Indian Journal of Orthopaedics最新文献

{"title":"Correlation Between Planned and Executed Bone Cuts Using Robotics in Total Knee Arthroplasty: A Prospective Study of 500 Patients","authors":"Neeraj Adkar, Mangesh Patil, Swapnil Vaidya, Rajendra Kumbar, Ravi Kerhalkar, Girish Mote, Satwik Thareja, Prajwal Sadalagi, Supreet Bajwa","doi":"10.1007/s43465-024-01196-2","DOIUrl":"https://doi.org/10.1007/s43465-024-01196-2","url":null,"abstract":"","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141375356","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":"Risk of Nerve Injury Following Peroneus Longus Harvest is Very Low: A Prospective Cohort of 600 Patients","authors":"M. Arora, T. Shukla, Mohit Singla","doi":"10.1007/s43465-024-01180-w","DOIUrl":"https://doi.org/10.1007/s43465-024-01180-w","url":null,"abstract":"","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141377317","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":"Arthroplasty at Very High Altitude with Restricted Resources: Our Experience and Review of Literature","authors":"Chandrashekhar Yadav, Apoorva Kabra, Anwar Hussain, Tsering Morup, Tsewang Dorje, S. Mittal","doi":"10.1007/s43465-024-01191-7","DOIUrl":"https://doi.org/10.1007/s43465-024-01191-7","url":null,"abstract":"","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141385176","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 Robotic Assistance Help with Bone Preservation in Total Knee Replacement?","authors":"S. S. Varun Roheet, Arun Kannan","doi":"10.1007/s43465-024-01126-2","DOIUrl":"https://doi.org/10.1007/s43465-024-01126-2","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>This research paper investigates whether robotic total knee replacement (TKR) reduces bone resection compared to conventional TKR. While TKR is a successful procedure, revision surgery remains a challenge with up to 8.3% of all knee replacement procedures requiring revisions.</p><h3 data-test=\"abstract-sub-heading\">Materials and methods</h3><p>The study retrospectively analyzed the tibial polyethylene inserts used and bone cuts made in 157 primary TKRs performed by a single surgeon. The results show that 93.3% of robotic TKRs used the base size tibial polyethylene of 9 mm, and the average distal femoral cut was 7.4 mm and the average tibial cut was 6.4 mm, with the minimum being 3 mm.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>The study suggests that robotic TKR reduces bone resection compared to conventional TKR.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141254390","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":"Increased Cellular Dosage of Bone Marrow Aspiration Concentrate Does Not Translate to Increased Clinical Effectiveness in Knee Osteoarthritis: A Phase I Dose Escalation Study","authors":"Sathish Muthu, Karthikraja Ramanathan, Sangilimuthu Alagar Yadav, Saurabh Kumar Jha, Rajni Ranjan","doi":"10.1007/s43465-024-01197-1","DOIUrl":"https://doi.org/10.1007/s43465-024-01197-1","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>Knee osteoarthritis (KOA), a chronic degenerative disease, significantly impairs quality of life due to pain and mobility limitations. Traditional treatments focus on symptom management without addressing the underlying disease progression, leading to a growing interest in regenerative medicine approaches. Bone marrow aspirate concentrate (BMAC), rich in mesenchymal stem cells and growth factors, has shown potential for cartilage repair and symptom relief in KOA. Despite promising outcomes, the optimal BMAC dosage for knee OA treatment remains undetermined. This study aims to evaluate the clinical efficacy and safety of varying BMAC dosages in knee OA treatment.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>This prospective controlled dose–escalation study involved 75 patients with early-stage knee OA, categorized into three groups based on BMAC dosage administered 10 × 10⁶ cells (low-dose group), 50 × 10⁶ cells (medium-dose group), or 100 × 10⁶ cells (high-dose group). All the patients underwent a single intra-articular injection of BMAC and were monitored over a year. The primary outcomes include Visual Analog Scale (VAS) for pain and the Knee Injury and Osteoarthritis Outcome Score (KOOS) for joint function recorded at baseline, 1, 3, 6, and 12 months post-intervention. Adverse events were also documented.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Significant clinical improvements in VAS and KOOS scores were noted across all groups at all time points compared to the baseline. However, these improvements did not significantly differ between dosage groups throughout the follow-up period. Adverse effects were minimal and primarily consisted of transient post-injection pain and effusion, with no dose-dependent increase in complications.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>BMAC treatment for knee OA is safe and demonstrates potential for significant pain relief and functional improvement, irrespective of the dosage administered within the tested range. The lack of significant differences among varying dosages suggests a plateau in therapeutic efficacy beyond a certain threshold. Further research is necessary on the long-term outcomes to optimize the dosing strategy.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141254409","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":"Zoledronic Acid and Enriched Autologous Bone Marrow Stem Cell Implantation for Femoral Head Osteonecrosis","authors":"Xuedong Li, Huiling Tian, Jingyi Zhang, Bangxian Dou","doi":"10.1007/s43465-024-01188-2","DOIUrl":"https://doi.org/10.1007/s43465-024-01188-2","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>This study evaluated the clinical results of zoledronic acid in the treatment of early osteonecrosis of the femoral head (ONFH).