Versus Manual Techniques in Total Hip Arthroplasty.","authors":"Adarsh Annapareddy, Praharsha Mulpur, Tarun Jayakumar, Chetan Shende, Vemaganti Badri Narayana Prasad, A V Gurava Reddy","doi":"10.1007/s43465-024-01271-8","DOIUrl":"https://doi.org/10.1007/s43465-024-01271-8","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1007/s43465-024-01232-1.].</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 1","pages":"131"},"PeriodicalIF":1.1,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11680508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902770","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":"Outcome of Soft Tissue Popliteal Sarcomas: 15 Years of Experience.","authors":"Hüseyin Emre Tepedelenlioğlu, Tolga Tolunay, Özlem Orhan, Şefik Murat Arikan, Erkan Akgün, Güray Toğral","doi":"10.1007/s43465-024-01263-8","DOIUrl":"10.1007/s43465-024-01263-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Soft-tissue sarcoma involving the popliteal fossa remains challenging because it is difficult to achieve wide margins with limb salvage in this location. Adjuvant therapy is frequently necessary, and limb function can be adversely affected. We reviewed our experience with these tumors. A variety of lesions can be identified within the posterior knee, ranging from simple Baker's cysts to malignant lesions. We present a review of frequently encountered and less common entities using an anatomic sieve, with the aim of providing a diagnostic approach to popliteal fossa masses Soft-tissue sarcomas (STSs) arising from the popliteal fossa present a challenge with regard to local control of primary tumors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;In the study, patients who were operated for a mass in the popliteal region between 2007 and 2018 in our clinic were retrospectively analyzed. Patients were categorized by parameters such as age, gender, extremity direction, type of surgery, AJCC scores, surgical margin, tumor size, presence of distant metastases, mass pathology, follow-up time and MSTS score.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Our study included 13 patients (eight women and five men). The mean age was 48 (range 12-84) years. The mass was located in the left knee in nine patients and the right knee in four patients. Frequent histologic diagnoses were for maliğn soft-tissue tumor liposarcoma (&lt;i&gt;n&lt;/i&gt;= 5), synovial sarcoma (&lt;i&gt;n&lt;/i&gt;= 3) and pleomorphic sarcoma (&lt;i&gt;n&lt;/i&gt;= 2), rabdomyorsarcoma, clear cell sarcoma, peripheral nerve sheath tumor (&lt;i&gt;n&lt;/i&gt;=1). Tumor size varied from 3 to 14 cm (median 7 cm). American Joint Committee on Cancer staging was as follows: three patients had stage IIA disease, five patients had stage IIB disease, two patients had stage III and stage IB and 1 patient had stage IV disease. The mean duration of follow-up was 39 (range 12-96) months. All patients underwent wide resection. Recurrence developed in four of these patients during the 5-year follow-up period. Recurrence resection was performed in three of the patients who developed recurrence, while recurrence resection + femur distal tumor resection arthroplasty was performed in one patient. In addition, 3 of these 13 patients received neoadjuvant chemotherapy, while 5 received adjuvant chemotherapy treatment. Neoadjuvant RT was applied to 4 patients with a mass greater than 9 cm. Margins were negative in seven of 13 patients and microscopically positive in five patients. Complications included wound infections in four patients and thrombophlebitis in two patients and one patients peroneal nerve nöropraxy. Of the patients undergoing limb-salvaging procedures, two experienced local recurrences after limb salvage and four experienced lung metastases. Local recurrence was always associated with positive margins. The mean MusculoskeletalTumor Society 1987 score was 50 ( range 35-68). At latest follow-up, six patients had died of disease, one was alive ","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"59 1","pages":"34-39"},"PeriodicalIF":1.1,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11680513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902999","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":"Atypical Multi-ligamentous Knee Injury (MLKI): Binary Injury with Avulsion of One Cruciate and Tear of the Other, or Bi-cruciates Avulsion with or Without Collateral Ligament Injury Following Road Traffic Accidents (RTA).","authors":"Rajagopalakrishnan Ramakanth, Silvampatti Ramasamy Sundararajan, Suchit Chavan, Kenchi Charith Nagarjun, Terence D'souza, Arumugam Palanisamy, Shanmuganathan Rajasekaran","doi":"10.1007/s43465-024-01256-7","DOIUrl":"10.1007/s43465-024-01256-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Multi-ligamentous knee injuries (MLKI) fall within a narrow spectrum, accounting for around 11% of all knee injuries. Atypical MLKI involve binary injury: avulsion of one cruciate and tear of the other, or both cruciates avulsion with or without collateral ligament injury.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;The purpose of this study is to analyse the clinical and radiological outcomes of patients diagnosed with atypical MLKI, and to assess the differences in outcomes between patients with collateral injury and those without.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;66 patients with atypical MLKI were studied and compared in this retrospective cohort. 