Indian Journal of Orthopaedics最新文献

{"title":"Orthopedic or Surgical Treatment in Gartland Type II Supracondylar Humerus Fractures: A Systematic Review","authors":"Isabel Barber-Vidal, Ignacio Miranda, Francisco J. Miranda","doi":"10.1007/s43465-024-01227-y","DOIUrl":"https://doi.org/10.1007/s43465-024-01227-y","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>There is a broad consensus among orthopedic surgeons in the treatment of Gartland type I supracondylar humerus fractures (conservative) and Gartland type III (surgical) fractures, but there is controversy regarding the treatment of choice for Gartland type II fractures. The aim was to analyze the existing current evidence on the choice of surgical or conservative treatment of Gartland type II supracondylar humerus fractures.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A systematic review was carried out following the PRISMA guidelines. The search was conducted on May 24, 2023, in PubMed and Cochrane Central, introducing the terms (“humerus” AND “supracondylar”) AND (“Gartland II” OR “Gartland 2”). The selected studies were evaluated with the JBI checklist for quasi-experimental studies.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>5 retrospective comparative studies were included (evidence level III). Radiological and functional results were good with both treatments. Only one study obtained a better result with surgical treatment (with <i>n</i> = 4 in the conservative group); the other four studies did not find significant differences between the two types of treatment. There are risks of bias in all studies.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Both types of treatment (conservative and surgical) are valid for type II Gartland supracondylar humerus fractures, and provide good results, both functional and radiological. There is not enough scientific evidence to be able to affirm that one of the two treatments (surgical or conservative) is superior to the other for the treatment of these fractures. Findings on the initial radiograph, such as rotational deformity, coronal malalignment, or a severely angulated distal humeral fragment, can assist in the decision-making process.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"181 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217208","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 Radiological Comparison of Robotic-Assisted Versus Manual Techniques in Total Hip Arthroplasty","authors":"Adarsh Annapareddy, Praharsha Mulpur, Tarun Jayakumar, Chethan Shinde, Vemaganti Badri Narayana Prasad, A. V. Gurava Reddy","doi":"10.1007/s43465-024-01232-1","DOIUrl":"https://doi.org/10.1007/s43465-024-01232-1","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>This study investigates the radiological outcomes of robotic-assisted total hip arthroplasty (RATHA) compared to manual total hip arthroplasty (mTHA), addressing the ongoing debate on the effectiveness of RATHA in achieving superior implant positioning accuracy.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A prospective cohort of 212 patients (103 robotic, 109 manual) underwent THA and were evaluated for postoperative radiological outcomes, focusing on the inclination and anteversion angles of the acetabular cup. Outlier prevalence was assessed based on angles outside the defined Lewinnek safe zones. All post-operative measurements were made using the BoneNinja application.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>High inter-observer and intra-observer reliabilities were observed, validating the measurement accuracy. The mean anteversion and inclination angles in the RATHA cohort were 40.5 ± 1.5 and 24.5 ± 3.1° respectively; and the mTHA cohort were 42.1 ± 4.9 and 24.9 ± 4.5°. There was a statistically significant difference in inclination angles between the two cohorts whereas the anteversion angles showed no difference. Majority of the conventional THRs (<i>N</i> = 72, 55.4%) were placed outside the safe zone for anteversion. The inclination angles revealed a highly significant difference between the cohorts (<i>p</i> &lt; 0.0001), with all the robotic THRs (<i>N</i> = 121, 100%) being placed within the safe zone for inclination, whereas only 70% (<i>N</i> = 91) of the conventional THRs were within the safe zone. 97.5% of RA-THRs were within 3° of the proposed plan, demonstrating high accuracy.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>RATHA significantly outperforms MTHA in radiological accuracy, achieving precise acetabular cup positioning with minimal outliers. These results advocate for RATHA's adoption in THA to enhance outcome predictability and affirm its reliability and safety over manual methods.