Journal of Musculoskeletal Surgery and Research最新文献

{"title":"Inserting the best knee: A short-term analysis of posterior stabilized versus cruciate substituting ultracongruent tibial inserts for total knee replacement","authors":"T. V. Rajguhan, Pravin K. Vanchi, K. Prashanth, R. Veeraraghavan, Mohan K. Murugesan","doi":"10.25259/jmsr_118_2023","DOIUrl":"https://doi.org/10.25259/jmsr_118_2023","url":null,"abstract":"\u0000\u0000As the posterior cruciate ligament is a primary stabilizer of the knee, it is functionally replaced using posterior stabilized (PS) or anterior stabilized ultracongruent (UC) inserts in cases where it is attenuated or requires resection. This study compared PS and UC inserts in terms of functional and pain scores in patients undergoing total knee replacement (TKR).\u0000\u0000\u0000\u0000This prospective randomized study included 90 consecutive patients who underwent total TKR; PS and UC inserts were used in 47 and 43 patients, respectively. Outcomes were measured over 1 year. The duration of surgery was recorded, and the pain was assessed using the Visual Analog Scale score; functional outcomes were evaluated by assessment of the range of motion (ROM), Knee Society Score, and joint stability. All parameters and scores were assessed pre-operatively, immediately post-operative, 1 month, 3 months, and at 1-year follow-up.\u0000\u0000\u0000\u0000The groups showed no significant differences and matched similarly in terms of body mass index, sex, or age. At a minimum of 1-year follow-up, TKR using either insert significantly improved the mean ROM and Knee Society and functional scores, which were comparable between the groups. Overall, 14 and 13 patients with UC and PS inserts, respectively, had excellent outcomes; 2 and 1 patients from the PS and UC groups, respectively, were lost to follow-up. Surgery was significantly shorter in the UC group. Although the Visual Analog Scale score had reduced significantly in both groups at the end of 3 months, one patient from the PS group had persistent knee pain with decreased ROM.\u0000\u0000\u0000\u0000The inserts showed no significant differences in terms of the ROM and Knee Society and functional scores. Surgery was notably shorter in the UC group (by 5 min). TKR using UC inserts is an effective alternative in patients with small bony geometry and may preserve intercondylar bone.\u0000","PeriodicalId":266222,"journal":{"name":"Journal of Musculoskeletal Surgery and Research","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130854332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anteater nose sign and reverse anteater nose sign: Are they specific for calcaneonavicular coalition?","authors":"R. Bhoil, A. Ahluwalia, Ritu Sharma, Abhishek Das, A. Jhobta","doi":"10.25259/jmsr_85_2023","DOIUrl":"https://doi.org/10.25259/jmsr_85_2023","url":null,"abstract":"The anteater nose sign has been described on imaging in the case of the calcaneonavicular coalition and is produced by a tubular elongation of the anterior calcaneal process that approaches or overlaps the navicular bone, resembling an anteater’s nose. Similarly, the reverse anteater sign refers to the posterior and lateral extension of the navicular bone, also seen in the case of the calcaneonavicular coalition. Originally described on lateral or oblique foot/ankle radiographs, this appearance is also observed in the case of magnetic resonance images (MRI) on sagittal sections. We describe a case of a talocalcaneal coalition, in which the MRI had a similar appearance, thereby confusing the imaging findings of the case, and discuss the key imaging features for the correct diagnosis. We also propose a new sign, “Opposing beak sign,” for this similar appearance in the case of a talo-calcaneal coalition, awareness of which as a distinct entity on sagittal MRI would help correct preoperative diagnosis and subsequent management.","PeriodicalId":266222,"journal":{"name":"Journal of Musculoskeletal Surgery and Research","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128068386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The need for standardization in foot and ankle outcome measures: Implications for evidence-based medicine in orthopedics","authors":"O. Al-Mohrej, Preksha Rathod, Caitlin Svendsen, Jamal Al-Asiri, B. Petrisor","doi":"10.25259/jmsr_133_2023","DOIUrl":"https://doi.org/10.25259/jmsr_133_2023","url":null,"abstract":"","PeriodicalId":266222,"journal":{"name":"Journal of Musculoskeletal Surgery and Research","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131205254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Musculoskeletal corticosteroid injections were used safely in patients during the COVID-19 pandemic","authors":"P. Raval, M. Baguley, H. Singh, R. Bhatt, R. Pandey","doi":"10.25259/jmsr_78_2023","DOIUrl":"https://doi.org/10.25259/jmsr_78_2023","url":null,"abstract":"\u0000\u0000Studies have highlighted that corticosteroid use can cause immunocompromise. During the COVID-19 pandemic, caution was advised on corticosteroid injections (CSIs) use and the possibility of increasing patients’ susceptibility to COVID-19. CSI is commonly used to manage pain, which is increasingly important with prolonged waiting lists. This study aimed to assess the occurrence of COVID-19 infection following the administration of CSI for musculoskeletal pain.