32 of these patients did not have collateral injuries, while the remaining 34 patients did have collateral injuries. The duration of the study was from 2010 to 2022. Reconstruction for the cruciate tears and open or arthroscopic reduction and fixation (ORIF/ARIF) of the cruciate avulsion were performed. In earlier years (2010-2015), posterior cruciate ligament avulsions were open reduced and fixed using the double draping approach. However, in later years (2016-2022), the double draping method was replaced by the single draping technique. Conservative or surgical management of the collateral ligaments was determined based on factors such as intraoperative laxity, tissue quality, injury site, and chronicity. Group 1 comprised of atypical MLKI patients without collateral ligament injuries, while Group 2 included atypical MLKI patients with collateral ligament injuries and subgroup was based on the various combinations of cruciate avulsions, tears and collateral injuries. A comparative statistical analysis was conducted on the International Knee Documentation Committee (IKDC) score, Lysholm score, knee flexion range of motion (ROM), and laxity on stress radiographs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The male:female ratio were 54:12 patients. The average follow-up was 26.48 months (range 23-30 months). The average age of the patients is 37.66 (range 20-50 years). All patients had significant improvement from pre-operative scores to final follow-up scores (&lt;i&gt;P&lt;/i&gt; &lt; 0.001). There was no significant difference between the atypical MLKI with collateral and atypical MLKI without collateral injury in terms of the postoperative IKDC score (&lt;i&gt;P&lt;/i&gt; = 0.154), Lysholm score (&lt;i&gt;P&lt;/i&gt; = 0.387), knee flexion ROM (&lt;i&gt;P&lt;/i&gt; = 0.314), and laxity on radiographs with anterior stress (&lt;i&gt;P&lt;/i&gt; = 0.108) and posterior stress (&lt;i&gt;P&lt;/i&gt; = 0.272). The intergroup analysis was not statistically significant. There was no significant difference in patients' functional outcomes at final follow-up based on fixation modality. Patients recovered to their pre-injury activity levels without knee joint giving way on daily activities. None of the patients in our series had infections.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The incidence of atypical MLKI in multi-ligamentous injury was 9.53% (66/692). Atypical MLKI with cr","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"58 11","pages":"1594-1606"},"PeriodicalIF":1.1,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11554968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619307","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":"Nonunion of Fractures: A Review of Epidemiology, Diagnosis, and Clinical Features in Recent Literature","authors":"Eman Gharu, Bobby John","doi":"10.1007/s43465-024-01249-6","DOIUrl":"https://doi.org/10.1007/s43465-024-01249-6","url":null,"abstract":"<p>Understanding the etiology of nonunion is crucial to its effective management. Nonunion arises from a complex interplay of biological and mechanical factors. High-velocity injuries, which are becoming more prevalent, often involve extensive soft-tissue damage and stripping compromises the vascularity of bone fragments. The lack of adequate blood supply hampers the healing process and contributes to persistence of nonunion. Such injuries often result in high levels of contamination and persistent infections, making fractures particularly difficult to manage and leading to nonunion. Despite recent advances in medical techniques and interventions, managing the problem of nonunion still remains a formidable challenge. Much effort has gone into the understanding of the problem. With this review, we have made an attempt to correlate some of the known factors and looked at the future including the possible role of genetics in predicting the problem and modifying the outcome of nonunion.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"31 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142255913","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":"Location of the Anatomic Footprint Centers of the Anterior Cruciate Ligament Determined by Quadrant Method on Three-Dimensional Magnetic Resonance Imaging","authors":"Vũ Tú Nam, Võ Sỹ Quyền Năng, Phạm Trung Hiếu, Hồ Ngọc Minh, Phan Bá Quỳnh, Trần Trung Dũng, Dương Đình Toàn","doi":"10.1007/s43465-024-01234-z","DOIUrl":"https://doi.org/10.1007/s43465-024-01234-z","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>The quadrant method is widely used to determine the femoral footprint center (FFC) on radiographs or computed tomography (CT) and can also describe the tibial footprint center (TFC). However, its application on three-dimensional (3D) magnetic resonance imaging (MRI) has been limited. This study aims to describe the ACL footprint center position on 3D MRI of healthy knees using the quadrant method.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Proton density (PD) sequence 3D MRI was conducted on 45 intact knees, aged 18 to 45 years. The centers of the ACL footprints were determined, and 2D simulated radiographic images were generated from the 3D MRI data. The quadrant method was then applied to calculate the positions of the footprint centers.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The FFC was located at 31.6% in the deep–shallow (DS) direction and 31.3% in the high–low (HL) direction. The TFC was positioned at 45.1% in the mediolateral (ML) direction and 39.9% in the anteroposterior (AP) direction.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>The ACL footprint centers identified in this study were positioned similarly to previous studies, with the exception of the TFC in the ML direction, which was found to be more medial. This approach has the potential to enhance preoperative planning and intra-operative navigation in ACL reconstruction surgeries.