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"20 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217161","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 Proprioception-Based Rehabilitation Enhance Functional Outcome in Total Knee Arthroplasty? A Prospective Randomised Study","authors":"Yuvarajan Palanisamy, Arjun R. Prasad, Karthik Seetharaman, K. Ganesan, M. Kavitha, David V. Rajan","doi":"10.1007/s43465-024-01218-z","DOIUrl":"https://doi.org/10.1007/s43465-024-01218-z","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Introduction</h3><p>Rehabilitation after Total Knee Arthroplasty (TKA) often includes proprioceptive exercises to prevent falls, but studies on proprioceptive training have yielded conflicting findings. This study aims to explore impact of proprioceptive training on functional performance after TKA.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Eighty patients who underwent unilateral TKA were randomly assigned to a proprioceptive exercise (PE) group or a routine exercises (RE) group. The PE group received proprioceptive exercises in addition to routine physiotherapy. Osteoarthritis Research Society Internal (OARSI) recommended tests and Oxford Knee Score (OKS) were used to assess performance and outcome at 3 and 6 months.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>In the 30-s chair sits test, the PE group outperformed the RE group at 3 months (13.69 vs. 9.17) and 6 months (21.07 vs. 18.63) (<i>p</i> &lt; 0.001 and <i>p</i> = 0.030). Stair climbing favoured PE group at 3 months (8.86 vs. 16.66, <i>p</i> = 0.037) and 6 months (0.556 vs. 1.133, p = 0.001). At 6 months in the 40-m fast-paced walk test, the PE group had a significantly shorter time (0.308 min vs. 0.557 min, <i>p</i> &lt; 0.001). Timed up and go test at 6 months favoured PE group (0.204 min vs. 0.377 min). In the 6-min walk test, the PE group covered significantly greater distances than the RE group at 3 months (589.59 vs. 346.53 m, <i>p</i> &lt; 0.001) and 6 months (649.60 vs. 448.32 m, <i>p</i> &lt; 0.001). OKS at 3 months was 38 ± 2.0 for PE group and 38 ± 4 for RE group (<i>p</i> = 1). OKS at 6 months was 42 ± 4 for PE group and 40 ± 2 for RE group (<i>p</i> = 0.94).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>This study highlights the importance of proprioception-based rehabilitation in improving functional performance for TKA patients, surpassing traditional rehabilitation programmes.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"53 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141934720","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":"Successful Management of a Pediatric Patient with Humeral Lateral Condyle Non-union, Elbow Valgus Deformity and Ulnar Neuropathy","authors":"İdris Çoban, Mustafa Karakaplan, Emre Ergen, Okan Aslantürk, Muhammed Köroğlu, Kadir Ertem","doi":"10.1007/s43465-024-01222-3","DOIUrl":"https://doi.org/10.1007/s43465-024-01222-3","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Humeral lateral condyle fracture is the most common elbow fracture in children after supracondylar fractures. Non-union of these fractures may cause ulnar nerve deficit, deformity and loss of joint motion, which are difficult to manage. Treatment of lateral condyle non-union can be done in two stages or one stage. However, despite all types of treatment, the chance of success is very variable. Many complications such as avascular necrosis, loss of motion, non-union, chronic pain, and heterotopic ossification have been reported as a result of surgeries performed for lateral condyle pseudoarthrosis.</p><h3 data-test=\"abstract-sub-heading\">Objective</h3><p>In this article, we applied two-stage surgical treatment to a pediatric patient who developed ulnar neuropathy and elbow valgus deformity as a result of lateral condyle non-union.</p><h3 data-test=\"abstract-sub-heading\">Case report</h3><p>A 8-year-old boy with lateral condyle nonunion presented to our clinic with pain and deformity. After initial examination, two-stage surgical treatment was planned to achieve union and deformity correction. In the first stage, we performed pseudoarthrosis surgery and ulnar nerve anterior transposition, and in the second stage, we performed elbow valgus deformity correction surgery. In three year follow-up, the range of elbow was 130/5/0 flexion/extension, with full supnation and pronation. Carrying angle was same with the opposite side.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Pediatric humeral lateral condyle nonunions cause deformity, pain, loss of motion, instability and neuropathy. Surgical treatment of nonunions with a careful planning provide excellent clinical and functional results.