Indian Journal of Orthopaedics最新文献

{"title":"Evaluation of the Prognostic and Therapeutic Factors Affecting Outcomes in Parosteal Osteosarcoma of Bone.","authors":"Manish Pruthi, Anjana Reddy, Ashish Gulia, Prakash Nayak, Poonam Panjwani, Ajay Puri","doi":"10.1007/s43465-026-01776-4","DOIUrl":"10.1007/s43465-026-01776-4","url":null,"abstract":"<p><strong>Purpose: </strong>The goal in treating parosteal osteosarcoma is to achieve wide margins while minimizing morbidity. Marginal resections increase local recurrence (LR) risk. The impact of intramedullary involvement on outcomes remains unclear. We examined the role of quantitative margins and the effect of intramedullary involvement  on LR  and outcomes.</p><p><strong>Methods: </strong>We performed a retrospective analysis of 42 surgically treated parosteal osteosarcoma cases over 20 years (2000-2020) at a tertiary cancer centre. Final histopathology confirmed low-grade tumors in 39 cases and dedifferentiated in 3. Of 39 patients, 2 had amputations and 37 underwent limb salvage. Eight needed intra-operative vascular reconstruction. Quantitative margins were assessed in 25 primary cases with adequate follow-up: 10 had margins < 2 mm, 15 had ≥ 2 mm; 15 had margins < 5 mm, 10 had ≥ 5 mm. Among 37 patients with follow-up, 31 are alive and disease-free (22 continuously disease-free), while 6 have died (5 due to disease, 1 cardiac event). Median follow-up was 108 months (range 27-273).</p><p><strong>Results: </strong>Ten patients had LR. Margins of ≤ 2 mm versus > 2 mm did not significantly influence outcomes, indicating that simply exceeding 2 mm was not associated with improved local control. However, a critical threshold effect was observed at ≥ 5 mm, as no patients with margins ≥ 5 mm developed local recurrence (LR). Three had isolated LR, seven combined relapses (LR + distant). Of these ten, five are alive and disease-free, four died of disease, one died of cardiac event. Intramedullary involvement did not affect LR (p = 0.69) but had a trend towards poor disease specific survival (DSS).</p><p><strong>Conclusion: </strong>The above findings underscore that achieving margins ≥ 5 mm represents a clinically meaningful cutoff, beyond which the risk of local or combined relapse is minimized, supporting ≥ 5 mm as the optimal target for oncologic resection margins. Intramedullary involvement and LR have a trend towards poor DSS.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 7","pages":"1641-1653"},"PeriodicalIF":1.3,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13385554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548853","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":"Medial Patellofemoral Ligament Reconstruction: A Non-implant Technique.","authors":"Claudia Arias, César Carreño, Ronald Sánchez, Margarita Chonate, Yenny Astacio, S Samundeeswari, Saseendar Shanmugasundaram","doi":"10.1007/s43465-026-01740-2","DOIUrl":"10.1007/s43465-026-01740-2","url":null,"abstract":"<p><p>Medial patellofemoral ligament (MPFL) reconstruction is a widely performed procedure for patellofemoral instability. However, there is no consensus on the optimal graft choice, fixation method, or surgical technique. Most described techniques require implants such as anchors or interference screws, which increase stiffness and cost. In many developing countries, the high cost of implants limits access to surgery. We describe a reproducible, effective, and low-cost MPFL reconstruction technique that avoids implants, using a semitendinosus autograft, a modified Fithian technique for patellar fixation, and an adductor tendon loop (\"adductor sling\") for femoral fixation. The technique was developed to minimize complications related to implant use and reduce costs, while maintaining anatomical graft placement and dynamic stability assessment. This implant-free MPFL reconstruction technique offers a safe and affordable surgical option for the management of patellofemoral instability, particularly in resource-limited settings. Socioeconomic factors should be considered when selecting a reconstruction method.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 4","pages":"893-900"},"PeriodicalIF":1.3,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769766","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":"When the Tibia Hurts: Pain and Revision After Extendable Distal Femoral Endoprostheses in Young Patients.","authors":"Muhammad Khatib, Assil Mahamid, Hamza Murad, Feras Qawasmi, Ali Yassin, Mustafa Yassin","doi":"10.1007/s43465-026-01768-4","DOIUrl":"10.1007/s43465-026-01768-4","url":null,"abstract":"<p><strong>Objective: </strong>En-bloc excision with limb salvage is the gold standard for aggressive bone tumors around the knee, but up to 15% of cases occur in skeletally immature patients, creating a risk of limb-length discrepancy. Growing distal femoral prostheses with passive sliding tibial components address this issue but introduce unique mechanical challenges and potential complications. This study aimed to evaluate the incidence of tibial pain and complications beneath extendable distal femoral endoprostheses, and to correlate clinical symptoms and revision surgery.