Indian Journal of Orthopaedics最新文献

{"title":"Combined AMRI and ALRI of the Knee in Elite Kabaddi Players: A Prospective Cohort Study of 26 Players","authors":"Manit Arora, Ananya Sharma, Tapish Shukla, Jay Shah","doi":"10.1007/s43465-024-01268-3","DOIUrl":"https://doi.org/10.1007/s43465-024-01268-3","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>ACL tears are the most common injuries in kabaddi, an inherently violent high pivoting and high-velocity direct contact sport. Combined ACL and MCL injuries and combined ACL and ALL injuries have been better understood but there is a lacuna of literature on these combined injuries in kabaddi players and no literature on combined AMRI and ALRI injuries. The present prospective cohort study aims to assess knee outcomes and return to sport for these injuries in elite kabaddi players.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A prospective cohort of 26 elite kabaddi players with clinical and MRI findings of ACL and MCL high-grade partial or complete tears were recruited. After ACL reconstruction and MCL repair, the resultant pivot shift was assessed against the now intact medial pillar and those with high-grade or explosive pivot were addressed using a modified deep Lemaire lateral extra-articular tenodesis. Pain scores (VAS) and knee outcomes (IKDC and Lysholm scores) were assessed pre-operatively and at regular intervals until 1-year follow-up. Return to sport and complications were also assessed.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>There was significant improvement in pain and knee scores throughout the study period, with most patients achieving full scores by six months duration. Return to sport was 96% and return to sport at pre-injury level was 77%. Complication rate of the combined triple procedure was low (&lt; 5%), with most complications being minor.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>The triple procedure of ACL reconstruction, MCL repair and Lateral extraarticular tenodesis successfully addressed the combined AMRI and ALRI in elite kabaddi players with a high rate of return to sport, excellent knee outcomes and low complication rate.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"22 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142255916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower Limb Length and Body Weight are Surrogate Predictors of Peroneus Longus Autograft Diameter","authors":"Manit Arora, Sachin Tapasvi, Tapish Shukla, Chiranjeev Jani","doi":"10.1007/s43465-024-01266-5","DOIUrl":"https://doi.org/10.1007/s43465-024-01266-5","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>Graft diameters are essential in any ACL surgery, with diameters less than 8mm associated with higher revision rates. Peroneus longus (PL) grafts have garnered much attention recently due to ease of harvest and more reliable graft diameters. The present study aimed to study various anthropometric parameters associated with PL-graft diameters.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We performed a prospective cohort study of 50 patients undergoing PL harvest for ACL surgery at a tertiary referral hospital. Age, gender, height, weight, length of the lower leg (lateral tibial plateau to the tip of the fibula), circumference at the head of the fibula and girth at the lateral malleolus were measured pre-operatively. The length of the graft doubled and tripled graft diameters were assessed intra-operatively. Pearson correlation coefficient was used to study the association between the pre-operative anthropometric variables and the intra-operative graft diameters and length of graft harvested.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The mean doubled and tripled PL-graft diameter in our study population was 7.7 ± 0.9 mm and 8.7 ± 0.8 mm, respectively. The mean length of the graft was 25.9 ± 3.5 cm. We found no significant correlation between graft diameters and age, gender or height of the patient. We found that the patient's weight significantly correlated (<i>p</i> &lt; 0.001) with graft diameter. We also found that the length of the lower leg (<i>p</i> &lt; 0.0001), circumference at the head of the fibula (<i>p</i> = 0.001) and girth at the lateral malleolus (<i>p</i> = 0.029) showed significant correlation with tripled PL-graft diameter.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>We found that weight, length of the lower leg and girth at the head of the fibula showed a strong correlation with tripled PL-graft diameter.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"4 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217135","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":"Atypical Hydatid Cyst of Entire Right Femur with Pathological Fracture: Total Femur Replacement Case Report","authors":"Hemant Sharma, Lokesh Garg, Rajesh Kumar Verma, Asgar Ali, Lovesh Agarwal, Guruditta Khurana, Lalit Kumar, Sourabh Chachan, Jasmine Kokiloo, Nikita Jajodia","doi":"10.1007/s43465-024-01226-z","DOIUrl":"https://doi.org/10.1007/s43465-024-01226-z","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>Hydatid disease is uncommon in Humans. It rarely affects the bones and joints (0.5–4%). Frequent sites of bony involvement are vertebrae, pelvic bones, upper end of long bones e.g. humerus, femur and tibia.</p><h3 data-test=\"abstract-sub-heading\">Material and methods</h3><p>We report a case of 41-year old female with primary Hydatid cyst of the entire right femur. Patient complaint of severe pain and was non ambulatory since the last 2 months.