</p><h3 data-test=\"abstract-sub-heading\">Materials and Methods</h3><p>Study retrospectively analyzed 60 patients with zoledronic acid with bone marrow stem cell (BMSC) implantation (The study group) and 64 patients with BMSC implantation (The control group). The primary evaluation index included VAS, HHS, collapsed rate, and total hip replacement arthroplasty (THA) conversion rate.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The study group had a lower VAS (1.12 ± 0.22 vs 1.44 ± 0.32) and higher HHS (75.07 ± 3.66 vs 68.78 ± 2.24) compared to the control group in 6 months after surgery (<i>P</i> &lt; 0.05). In the study group, 12 hips (20%) collapsed, and 7 of 60 hips (11.67%) required THA surgery at the last follow-up. However, 25 hips (38.8%) collapsed in the control group, and 19 hips (29.69%) required THA surgery. The study group had a lower collapsed rate (<i>P</i> = 0.029) and THA conversion rate (<i>P</i> = 0.016) in survival analysis.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Zoledronic acid and BMSC implantation in the treatment of early ONFH is safe and effective, reduces pain shortens recovery time, and reduces collapsed rate and THA conversion rate in ONFH patients.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141254442","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":"Artificial Intelligence (AI): A Potential Game Changer in Regenerative Orthopedics—A Scoping Review","authors":"Raju Vaishya, Sakshi Dhall, Abhishek Vaish","doi":"10.1007/s43465-024-01189-1","DOIUrl":"https://doi.org/10.1007/s43465-024-01189-1","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background and Aims</h3><p>Regenerative orthopedics involves approaches like stem cell therapy, platelet-rich plasma (PRP) therapy, the use of biological scaffold implants, tissue engineering, etc. We aim to present a scoping review of the role of artificial intelligence (AI) in different treatment approaches of regenerative orthopedics.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Using the PRISMA guidelines, a search for articles for the last ten years (2013–2024) on PubMed was done, using several keywords. We have discussed the state-of-the-art, strengths/benefits, and limitations of the published research, and provide a useful resource for the way ahead in future for researchers working in this area.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Using the eligibility criteria out of 82 initially screened publications, we included 18 studies for this review. We noticed that the treatment responses to regenerative treatments depend on several factors; hence, to facilitate better comprehensive and patient-specific treatments, AI technology is very useful. Machine learning (ML) and deep learning (DL) are a few of the most frequently used AI techniques. They use a data-driven approach for training models to make human-like decisions. Data are fed to the ML/DL algorithm and the trained model makes classifications or predictions based on its learning.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>The area of regenerative orthopedics is highly sophisticated and significantly aids in providing cost-effective and non-invasive treatments to patients suffering from orthopedic ailments and injuries. Due to its promising future, the use of AI in regenerative orthopedics is an emerging and promising research field; however, its universal clinical applications are associated with some ethical considerations, which need addressing.</p><h3 data-test=\"abstract-sub-heading\">Graphical Abstract</h3>\u0000","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141191651","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":"Evaluation of Chondral Defect Repair Using Human Fibronectin Adhesion Assay-Derived Chondroprogenitors Suspended in Lyophilized Fetal Collagen Scaffold: An Ex Vivo Osteochondral Unit Model Study","authors":"Ganesh Parasuraman, Soosai Manickam Amirtham, Deepak Vinod Francis, Abel Livingston, Boopalan Ramasamy, Solomon Sathishkumar, Elizabeth Vinod","doi":"10.1007/s43465-024-01192-6","DOIUrl":"https://doi.org/10.1007/s43465-024-01192-6","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>Chondral defect repair is challenging due to a scarcity of reparative cells and the need to fill a large surface area, compounded by the absence of self-healing mechanisms. Fibronectin adhesion assay-derived chondroprogenitors (FAA-CPs) have emerged as a promising alternative with enhanced chondrogenic ability and reduced hypertrophy. De-cellularized bio-scaffolds are reported to act as extracellular matrix, mimicking the structural and functional characteristics of native tissue, thereby facilitating cell attachment and differentiation. This study primarily assessed the synergistic effect of FAA-CPs suspended in fetal cartilage-derived collagen-containing scaffolds in repairing chondral defects.</p><h3 data-test=\"abstract-sub-heading\">Methodology</h3><p>The de-cellularized and lyophilized fetal collagen was prepared from the tibio-femoral joint of a 36 + 4-week gestational age fetus. FAA-CPs were isolated from osteoarthritic cartilage samples (<i>n</i> = 3) and characterized. In ex vivo analysis, FAA-CPs at a density of 1 × 106 cells were suspended in the lyophilized scaffold and placed into the chondral defects created in the Osteochondral Units and harvested on the 35th day for histological examination.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The lyophilized scaffold of de-cellularized fetal cartilage with FAA-CPs demonstrated effective healing of the critical size chondral defect. This was evidenced by a uniform distribution of cells, a well-organized collagen-fibrillar network, complete filling of the defect with alignment to the surface, and favorable integration with the adjacent cartilage. However, these effects were less pronounced in the plain scaffold control group and no demonstrable repair observed in the empty defect group.