</p><p><strong>Methods: </strong>The study comprised a retrospective review of 31 extendible distal femur endoprostheses from a single tertiary institution between 2008 and 2018. Measurements of radiographic parameters included coronal alignment, cortical thickness, cortical stem distances, stress shielding, and pedestal and periosteal reaction. The radiographic features were correlated with clinical evidence of tibial pain and the need for subsequent revision of the tibial component.</p><p><strong>Results: </strong>17 patients reported tibial pain during the follow-up period, with a mean time of onset of 62.2 months (range, 27-132). There were 14 revisions in 12 patients, 4 revisions for tibial pain. Stress shielding and pedestal formation were seen in all patients after 28 months following insertion. Lateral cortical hypertrophy was more prominent in the group with pain with a mean thickness of 5.8 mm (range, 4-9.8). Varus shift of the tibial stem was radiographically evident during follow-up (<i>n</i> = 18). 95% of the patients with tibial pain had radiographic evidence of stem migration, 88% showed a periosteal reaction, and 76% had varus malalignment. In 13 patients (76%) with pain, all three of these parameters were present.</p><p><strong>Conclusion: </strong>There is a strong correlation between radiographic evidence of tibial stem migration and periosteal reaction and the development of symptoms. Patients should be warned of the need for revision of the tibial component for pain during the lifetime of the implant.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 6","pages":"1374-1384"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13242327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204666","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":"Radial Head Fractures Mason Type 3: Comparison of Treatment Options-Open Reduction and Internal Fixation, Arthroplasty or Excision.","authors":"Cnaana Dorir, Ruta Jakusonoka, Mor Ani, Mojahed Sakhnini, Simons Svirskis, Alexander Lerner, David Rothem","doi":"10.1007/s43465-026-01766-6","DOIUrl":"https://doi.org/10.1007/s43465-026-01766-6","url":null,"abstract":"<p><strong>Background: </strong>Treatment of Mason type 3 radial head fractures is not uniform and includes three main options: open reduction and internal fixation (ORIF), radial head arthroplasty (RHA), and radial head excision (RHE). Evidence regarding the optimal surgical treatment option in the literature remains controversial. The purpose of this study was to compare mid-term clinical, radiological, and functional outcomes of ORIF, RHA, and RHE in patients who sustained Mason type 3 radial head fractures.</p><p><strong>Methods: </strong>This retrospective study included 56 patients (24 males, 32 females) with a mean age of 49 ± 15 years who were admitted to our medical center from May 2010 to May 2022 and underwent surgery for Mason type 3 radial head fractures. Patients' radiological results, Visual Analog Scale (VAS) scores, Quick Disabilities of the Arm, Shoulder and Hand (Quick DASH) scores, ulnar variance, carrying angle, and range of motion were analyzed.</p><p><strong>Results: </strong>Thirty-one patients were treated with ORIF, thirteen with RHA, and twelve with RHE surgeries. Mean follow-up was 5.59 years. The patients receiving ORIF, RHA, and RHE had median VAS scores of 5, 1 (<i>p</i> < 0.05), and 3.5; Quick DASH scores of 54, 6.8, and 57 (<i>p</i> < 005); ulnar variance of 7, 7, and 6 (<i>p</i>˃0.05); and carrying angles of 22, 19, and 23 (<i>p</i> = 0.05) degrees, respectively. The RHA group demonstrated the highest range of motion (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>Radial head arthroplasty for Mason type 3 radial head fractures might be considered in the management of comminuted fractures, as it is possible to achieve good functional results and range of motion in the elbow and radioulnar joints.