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"34 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141739172","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":"Effect of Timing of Surgery on the Outcomes and Complications in Multi-ligament Knee Injuries: An Overview of Systematic Reviews and A Meta-analysis","authors":"Raju Vaishya, Mohit Kumar Patralekh, Abhishek Vaish, Luke V. Tollefson, Robert F. LaPrade","doi":"10.1007/s43465-024-01224-1","DOIUrl":"https://doi.org/10.1007/s43465-024-01224-1","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background and Aims</h3><p>Multi-ligament knee injuries (MLKI) are serious and challenging to manage. This study aimed to elucidate the impact of surgical timing on both early and long-term outcomes following an MLKI.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A comprehensive search strategy was employed across PubMed, Scopus, Web of Science, and the Cochrane Library. Studies were identified using a combination of relevant keywords encompassing “multi-ligament knee injury,” “knee dislocation,” “reconstruction,” “repair,” “surgery,” and “timing,” and their synonyms, along with appropriate Boolean operators. Selection of articles (systematic reviews and meta-analyses) adhered to predefined inclusion and exclusion criteria. Furthermore, a meta-analysis was conducted utilizing data extracted from primary studies.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Early surgery for MLKI demonstrated a significant advantage over delayed surgery, reflected by significantly higher Lysholm scores (Mean Difference [MD] 3.51; 95% Confidence Interval [CI] 1.79, 5.22), IKDC objective scores (Mantel–Haenszel Odds Ratio [MH-OR] 2.95; 95% CI 1.30, 6.69), Tegner activity scores (MD 0.38; 95% CI 0.08, 0.69), and Mayer’s ratings (MH-OR 5.47; 95% CI 1.27, 23.56). In addition, we found a significantly reduced risk of secondary chondral lesions (MH-OR 0.33; 95% CI 0.23, 0.48), lower instrumented anterior tibial translation in the early surgery group (MD −0.92; 95% CI −1.83, −0.01), but no significant difference was observed in the secondary meniscal tears, between the two groups. However, the early surgery group also exhibited a significantly increased risk of knee stiffness (MH-OR 2.47; 95% CI 1.22, 5.01) and a greater likelihood of requiring manipulation under anaesthesia (MH-OR 3.91; 95% CI 1.10, 13.87).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Early surgery for MLKI improves function, and stability, and reduces further articular cartilage damage, but increases the risk of stiffness.</p><h3 data-test=\"abstract-sub-heading\">Level of Evidence</h3><p>IV.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"45 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141739171","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":"Serum Sirt6 as a Potential Biomarker for Osteoarthritis and its Correlation with IL-6 Alterations","authors":"Nikhil Gupta, Anchal Arora, Navjot Kanwar, Kavin Khatri, Abhinav Kanwal","doi":"10.1007/s43465-024-01223-2","DOIUrl":"https://doi.org/10.1007/s43465-024-01223-2","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Objective</h3><p>The study aimed to assess Sirt6 levels in serum of knee osteoarthritis (OA) patients compared to healthy individuals to evaluate its correlation with OA and to understand how Sirt6 is linked with the change in IL-6 levels.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>The cross-sectional study involved 50 knee OA patients clinically diagnosed as per the American College of Rheumatology guidelines and 50 healthy controls. Radiological examination as per Kellgren–Lawrence (KL) criteria was done to determine the disease severity. Peripheral blood samples were collected from each participant, and serum Sirt6 and IL-6 levels were measured using ELISA.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The serum Sirt6 levels in knee OA patients were significantly lower as compared to healthy controls (p = 0.023). Patients with knee OA of KL grade 4 had significantly lower Sirt6 levels as compared to those with KL grade 2 OA (p = 0.031). Individuals of younger age group had higher Sirt6 levels compared to older age group. IL-6 levels in knee OA patients were significantly higher as compared to controls (p = 0.007). A negative correlation was observed between serum Sirt6 and IL-6 levels (r = − 0.407; p = 0.035).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>The study concludes that serum Sirt6 levels are inversely associated with knee OA and may serve as a potential biomarker for the disease. Moreover, a negative correlation between Sirt6 and IL-6 levels was observed in this study. Further investigations are necessary to confirm these findings and to explore the mechanisms by which Sirt6 and IL-6 are involved in OA.