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"7 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142269136","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":"Can a Surgical Vulnerability Score Predict Outcomes of Hip Reconstruction in Children with Severe Neuromuscular Disability?","authors":"Alistair Bevan, Stephanie Buchan, Alexander Aarvold, Simon Bennet, Darius Rad, Nick Le Prevost, Caroline Edwards","doi":"10.1007/s43465-024-01257-6","DOIUrl":"https://doi.org/10.1007/s43465-024-01257-6","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Hip surgery is often necessary for children with severe neuromuscular disabilities to avoid chronic pain resulting from hip migration. This study correlated the Surgical Vulnerability Score (SVS), a novel measure of physiological reserve, with reconstructive hip surgery outcomes to improve shared surgical decision-making.</p><h3 data-test=\"abstract-sub-heading\">Materials and methods</h3><p>Sixty-eight cases performed by a single surgeon were retrospectively evaluated. Cases were graded according to physiological vulnerability using the SVS, which was then correlated with two outcomes: length of hospital stay (LOS) and severity of postoperative complications. The Gross Motor Function Classification System (GMFCS) level was used as a baseline comparison. Sub-analysis compared results for patients who underwent only a femoral varus derotation osteotomy (VDRO) (<i>n</i> = 48) with those who underwent a combined VDRO and Dega Pelvic Osteotomy (Dega PO) (<i>n</i> = 20).</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Results showed that a higher SVS was associated with increased LOS (<i>p </i>= 0.001) and severity of postoperative complications (<i>p</i> = 0.0008). A greater GMFCS level was not associated with either LOS (<i>p</i> = 0.246) or the severity of postoperative complications (<i>p</i> = 0.282). For patients who underwent only a VDRO, an increase in SVS had no association with LOS (<i>p</i> = 0.483) or severity of complications (<i>p</i> = 0.981). However, for patients who underwent both a VDRO and Dega PO, a higher SVS was associated with increased LOS (<i>p</i> = 0.0002) and severity of complications (<i>p</i> = 0.0001).</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>The SVS can aid surgical decision-making and prepare the child’s family for surgery. Early intervention and fixation using only a VDRO may lead to better outcomes, underscoring the importance of hip surveillance programs in the early identification of migrating hips.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"7 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142255914","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 Modern-Day Algorithm for the Treatment of Multi-Ligament Knee Injuries","authors":"Fidelius von Rehlingen-Prinz, Sebastian Rilk, Victor Beckers, Robert O’Brien, Gregory S. DiFelice","doi":"10.1007/s43465-024-01252-x","DOIUrl":"https://doi.org/10.1007/s43465-024-01252-x","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>Multiligament knee injuries (MLKI) are rare and complex, significantly impacting long-term outcomes, with risks of osteoarthritis, joint stiffness, and reduced activity levels.</p><h3 data-test=\"abstract-sub-heading\">Objective</h3><p>To explore the evolution of MLKI treatment protocols, comparing historical and modern approaches, and to present a patient-tailored, preservation-first algorithm.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>This article reviews the literature on MLKI management, focusing on surgical timing, techniques, and rehabilitation protocols. The proposed algorithm categorizes MLKIs based on tear location and tissue quality, incorporating options, such as primary ligament repair, augmentation, and reconstruction.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The modern preservation-first algorithm provides a tailored approach to MLKI treatment, addressing the complexity and heterogeneity of these injuries, and aims to mitigate risks like postoperative arthrofibrosis.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>MLKI management remains complex and controversial. The presented algorithm offers a structured, individualized treatment strategy that integrates modern surgical and rehabilitation advancements.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"10 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142255917","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":"Mini-LET: A Technique Note","authors":"Manit Arora, Tapish Shukla, Jay Shah","doi":"10.1007/s43465-024-01269-2","DOIUrl":"https://doi.org/10.1007/s43465-024-01269-2","url":null,"abstract":"<p>Lateral extra-articular tenodesis (LET) has shown an upswing in popularity since the role of antero-lateral rotatory instability (ALRI) in ACL tears has become better understood. Its primary aim is to restore antero-lateral rotatory stability and hence reduce stresses placed on the ACL graft in high-risk individuals which should reduce graft failure rates. Many techniques have been described for LET using a variety of fixation methods (screws, anchors, etc.). Most of these techniques rely on a large incision laterally. We describe a novel technique (‘mini-LET’) which uses a 3–4 cm incision, to improve cosmesis.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"75 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142255918","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}