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 9","pages":"2387-2394"},"PeriodicalIF":1.3,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108875","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":"Guide for Navigating 3D-Printed Cortical Bone Trajectory Screws in Situations with Previously Instrumented Pedicle Screws.","authors":"Wei-Che Tai, Jen-Chung Liao","doi":"10.1007/s43465-026-01764-8","DOIUrl":"10.1007/s43465-026-01764-8","url":null,"abstract":"<p><strong>Purpose: </strong>Traditional surgical interventions for adjacent segment disease (ASD) repair commonly mandate the exposure of all pre-existing hardware. Cortical bone trajectory (CBT) screws have been innovated to amplify the contact surface between the screw and cortical bone, offering a promising approach to mitigate the challenge sassociated with traditional ASD repair surgeries.</p><p><strong>Methods: </strong>In this study, a tangible manifestation of the cortical bone trajectory screw navigation guide was produced by utilizing a 3D printer to facilitate the insertion of cortical bone trajectory screws. A comprehensive set of radiographic images and computed tomography scans was gathered to evaluate the accuracy of K-wire through CBT screw guide inside the vertebrae which was previously implanted with a pedicle screw.</p><p><strong>Results: </strong>The variance in the K-pin circle centre distance before and after surgery ranges from 0.2 mm to 3.54 mm. The K-pin angle difference falls within the range of 0.4° to 5.8° in the sagittal plane, ranges from 1.46° to 1.7° in the transverse plane.</p><p><strong>Conclusion: </strong>This research process has successfully yielded a navigation guide that holds promise for inserting CBT screw even with previously pedicle screw at the same vertebrae.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 6","pages":"1545-1554"},"PeriodicalIF":1.3,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13242333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204192","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":"Exogen Therapy for the Treatment of Non-unions: A Single-Centre UK Experience.","authors":"Abdur Rehman Asrarul Haque, Nayeem Zafar Hali, Zafar Ahmad Khan, Muhammad Zain-Ur-Rehman, Syed Talal Aqueel Ahmed Quadri, Keshav Mathur","doi":"10.1007/s43465-026-01771-9","DOIUrl":"https://doi.org/10.1007/s43465-026-01771-9","url":null,"abstract":"<p><strong>Introduction: </strong>Non-unions are an important complication with significant costs to patients' quality of life as well as the healthcare system. Low-intensity pulsed ultrasound (LIPUS) is a promising modality as a low-risk and lower-cost alternative to revision surgery. We analysed the efficacy of LIPUS using Exogen® device in treating non-unions arising from traumatic fractures, osteotomies, and fusion procedures.</p><p><strong>Materials and methods: </strong>Patients who underwent Exogen therapy were identified from the local device registry and data were collected retrospectively from patient records. 44 patients with 46 non-unions were included in the final analysis. The primary outcome assessed was clinical and radiological healing. Secondary outcomes assessed included the correlation of healing with patient comorbidities, fracture characteristics, time gaps, and duration of therapy.</p><p><strong>Results: </strong>Union was achieved in 54.4% (25/46) of cases: 57.6% (19/33) arising from fractures and 46.2% (6/13) arising secondary to osteotomies or joint fusions. There was a significant correlation of success with Exogen when the underlying site was fixed with plating vis-à-vis nailing. No significant correlation was discovered with other assessed variables.</p><p><strong>Conclusions: </strong>LIPUS offers a safer and non-invasive alternative to revision surgery in selected cases of established non-union. Our outcomes (54.4% success rate) fall short of the success rates with Exogen according to NICE (National Institute for Health and Care Excellence, UK) medical guidance and systematic review. However, it is in line with more recently published studies of single-centre experiences. More research is needed directly comparing Exogen vis-à-vis revision surgery to make more confident assertions.</p><p><strong>Graphical abstract: </strong></p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at https://doi.org/10.1007/s43465-026-01771-9.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 9","pages":"2452-2460"},"PeriodicalIF":1.3,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108915","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":"Glenoid Tilt Angle: A Novel and Potential Risk Factor for Anterior Glenohumeral Instability.","authors":"Shyam Sundar, Mohammed Junaidh, Praveen K Rajan, Amarjeet Singh, Girinivasan Chellamuthu, David V Rajan","doi":"10.1007/s43465-026-01761-x","DOIUrl":"10.1007/s43465-026-01761-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The alterations in glenoid morphology have been studied in its axial and coronal planes viz , glenoid version and inclination, respectively, and their significance with respect to shoulder instability has been reported. The glenoid also exhibits