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"253 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141739284","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":"Barriers and Solutions Towards Integrating Orthobiologics into Clinical Orthopaedic Practice","authors":"Madhan Jeyaraman, Sathish Muthu, S. S. Amarnath","doi":"10.1007/s43465-024-01221-4","DOIUrl":"https://doi.org/10.1007/s43465-024-01221-4","url":null,"abstract":"","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"28 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141611811","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":"Meniscal Lesions in Multi-Ligament Knee Injuries","authors":"David Figueroa, María Loreto Figueroa, Martin Cañas, Alexandra Feuereisen, Francisco Figueroa","doi":"10.1007/s43465-024-01217-0","DOIUrl":"https://doi.org/10.1007/s43465-024-01217-0","url":null,"abstract":"&lt;h3 data-test=\"abstract-sub-heading\"&gt;Introduction&lt;/h3&gt;&lt;p&gt;Multi-ligament knee injuries (MLKIs) are rare and complex knee lesions and are potentially associated with intra-articular injuries, especially meniscal tears. Understanding the meniscal tear patterns involved in MLKI can help the orthopedic surgeon treat these complex injuries.&lt;/p&gt;&lt;h3 data-test=\"abstract-sub-heading\"&gt;Objective&lt;/h3&gt;&lt;p&gt;The purpose of this study was to describe the incidence, classification, and treatment of meniscal injuries in a cohort of patients with MLKIs and carry out an updated review of the evidence available.&lt;/p&gt;&lt;h3 data-test=\"abstract-sub-heading\"&gt;Materials and methods&lt;/h3&gt;&lt;p&gt;Descriptive retrospective study. Patients with a history of reconstructive surgery for MLKI performed between 2013 and 2023 were included. Informed consent was obtained from all patients included in the study. Patient demographics, magnetic resonance imaging (MRI) study, and operative reports were reviewed. Groups were then formed based on ligament injury patterns. Meniscal tears were identified by MRI and through diagnostic arthroscopy for each patient. The association between meniscal lesions and injury patterns was calculated through Fisher’s exact test. Agreement between the presence of meniscal tear on MRI and in diagnostic arthroscopy was measured using the kappa test. The sensitivity and specificity of MRI were calculated. We inferred the presence of a meniscal tear by injury pattern using the Agresti-Coull confidence interval. For the statistical analysis, a significance of 5% and a confidence interval of 95% were considered.&lt;/p&gt;&lt;h3 data-test=\"abstract-sub-heading\"&gt;Results&lt;/h3&gt;&lt;p&gt;Seventy patients with MLKIs were included, with a mean age of 30.69 years (SD 10.65). Forty-seven patients had meniscal lesions (67.1%). Of them, 6 had only medial meniscus tears, 31 had only lateral meniscus tears, and 10 had lesions of both menisci, comprising 57 meniscal lesions in total. An anterior cruciate ligament (ACL) + medial collateral ligament/posteromedial corner (MCL/PMC) was the most common injury pattern (52.86% of all patients). Of these 37 patients, 78.38% had meniscal injuries, and most of them (68.97%) were only lateral meniscus injuries. The odds ratio (OR) of having a meniscal tear when having an ACL + medial-side injury was 4.83 (95% CI; 0.89–26.17). Patients with ACL + lateral-side injury pattern had meniscal tears in 42.86%. The lateral meniscus was involved in 100% of these patients. 62.5% of medial meniscus injuries were treated by meniscal repair, and 37.5% by partial meniscectomy. 58.54% of lateral meniscus injuries were treated by meniscal repair, and 39.02% by partial meniscectomy. Agreement calculated using the kappa test between MRI and diagnostic arthroscopy for medial meniscal lesions was 78.57%, and for lateral meniscal lesions was 84.29%.&lt;/p&gt;&lt;h3 data-test=\"abstract-sub-heading\"&gt;Conclusion&lt;/h3&gt;&lt;p&gt;The ligament injury pattern and the side of the injured collateral ligament infl","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"13 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141611808","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":"Ilizarov External Fixator Versus Orthofix LRS in Management of Femoral Osteomyelitis: A Propensity Score Matched Analysis","authors":"Ayman K. Saleh, Nazri Mohd Yusof, Abdehamid A. Attallah, Ehab Abdelftah Elshal, Amr Abdelhalem Amr Khames, Mohamed Nagah Ahmed Ibrahim, Mohamed Mosa Mohamed Mahmoud, Gaber Eid Abdeltawab, Ibrahim Elsayed Abdellatif A. Abuomira","doi":"10.1007/s43465-024-01208-1","DOIUrl":"https://doi.org/10.1007/s43465-024-01208-1","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Treatment of osteomyelitis (OM) is challenging. Ilizarov bone transport is a commonly used technique for management of OM. The recently introduced limb reconstruction system (LRS) has been effectively used for management of OM. It was suggested to be easier in use and less invasive. The present retrospective study aimed to compare LRS and Ilizarov bone transport in management of femoral OM using a propensity score matched analysis.