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Here, single staged Total Right Femur Replacement was done under General Anaesthesia. Patient was discharged after 6 days of hospital stay in a stable condition where physical rehabilitation was initiated after day one of the surgery, progressing to aided walking, standing and active lower limb exercises.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Involvement of the entire femur was a challenging case. There is no consensus/gold standard treatment of severe cases. Given the involvement of the entire Right Femur along with spillage in the neighbouring muscles, patient underwent Total Femur Replacement with Hip and Knee Replacement.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"287 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217136","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":"Patient Morbidity due to Sterile Zone Fire Outbreak during an Orthopaedic Trauma Surgery: A Case Report","authors":"Nishit Palo, Mahima Lakhanpal, Madhan Jeyaraman, Abhishek Shukla","doi":"10.1007/s43465-024-01264-7","DOIUrl":"https://doi.org/10.1007/s43465-024-01264-7","url":null,"abstract":"<p>Operating room fires are considered ‘never events’; they are uncommon but can prove to be potentially damaging to the humans involved and the expensive operating room instrumentation. Research indicates that significant knowledge gaps exist in orthopaedic community relating to fire prevention, fire safety and fire management. A 24-year-old male patient with clavicle fracture was planned for surgical fixation. A nerve block procedure was performed. Skin preparation was done with 10% betadine scrub and surgical spirit. The surgical team performed skin incision, and superficial dissection was carried out using electrocautery. A fire broke out, and on noticing the fumes, saline was poured, drapes were removed and the authors observed charring of deeper linen and skin damage. A superficial thermal burn, greenish blue in colour (7 x 1.5 cms) located 1–1.5 cms above the surgical incision was evident (see Fig. 4). The event was later explained to the patient. The surgical scar was healthy, and burn margins became defined and darkish green blue. Dressing was done with megaheal ointment. The burn healed in 4 weeks. As these events are rare, a specific action protocol has not been orchestrated. With newer reports coming in, orthopaedic associations should work out a sustainable plan of action to minimize the occurrence of these events and the damage incurred. Training of orthopaedic and anaesthesia team and operating room personnel remains the most important step in countering a fire event, as more the helping hands, the better is the outcome. Maintaining a high vigil ensures timely action response to maintain patient safety and counter adverse events effectively.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"34 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217133","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":"Deep Learning for Automatic Knee Osteoarthritis Severity Grading and Classification","authors":"Shakti Kinger","doi":"10.1007/s43465-024-01259-4","DOIUrl":"https://doi.org/10.1007/s43465-024-01259-4","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>Knee osteoarthritis (OA) is a prevalent condition that significantly impacts the quality of life, often leading to the need for knee replacement surgery. Accurate and timely identification of knee degeneration is crucial for effective treatment and management. Traditional methods of diagnosing OA rely heavily on radiological assessments, which can be time-consuming and subjective. This study aims to address these challenges by developing a deep learning-based method to predict the likelihood of knee replacement and the Kellgren–Lawrence (KL) grade of knee OA from X-ray images.</p><h3 data-test=\"abstract-sub-heading\">Methodology</h3><p>We employed the Osteoarthritis Initiative (OAI) dataset and utilized a transfer learning approach with the Inception V3 architecture to enhance the accuracy of OA detection. Our approach involved training 14 different models—Xception, VGG16, VGG19, ResNet50, ResNet101, ResNet152, ResNet50V2, ResNet101V2, ResNet152V2, Inception V3, Inception, ResNetV2, DenseNet121, DenseNet169, DenseNet201—and comparing their performance.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The study incorporated pixel ratio computation and picture pre-processing, alongside a decision tree model for prediction. Our experiments revealed that the Inception V3 model achieved the highest training accuracy of 91% and testing accuracy of 67%, with notable performance in both training and validation phases. This model effectively identified the presence and severity of OA, correlating with the Kellgren–Lawrence scale and facilitating the assessment of knee replacement needs.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>By integrating advanced deep learning techniques with radiological diagnostics, our methodology supports radiologists in making more accurate and prompt decisions regarding knee degeneration. The Inception V3 model stands out as the optimal choice for knee X-ray analysis, contributing to more efficient and timely healthcare delivery for patients with knee osteoarthritis.