an anterior tilt around the scapular axis in the coronal plane, which we refer to as the \"glenoid tilt angle\". The principal objective of this study was to assess glenoid tilt angle in a cohort of Indian population to establish a baseline value and find its clinical significance with respect to anterior shoulder instability. To our knowledge there are no studies in the literature explaining this angle and its implications in shoulder pathologies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Retrospective analysis was done on consecutive patients who underwent CT for anterior shoulder instability (Group 1, &lt;i&gt;n&lt;/i&gt; = 100) and for other non-glenoid shoulder pathologies (Group 2, &lt;i&gt;n&lt;/i&gt; = 100). Glenoid tilt and spinoglenoid distance were measured on lateral en face view of 3D-CT, while glenoid version and spinoglenoid angle were measured on axial view of CT. For group comparisons, independent samples t-tests were employed to analyse differences in all four parameters between the instability and control groups, reporting means, standard deviations, t-values, and p-values. The Mann-Whitney &lt;i&gt;U&lt;/i&gt; test was used for the glenoid version, suggesting a non-normal distribution of this variable, with additional median and interquartile range reporting. Pearson correlation analysis was used to examine the relationships between glenoid tilt angle and glenoid version, as well as between spinoglenoid distance and spinoglenoid angle, both overall and within each group separately. Inter-observer reliability for glenoid tilt angle was assessed using the intraclass correlation coefficient (ICC) based on a two-way random effects model with absolute agreement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Reults: &lt;/strong&gt;In Group 1, the mean glenoid tilt angle was 25.1° ± 6.9°, the mean glenoid version was 1.84° ± 5.43°, the mean spinoglenoid distance was 18.6 ± 4.3 and the mean spinoglenoid angle was 31.6 ± 6. In Group 2, the mean glenoid tilt angle was 20.3° ± 7.1°, mean glenoid version was 1.46° ± 5.51°, mean spinoglenoid distance was 17.9 ± 4.6, and mean spinoglenoid angle was 30.0 ± 5.4. Between both the groups, differences were statistically significant for glenoid tilt angle with a &lt;i&gt;P&lt;/i&gt; value of &lt; 0.001. Inter-observer reliability for glenoid tilt angle measurement was excellent (ICC = 0.98) indicating high measurement reproducibility. In a reduced multivariate logistic regression model adjusting for age and sex, glenoid tilt angle demonstrated an independent positive association with anterior shoulder instability (adjusted OR 1.04 per degree). Correlational analysis showed stronger negative correlation between the glenoid tilt angle and glenoid version (&lt;i&gt;r&lt;/i&gt; = - 0.253, &lt;i&gt;p&lt;/i&gt; = 0.011) in the instability group. For ot","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 8","pages":"1908-1916"},"PeriodicalIF":1.3,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13438495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677401","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":"The End of the First Quarter, A Second Part of a Very Special Issue, and Launching Curated Collections.","authors":"Murali Poduval, Srinivas B S Kambhampati, Rujuta Mehta","doi":"10.1007/s43465-026-01747-9","DOIUrl":"10.1007/s43465-026-01747-9","url":null,"abstract":"","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 4","pages":"809-810"},"PeriodicalIF":1.3,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770225","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":"Artificial Intelligence and Decision Support in Orthopaedic Emergencies: A Review.","authors":"Raju Vaishya, Ayaz Saiyed, Abhishek Vaish, Rajesh Botchu, Kartikeyan P Iyengar, Albina Arjuman","doi":"10.1007/s43465-026-01760-y","DOIUrl":"https://doi.org/10.1007/s43465-026-01760-y","url":null,"abstract":"<p><strong>Background: </strong>Orthopaedic emergencies require rapid, accurate clinical decisions to prevent limb- and life-threatening complications. Increasing patient volume, limited specialist availability, and diagnostic complexity contributes to delays and errors in emergency care. Artificial intelligence (AI) encompasses machine learning (ML) and deep learning (DL) and has emerged as a promising tool to augment decision-making in orthopaedic emergencies.</p><p><strong>Purpose: </strong>To review current applications, evidence, limitations, and future directions of AI-based decision-support systems in orthopaedic emergency care, with particular relevance to low- and middle-income healthcare settings.