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>The present retrospective study included 80 consecutive patients with femoral OM. The studied patients were managed either using Ilizarov external fixator (<i>n</i> = 40) or Orthofix LRS (<i>n</i> = 40). The clinical outcome measurements included union time, limb length discrepancy, additional operative procedures, refracture and infection.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Patients in the LRS group were exposed to significantly higher frequency of bone transport (30.0 versus 15.0%) and lower frequency of acute compression and lengthening (10.0 versus 32.5%). Patients in Ilizarov group had significantly higher frequency of tobramycin pellets as compared to their counterparts. The studied groups were comparable regarding the operative complications including pin-tract infection, non-union at docking site and refracture. Patients in the Ilizarov had significantly shorter time to union (8.2 ± 3.2 versus 11.0 ± 5.6 months, <i>p</i> = 0.012). No statistically significant differences were found between the studied groups regarding the quality-of-life domains.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Use of Ilizarov external fixator and Orthofix LRS devices proved to be effective and reliable. Their influences on patients’ quality appear to be comparable.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"295 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141573707","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":"Developmental Dysplasia of the Hip and Laterality: The Importance of Graded Severity of the Contralateral Hip","authors":"Emily K. Schaeffer, Charles T. Price, Kishore Mulpuri","doi":"10.1007/s43465-024-01157-9","DOIUrl":"https://doi.org/10.1007/s43465-024-01157-9","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Laterality and bilaterality have been reported as prognostic variables in developmental dysplasia of the hip (DDH) outcomes. However, there is little clarity across the literature on the reporting of laterality in developmental dysplasia of the hip (DDH) due to the variability in severity of the condition. It is widely accepted that the left hip is most frequently affected; however, the true incidence of unilateral left, unilateral right and bilateral cases can be hard to quantify and compare across studies. The purpose of this study was to examine laterality accounting for graded severity in a multi-centre, international prospective observational study of infants with hip dysplasia to demonstrate the complexity of this issue.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A multi-centre, prospective hip dysplasia database was analyzed from 2010 to April 2015. Baseline diagnosis was used to classify patients into a graded laterality category accounting for hip status within the DDH spectrum.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>A total of 496 patients were included in the analysis; 328 were &lt;6 months old at diagnosis and 168 were between 6 and 18 months old. Of these patients, 421 had at least one frankly dislocated hip. Unilateral left hip dislocations were most common, with 223 patients, followed by unilateral right and bilateral dislocations with 106 and 92 respectively. Stratifying these patients based on status of the contralateral hip, 54 unilateral left and 31 unilateral right dislocated patients also had a dysplastic or unstable contralateral hip. There were significantly fewer bilateral patients in the 6 to 18-month group (<i>p</i> = 0.0005). When classifying laterality by affected hip, bilaterality became the predominant finding, comprising 42% of all patients.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Findings from this multi-centre prospective study demonstrate the necessity to account for the graded severity in hip status when reporting DDH laterality. To accurately compare laterality across studies, a standardized, comprehensive classification should be established, as contralateral hip status may impact prognosis and treatment outcomes.</p><h3 data-test=\"abstract-sub-heading\">Level of Evidence</h3><p>Level II Prognostic Study.</p>","PeriodicalId":13338,"journal":{"name":"Indian Journal of Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141573708","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}