\u0000\u0000\u0000\u0000A prospective cohort study of patients receiving CSI for musculoskeletal conditions through the COVID-19 pandemic was followed. It monitored post-injection through clinical review and telephone follow-up as to whether they were diagnosed with COVID-19 or had its symptoms. Patients were administered either half or full-dose corticosteroids as per guidance at the time. Patients were followed up at 8 weeks, 3 and 6 months.\u0000\u0000\u0000\u0000One hundred and ninety-six patients were included (100 males and 96 females). One hundred and fourteen patients received 40 mg of Depo-Medrone, and 90 received 20 mg of Depo-Medrone. No patients suffered COVID-19 symptoms or had positive viral polymerase chain reaction (PCR) tests by 3-month follow-up. By the 6-month follow-up, four of the cohort had mild symptoms and a positive PCR test for COVID-19. None required hospitalization.\u0000\u0000\u0000\u0000Our study demonstrated only a 2% incidence of COVID-19 infection following the administration of CSI for musculoskeletal pain within the 6-month follow-up, despite a high local prevalence for infection. We observed no correlation between CSI and COVID-19 acquisition and noted no clear increase in risk. We would therefore endorse CSI use if required for patients after careful patient selection and shared decision-making.\u0000","PeriodicalId":266222,"journal":{"name":"Journal of Musculoskeletal Surgery and Research","volume":"60 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128362506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can clinical tests show high diagnostic accuracy in the assessment of degenerative full-thickness rotator cuff tears?","authors":"Aditi Pandey, D. Adla, R. Pandey","doi":"10.25259/jmsr_63_2023","DOIUrl":"https://doi.org/10.25259/jmsr_63_2023","url":null,"abstract":"\u0000\u0000At present, the diagnosis of full-thickness rotator cuff tears (FTCTs) relies heavily on imaging. We suggest that clinical examination can reliably be used as a substitute for diagnostic imaging, particularly in relatively older patients who are undergoing conservative management. Our study evaluated the diagnostic value of five clinical tests in assessing FTCT in secondary care.\u0000\u0000\u0000\u0000One hundred and fifteen patients were examined by a consultant shoulder surgeon for suspected FTCT and underwent diagnostic imaging. Clinical examination included the empty-can test, resisted external rotation test, external rotation lag test, belly-press test, and lift-off test. Fifty two (45%) of these patients were referred for shoulder arthroscopy, while the rest were managed conservatively. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of these tests were calculated, comparing clinical results with arthroscopic findings.\u0000\u0000\u0000\u0000Our results showed that, in combination, these five special tests have high diagnostic values for FTCT, with an overall accuracy of 90%. Both the empty-can test and the resisted external rotation test had a sensitivity of 97%. While the external rotation lag test had poor accuracy, it was 100% successful at ruling in tears. The belly-press and lift-off tests were 100% sensitive and specific for full-thickness tears of the subscapularis.\u0000\u0000\u0000\u0000Clinical tests for diagnosing FTCT have high diagnostic value, comparable to imaging modalities explored in the literature. Overreliance on magnetic resonance imaging and ultrasonography may not be justified, particularly in a relatively older population when a rotator cuff tear repair is not scheduled.\u0000","PeriodicalId":266222,"journal":{"name":"Journal of Musculoskeletal Surgery and Research","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128517311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of screw cutout in the surgical fixation of peritrochanteric hip fractures: A retrospective cohort study","authors":"Mohanad Aboulebda, Loay A. Salman, Mohammad Hammad, Mazin A. Foodool, G. Kong, A. Abunimer, H. A. Hejleh, Ghalib O. Ahmed","doi":"10.25259/jmsr_76_2023","DOIUrl":"https://doi.org/10.25259/jmsr_76_2023","url":null,"abstract":"\u0000\u0000This study aimed to evaluate the impact of the tip-apex distance (TAD) and other reported risk factors on the screw cutout rate.