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"37 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217132","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":"Use of Internal Bracing in Multi-ligamentous Knee Injury Reconstruction: A Systematic Review","authors":"Abbie Randall, Richard Pearse, Shahnawaz Khan, Henry Atkinson","doi":"10.1007/s43465-024-01260-x","DOIUrl":"https://doi.org/10.1007/s43465-024-01260-x","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Multi-ligament Knee Injuries (MLKI) are often caused by a high-energy impact resulting in dislocation of the knee joint. Given the higher degree of instability associated with these MLKIs, surgical fixation with adjunctive internal bracing and the use of suture augmentation have been proposed with the intention of better restoring knee stability and improving the long-term outcomes of surgery. This systematic review seeks to appraise the current literature in relation to the role of internal bracing in the management of MLKI.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>All randomised control trials, observational studies, cohort studies, and cross-sectional studies containing patients with multi-ligamentous knee injuries managed with the use of internal bracing or suture tape augmentation were included in this review. The primary outcomes of interest were re-operation and failure rates, with secondary outcomes focussed on patient-reported outcome measures (PROMs) and examination findings of knee stability.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>282 studies were identified for screening, 13 of which were suitable for inclusion and five of these had injuries with Schenck grade III or above. Of the studies identified, failure rates ranged from 0 to 13.6%. Lysholm score was the most commonly utilised PROM tool with scores ranging from 61.8 to 95. Stiffness requiring MUA ± adhesiolysis was a common complication identified across studies.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>The use of internal bracing in Multi-ligament Knee Injuries appears to be as effective as not using an internal bracing technique. The post-operative PROMs and relatively low failure rates reflect promising outcomes for the ongoing use of internal bracing in MLKI. However, further prospective studies directly comparing braced versus non-braced ligamentous repairs are required in order to definitively determine if the use of the internal brace does allow for increased joint stability and early rehabilitation.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"20 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217140","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":"Single/ Multiple Dose Percutaneously Injected LR-PRP Enhances Union Rate in Fracture Delayed Unions: A Prospective Case Series","authors":"Kishor Kunal, Nitesh Gahlot, Neeraj Choudhary, Abhay Elhence","doi":"10.1007/s43465-024-01265-6","DOIUrl":"https://doi.org/10.1007/s43465-024-01265-6","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Average bone healing times of common fractures in adults ranges from 3 to 12 weeks and is location dependent. Platelet Rich Plasma (PRP) stimulates natural healing process through growth factors contained in platelets and has been employed for the same in delayed unions. </p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>All patients &gt; 18 years and documented delayed union were included in the study. Patients were followed up monthly after each Leucocyte-rich PRP (LR-PRP) injection and a decision for repeat PRP injection was taken on basis of visible impression in radiograph after previous injection.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Total 36 patients were studied in which 5 patients were lost to follow-up. Union was achieved in 28/31 (90.3%). 20 (71.4%) patients required only single PRP injections. 4 (14.3%) patients required 2 PRP injections, 3 (10.7%) patients required 3 PRP injections and 1 (3.6%) patient required 4 PRP injection. There was no significant correlation of number of PRPs to time from 1st PRP-union or time from last PPR- union.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Single/multiple dose percutaneously administered LR-PRP can be used as a fruitful alternative to catalyze union in patients having delayed union irrespective of site of injury.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"161 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217138","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":"The Accuracy of CT-Based Three-Dimensional Templating in Predicting Implant Sizes in Patients Undergoing Robot-Assisted Total Knee Arthroplasty","authors":"Neeraj Adkar, Mangesh Patil, Swapnil Vaidya, Rajendra Kumbar, Ravi Kerhalkar, Girish Mote, Satwik Thareja, Prajwal Sadalagi, Supreet Bajwa","doi":"10.1007/s43465-024-01244-x","DOIUrl":"https://doi.org/10.1007/s43465-024-01244-x","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Computed tomography (CT) based three-dimensional templating is increasingly being used to predict implant sizes in total knee arthroplasty (TKA). However, the existing data is heterogeneous, and the majority of studies lack adequate statistical power. This study investigated whether preoperative CT-based planning in robot-assisted TKA (RA-TKA) helps in predicting the accurate size of implant used.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>This is a single-center retrospective study of 632 consecutive RA-TKA surgeries. All surgeries were performed using a fully automatic Cuvis RA-TKA system. Cohen’s Kappa (κ) coefficient was used to measure the level of agreement between the predicted and the final implant sizes.