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>This study suggests the synergistic potential of FAA-CPs and collagen scaffold for chondral repair which needs to be further explored for clinical therapy.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141191652","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":"Extra Medullary Fixation in Unstable Proximal Femoral Fractures by PF-LCP","authors":"Krishna Kumar Mittal, Apoorva Agarwal, Nishant Raj, Nitin Kaushik","doi":"10.1007/s43465-024-01187-3","DOIUrl":"https://doi.org/10.1007/s43465-024-01187-3","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Perception that extra-medullary fixation of these fractures are fraught with difficulties and deficiencies is becoming inappropriate. This device provides angular stable fixation retaining fracture biology with minimum interference to osseous and soft-tissue vascularity and it does not require reaming which destroys 80% of endosteal vasculature for 6–12 weeks. PFLCP averts iatrogenic fracture in lateral trochanteric wall (LTW) which is frequent with DHS, protects LTW from secondary fracture in post-operative period. Aim is to assess outcome of unstable proximal femur fracture fixation by PFLCP.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Study included 64 from 2016 to 2020, divided in two groups. (A) Unstable intertrochanteric fracture and (B) subtrochanteric fracture (Seinsheimer types II–V). All fractures fixed by MIPO with PFLCP. Loss of reduction, infection, cut-out, cut-through, backing of screws, bending or breaking of plate and screw, malunion, non-union and revision were evaluated. Fracture healing and functional recovery assessed by Reborne Score and Parker Mobility Score (PMS) respectively.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Out of 64, 24 achieved pre-injury PMS, 32 declined by 1 point, 6 declined by 2 points and 1 by 3 points, one required revision. Using various parameters 37.5% patients had excellent results and 50% had good results, 9.38% had average and 3.12% had poor result. None reported non-union or breakage of plate.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>PFLCP provides angular stable fixation, torsional stability with high biomechanical strength to resist deforming stresses. MIPO avoids soft-tissue stripping reducing blood-loss, retains periosteal blood supply to inter-fragmentary bone fragments, enhancing fracture healing, reducing complications, such as delayed healing, nonunion, infection and implant failure.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141191730","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 Simple Surgical Technique for Correction of Varus Deformity in Advanced Osteoarthritis of Knees by Medial Femoral Condylar Sliding Osteotomy-Description of Procedure and short term Outcome-A Prospective Study","authors":"Chandan Pathak, Anjan Chattaraj, Sunit Hazra, Rwivudeep Saha, Sanjay Kumar, Mainak Chandra","doi":"10.1007/s43465-024-01158-8","DOIUrl":"https://doi.org/10.1007/s43465-024-01158-8","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Advanced osteoarthritis of knees with varus deformity consists of attenuation of lateral structures with contracture of the posteromedial structures and formation of medial osteophytes. The conventional step-wise medial and posteromedial release with measured resection may sometimes hinder achievement of perfectly balanced flexion and extension gaps with maintenance of flexion stability, without the use of a constrained prosthesis. Medial femoral epicondylar sliding osteotomy tailors the balancing to the need of the kinematics of the native knee and precludes the use of a constrained implant.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>15 patients with Ahlbäck Grades III through V osteoarthritic changes at Howrah Orthopaedic Hospital were included in a prospective cohort case series with a minimum period of follow-up being 12 months. Physical examination, clinical questionnaire and radiographic evaluation were done post-operatively for objectification by functional Knee Society and Oxford Knee Scores respectively.</p><h3 data-test=\"abstract-sub-heading\">Results and Analysis</h3><p>The mean post-operative femorotibial angulation ameliorated to a value of 3.73 ± 1.58° from 18.67 ± 4.2° in the pre-operative stage. The mean overall Range of Motion of operated knee was 109.87 ± 6.86° with no residual frontal laxity and/or laxity in the coronal plane. The mean amount of resection of tibial plateau in patients with severe varus deformity was kept to a minimum, 6.56 mm from the least deficient portion of the lateral condyle. There were no complications as regards component loosening and/or surgical-site infection.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>The main objective of balancing a severely varus-afflicted knee is to preserve as much of the Medial Collateral Ligament as possible, to retain its check rein function and not jeopardise the stability. This is ensured by distalisation and posteriorizing the medial epicondyle by an incomplete osteotomy in addition to modest tibial resection fetching a non-isometric point of knee flexion. All osteotomies united by bony union and restoration of kinematic alignment. The limitation of this study however includes the lack of long-term results, such as late instability and polyethylene wear.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141166125","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}