</p><p><strong>Methods: </strong>A comprehensive electronic search was performed in major academic databases. This included PubMed, Embase, Scopus, and Web of Science to identify all relevant literature published in English from inception up to February 2026, focusing on AI applications in orthopaedic trauma, emergency imaging, triage, clinical decision support, and outcome prediction. Emphasis was placed on clinically validated studies, systematic reviews, and emerging technologies relevant to emergency orthopaedics.</p><p><strong>Results: </strong>AI applications in orthopaedic emergencies primarily included automated fracture detection, injury classification, triage optimisation, clinical decision support, and complication prediction. DL models have demonstrated diagnostic accuracy comparable to or exceeding that of expert clinicians in fracture detection. AI-assisted triage systems reportedly outperformed conventional scoring tools in predicting severity and admission needed based on the studies included for this review. Clinical decision-support tools improved the completeness and consistency of emergency management recommendations based on hospital-based and practice-oriented studies. The reported challenges included those related to data bias, interpretability, clinical integration, ethical concerns, and regulatory oversight.</p><p><strong>Conclusions: </strong>AI has substantial potential to enhance diagnostic accuracy, efficiency, and decision-making in orthopaedic emergencies. Responsible adoption requires robust external validation, clinician education, explainable models, and integration into existing workflows. When appropriately implemented, AI can serve as a valuable adjunct to, rather than a replacement for, clinical expertise in orthopaedic emergency care.</p><p><strong>Graphical abstract: </strong></p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 9","pages":"2494-2504"},"PeriodicalIF":1.3,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108977","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":"Postoperative Pain Severity, Incidence of Chronic Pain, and Impact on Daily Function following Oncological Total Knee Replacements at Tertiary care centre.","authors":"Divya Choudhari, Aparna Chatterjee, Ashish Gulia, Bindiya Salunkhe","doi":"10.1007/s43465-026-01702-8","DOIUrl":"10.1007/s43465-026-01702-8","url":null,"abstract":"<p><strong>Background: </strong>Oncological Total Knee Replacements(TKR) are complex surgeries compared to Conventional TKR's as they involve morbid resections of bone and soft tissues with reconstructions. Literature on TKR for osteoarthritis, have reported around 10-34% incidence of moderate to severe Chronic post surgical pain(CPSP) which is documented to impact quality of life.</p><p><strong>Methodolgy: </strong>We therefore, conducted a prospective observational study of 139 patients over a 38 month period undergoing oncologic TKR to assess the severity of postoperative pain, incidence of CPSP at 4th and 6th months in this subset, identify any neuropathic pain component at 4 and 6th months and its impact on daily function. Adult patients undergoing primary oncological TKR surgeries were included in the study.</p><p><strong>Results: </strong>The mean average and worst pain scores were 3.17 (SD± 1.25) and 4.85 (SD±1.60) on the first postoperative day and decreased subsequently over the next 3 days. At 4th month 64 patients (46%) and at 6th month 30 patients (21.6%) continued to have pain, chiefly of mild and some with moderate intensity. The Pain Interference score deduced from Brief Pain Interference(BPI) questionnaire at 4th and 6th month was 1 (0-2.14) and 0 (0-1.29) respectively. At 4 th month, the main aspects which were found to be affected were walking ability and normal work (both outside the home and housework). At 6th month, 10 patients (7.19%) had pain suggestive of neuropathic character as per the pain descriptors used to describe the pain, however on applying the neuropathic questionnaire pain DETECT, all patients had a score below 12 which makes neuropathic pain highly unlikely. The median Musculoskeletal scoring system(MSTS) score was found to be 25 (IQR:24-26) and indicates a good functional outcome at 6 months following oncologic TKR.</p><p><strong>Conclusion: </strong>Hence, following oncologic TKR's, the pain was mild in intensity in majority patients. Around 1/5th of the patients had pain of mild intensity at 6 months which was not likely to be neuropathic. Pain did not interfere significantly with daily activities and the functionality as deduced from the MSTS score was good at 6 months.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"60 7","pages":"1684-1694"},"PeriodicalIF":1.3,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13385529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548689","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}