\u0000\u0000\u0000\u0000This study retrospectively reviewed electronic medical records from January 2016 to December 2018 to analyze the relationship between TAD and implant cutout failure rate in patients with peritrochanteric (PT) fractures who underwent cephalomedullary nail (CMN) or dynamic hip screw (DHS) fixation. Secondary factors analyzed included age, body mass index (BMI), fracture stability, posterolateral fragment presence, post-operative radiographic reduction, implant type, and screw position.\u0000\u0000\u0000\u0000A total of 68 patients (40 DHS, 28 CMN cases) were included in the study, with a mean age of 64 ± 20 years and a BMI of 25.5. Most of the included patients (65%; 44) were males. An overall cohort screw cutout rate of 7.3% (5 cases) was observed. The patient’s age, BMI, fracture classification (stability), implant type, and the level of the operating surgeon did not influence the screw cutout rate (P = NS). However, a TAD ≥25 mm (P = 0.02), lag screw position (P = 0.03), and fracture reduction in anteroposterior (P = 0.02) and lateral views (P = 0.024) showed statistically significant results.\u0000\u0000\u0000\u0000This study demonstrated that a TAD of ≥25 mm, lag screws malposition, and inappropriately reduced fracture in post-operative radiographs are significant risk factors for screw cutout in DHS and CMN fixation of PT fractures.\u0000","PeriodicalId":266222,"journal":{"name":"Journal of Musculoskeletal Surgery and Research","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134500134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of developmental dysplasia of the hip at a tertiary hospital in Oman","authors":"Mohammed Al Azri, Masoud N. Al Abdali, Alaa M. Taqi","doi":"10.25259/jmsr_45_2023","DOIUrl":"https://doi.org/10.25259/jmsr_45_2023","url":null,"abstract":"\u0000\u0000Developmental dysplasia of the hip (DDH) is common in Oman in clinical practice, but the incidence in Oman is still unknown. This study aimed to evaluate the incidence and characteristic features of DDH in the Omani population managed at Khoula Hospital (KH).\u0000\u0000\u0000\u0000This is a retrospective study conducted at KH, targeting all Omani pediatric patients who have been officially diagnosed with DDH between the periods from January 2009 to December 2019. The data were collected from the medical record system at the hospital and phone interviews with the patient’s family to fill out the missed information.\u0000\u0000\u0000\u0000The study included 795 DDH-diagnosed patients, out of which 652 (82.0%) were female and 143 (18.0%) were male, giving a ratio of 4.5:1. Bilateral DDH was diagnosed in 300 (37.7%) patients, left-sided DDH in 307 (38.6%), and right DDH in 188 (23.6%) patients. At least half of the DDH cases were 6 months old or younger at the first presentation to the hospital and 16.6% were diagnosed after the age of 18 months. Remarkably, at least one risk factor was present for 581 (73.1%) patients. The remaining patients had no risk factors for DDH at all. The prevalence of the first child in the family was 33.0% and oligohydramnios 10.9%. The estimated DDH incidence in this study is 1.05/1000 live births/year.\u0000\u0000\u0000\u0000Based on the national live births annual records from Oman National Center for Statistics and Information, this study estimated the DDH incidence to be 1.05/1000 live births. These findings cannot be generalized nationally as they are from a single center. We recommend conducting a multicenter prospective study to identify DDH incidence in Oman accurately. National guidelines and screening programs must be developed and executed for early detection and management.\u0000","PeriodicalId":266222,"journal":{"name":"Journal of Musculoskeletal Surgery and Research","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127561810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obtaining a bone biopsy in acute hematogenous osteomyelitis using a new surgical instrument: A technical note","authors":"Pavel Shklyaev, Ilnur I Yagudin, N. A. Kiryanov, A. Yuditskiy","doi":"10.25259/jmsr_74_2023","DOIUrl":"https://doi.org/10.25259/jmsr_74_2023","url":null,"abstract":"Acute hematogenous osteomyelitis is an infectious and inflammatory tubular bone disease involving the bone marrow. The final diagnosis is made based on a morphological study obtained from a bone biopsy. We have developed and patented a surgical instrument (Patent RU No 176629) for one-stage