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>A total of 632 knees were operated on 384 patients. A total of 136 unilateral cases whereas 248 patients had both knees operated on. For the tibial component, in 21.7% cases a bigger implant size was used while in 11.8% cases a smaller size was used. For the femoral component, in 5.1% cases a bigger implant size was used while in 4.9% cases a smaller size was used. The agreement between the predicted and actual implant sizes was <i>moderate</i> for the tibial component [κ = 0.56 (95% CI: 0.51 to 0.61); p &lt; 0.001] and <i>almost perfect</i> for the femoral component [κ = 0.87 (95% CI: 0.84 to 0.90); p &lt; 0.001].</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>This study suggests that planning of RA-TKA using a CT-based model can be valuable to surgeons in accurately predicting the component size for femur and to a lesser degree for tibia. Future studies should investigate the potential predictors of discordance between the predicted and actual tibial implant sizes.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"44 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217134","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":"Intra-Tunnel Knotless Anchor Fixation for Lateral Meniscus Posterior Root Tears: A Novel Technique","authors":"Manit Arora, Chiranjeev Jani, Tapish Shukla","doi":"10.1007/s43465-024-01262-9","DOIUrl":"https://doi.org/10.1007/s43465-024-01262-9","url":null,"abstract":"<p>Lateral meniscus posterior root tears (LMPRTs) are radial tears that occur within 10 mm of the posterior root tibial connection, also known as lateral meniscus posterior root avulsions. A common surgical approach for LMPRT (2) that contributes to positive biomechanical outcomes is independent transtibial pullout repair.(6,7,8) If this treatment is performed on people who need both LMPRT repair and ACL restoration, an extra tibial tunnel is required. The installation of a tibial tunnel increases surgical challenges and lengthens operation time, as well as the danger of iatrogenic damage to the normal architecture of the knee. To circumvent these drawbacks, we have developed a novel technique for intra-tunnel LMPRT repair using a knotless anchor construct at the upper posterior edge of the tibial tunnel. A stab incision is made to create the standard antero lateral portal and after introducing the trochar and the scope, a round of diagnostic arthroscopy is performed and the posterior root of lateral meniscus tear is identified. After creating an anteromedial portal, With help of 1 fiber tape, a loaded bite is taken with the help of a first pass mini device (Smith &amp; Nephew), via the antero medial portal, deep into the posterior root ( around 5 mm), using a self winching technique, and reduction of the LMPRT is checked. The position for the anchor entry is visualized in the superior edge of the tibial tunnel along its posterior wall, and the tapes are passed through the knotless anchor extra-articulately outside the AM portal. Thereafter, the anchor is shuttled in through the AM portal and punched in the footprint on the posterior-superior edge of the tibial tunnel with visualization of the reduction of the LMPR to the footprint. This technique offers a simple solution to a complex problem in the form of a simple procedure. This technique is a good choice when a tear of the posterior root of the LM occurs.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"64 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217137","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":"Proximal Fibulectomy for Giant Cell Tumours: What Works!","authors":"Ashwin Prajapati, Harsha S. S. Tadala, Ashish Gulia, Ajay Puri","doi":"10.1007/s43465-024-01231-2","DOIUrl":"https://doi.org/10.1007/s43465-024-01231-2","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Giant cell tumor of bone (GCTB) is the most common primary tumor of proximal fibula. Because of its close proximity to vascular structures, common peroneal nerve (CPN) and attachment of lateral collateral ligament (LCL), proximal fibulectomy poses unique challenges. We analyzed oncological and functional outcome of patients who underwent proximal fibulectomy for GCTB of proximal fibula.</p><h3 data-test=\"abstract-sub-heading\">Material and methods</h3><p>Between January 2006 and December 2020, 23 patients underwent proximal fibulectomy for GCTB of proximal fibula, four were recurrent tumors. Mean resection length was 9 cm (5 to 15 cm). The LCL and biceps tendon were not reconstructed in 22 cases. The common peroneal nerve was sacrificed in seven patients including three recurrent cases. Functional status was assessed using the Musculoskeletal Tumour Society (MSTS) scoring system.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>There were two vascular complications and one infection. With 4 patients lost to follow up, mean follow up was 90 months (12 to 197). No patient had local or distant recurrence. Mean MSTS score was 26 (21 to 30). Eleven of 23 patients (48%) had loss of common peroneal nerve function with poorer functional outcome. No patient had symptoms suggestive of knee instability.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Proximal fibulectomy is oncologically safe. Reconstruction of the LCL attachment is not mandatory and patients do not have symptomatic knee instability. Functional outcomes are compromised after sacrifice of common peroneal nerve and may be potentially improved with tendon transfers at index surgery.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"17 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217147","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}