osteoperforation and trepan biopsy. Bone biopsy specimens obtained have been tested for their suitability for morphological examination, namely light and electron microscopy. It has a diagnostic and therapeutic function. This report aimed to describe a new bone biopsy tool that allows obtaining specimens suitable for morphological studies.","PeriodicalId":266222,"journal":{"name":"Journal of Musculoskeletal Surgery and Research","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131101783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior slope of the tibial plateau in cohort of Omani patients undergoing total knee arthroplasty","authors":"Sami Ali Al Badwi, Nafaa S. Al Kindi, Muadh H. Al Zeedi, ahmed Al Ghaithi, J. Luthra","doi":"10.25259/jmsr_58_2023","DOIUrl":"https://doi.org/10.25259/jmsr_58_2023","url":null,"abstract":"\u0000\u0000Posterior tibial slope (PTS) is an important factor in restoring joint biomechanics after total knee arthroplasty (TKA). Given ethnic variation and the lack of recorded values for PTS, this study aimed to report PTS in a cohort of Omani patients (Arab ethnicity).\u0000\u0000\u0000\u0000This retrospective study included all Omani patients who underwent TKA in a specialized center between May 2017 and March 2020. Patients with revision TKA, extra-articular deformity, and tibial defects necessitating bony build-up and traumatic indications were excluded. Data collected include age, gender, and pre-and post-operative PTS.\u0000\u0000\u0000\u0000A total of 128 patients were included in the study, 94 (73.4%) were female and 34 (26.6%) were male. The mean age of the patients was 65.16 years, standard deviation (SD) 8.47 (Maximum 87–Minimum 43). The mean pre-operative PTS was 10.6° (SD 3.65), whereas most current TKA designs aim for a 5–6° posterior slope. We found no correlation between PTS value and age or gender (P > 0.05).\u0000\u0000\u0000\u0000Given the higher PTS angle found in this study, which is consistent with those reported in the literature for Asian and Arab populations. This study indicates the importance of examining PTS variation within the population served. The proximal tibia shape and cutting angle can be varied to avoid any discrepancy in PTS after implantation.\u0000","PeriodicalId":266222,"journal":{"name":"Journal of Musculoskeletal Surgery and Research","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117185996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of fracture risk among postmenopausal Sudanese women: Is the fracture risk assessment score beneficial?","authors":"S. K. Noor, Mawada S. Mohammed, Amro M. Farah, Sirelkhatim I. Farah, Fadul B. Mohammed, S. O. Bushara","doi":"10.25259/jmsr_23_2023","DOIUrl":"https://doi.org/10.25259/jmsr_23_2023","url":null,"abstract":"\u0000\u0000Osteoporosis leads to fragile bones with a high risk of fracture. Moreover, a bone mineral density test has low sensitivity to predict fractures. Alternatively, the World Health Organization fracture risk assessment (FRAX) tool helps improve the prediction of fractures in women even before they develop osteoporosis. This study aimed to assess the risk of developing fractures in Sudanese women using the FRAX tool by studying clinical risk factors that lead to decreased bone strength.\u0000\u0000\u0000\u0000A cross-sectional community-based study was conducted in the River Nile State, Sudan (Jan 2020–June 2020). A questionnaire comprising demographic data and clinical risk factors of fragility fracture was used to determine whether these factors met the FRAX criteria.\u0000\u0000\u0000\u0000Participants were 350 postmenopausal women between the ages of 51–60 (36%), with a body mass index (BMI) >25 in 61.4%. In addition, 11% were exposed to oral glucocorticoids, and premature menopause occurred among 20.3%. The risk of major osteoporotic fracture was highest (>20%) in approximately 7% of the women, and 16.3% of them had a high risk of hip fracture (>3%). The risk for fractures increases with age, and a lower BMI is significantly associated with minimal trauma fractures. This study observed significant relationships among systemic glucocorticoid use, insulin-dependent diabetes mellitus, premature menopause, and osteoporotic fractures. All significant associations had P < 0.05.\u0000\u0000\u0000\u0000This study observed that multiple risk factors significantly correlated with osteoporotic fractures. Therefore, the FRAX tool is useful in 10-year fracture risk predictions.\u0000","PeriodicalId":266222,"journal":{"name":"Journal of Musculoskeletal Surgery and Research","volume":"401 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133502489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}