{"title":"Functional outcome of surgical management of calcaneal spur by excision and autologous platelet-rich plasma injection","authors":"P. A. Ganie, A. Gulati, R. Prasad, A. Shetty","doi":"10.18231/j.ijor.2021.008","DOIUrl":"https://doi.org/10.18231/j.ijor.2021.008","url":null,"abstract":"The calcaneal spur is also known as an enthesophyte which is a bony outgrowth from the calcaneum at the plantar fascia insertion. Treatment aspect ranges from initial conservative methods, invasive techniques to surgical excision of the spur in cases which are not responding to any other alternative methods. This article aims in evaluating the functional outcome of calcaneal spur excision coupled with a dose of autologous platelet-rich plasma injection in recalcitrant cases of the calcaneal spur. A total of 42 cases of confirmed calcaneal spur cases were recruited for the study. All participants were offered with calcaneal excision with a dose of autologous platelet-rich plasma injection. All patients were evaluated preoperatively and post-operatively with VAS and FFI scores at the end of the 1, 3 and 6 months. The patients who received calcaneal spur excision along with a single dose of autologous platelet-rich plasma injection reported statistically significant pain relief at the end of 6 months while comparing with the pre-operative VAS score (p = 0.003) and FFI score showed a statistically significant functional outcome between both groups at the end of 6 months (p <0.001). Surgical removal of calcaneal spur along with a dose of an autologous platelet-rich plasma injection serve the better management for calcaneal spur and improves the functional quality of life.","PeriodicalId":274774,"journal":{"name":"IP International Journal of Orthopaedic Rheumatology","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124863705","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":"Role of Vitamin D3 in fracture union in adults","authors":"Amrit Kumar Singh, Arunabh Arora","doi":"10.18231/j.ijor.2021.009","DOIUrl":"https://doi.org/10.18231/j.ijor.2021.009","url":null,"abstract":"Fractures play an important role in morbidity and often premature mobility among the elderly population. Because inactivity as a result of a fracture is harmful both to bone healing and health, it appears early or rapid fracture healing would be highly recommendable for returning fracture patients to come back to normal as soon as possible with minimal side effects. The literature remains unclear regarding supplementation required for promoting bone healing in fracture cases. Hereby we evaluated the advantages and disadvantages of vitamin D3 supplementation in fracture cases along with the quantitative analysis of vitamin D3 at the time of fracture and after fracture union.: A total of 200 patients were assessed clinically, biochemically (serum alkaline phosphatase, serum vitamin D3, and serum parathormone), and radiologically. All patients who satisfy inclusion criteria are followed up and vitamin D3 levels were measured up within 1 day of fracture and at the interval of 6 months after the orthopaedic intervention. The outcomes were monitored by the 5 points radiographic scoring system by Warden et al. With the majority of patients falling under the vitamin insufficiency group i.e. 53% of all patients were found to be vitamin insufficient at the time of fracture. 33% of patients found to be vitamin D deficient while 14% found to be insufficient stage. No patient was found to be in a toxicity state. According to Warden’s scoring., 50% of patients were in grade 3, 15% in grade 4, 33% in grade 2, and only 2% in grade 1. Regarding the prevalence of vitamin D deficiency or insufficiency in the general population, this study shows an alarming rate of vitamin D insufficient patients in a group of 200 patients, which indicates the need for attention towards vitamin D status not only for bone-related issues but for other issues related to vitamin D deficiency.","PeriodicalId":274774,"journal":{"name":"IP International Journal of Orthopaedic Rheumatology","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124083997","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}
H. Sakale, A. Agrawal, B. Nayak, Bikram Kar, R. Dash, S. Yadav
{"title":"Adverse event following platelet rich plasma injection for the management of early Osteoarthritis of knee – A report of 4 cases","authors":"H. Sakale, A. Agrawal, B. Nayak, Bikram Kar, R. Dash, S. Yadav","doi":"10.18231/j.ijor.2021.010","DOIUrl":"https://doi.org/10.18231/j.ijor.2021.010","url":null,"abstract":"Osteoarthritis is the leading cause of chronic disability affecting more than 80% of people over the age of 55. Several treatment options are there for early Osteoarthritis (OA) knee, like- rest, ice, brace, NSAIDs, intra-articular corticosteroid, Intra-Articular Hyaluronic Acid (IAHA), and intra-articular platelet-rich plasma (PRP) injection. Growth factors in PRP (PDGF, IGF, VEGF) promote matrix synthesis, cell growth, and migration, thus facilitating protein transcription. Several studies regarding PRP injection in the management of OA knee support this line of management without any documented complications of PRP at the knee joint.We report 4 cases of acute inflammation related to PRP injection for the treatment of OA knee. Two patients developed mild inflammation which was treated with oral medication on an outpatient basis. Another two patients developed moderate to severe inflammation which warranted surgical intervention.Intraarticular PRP injection has been reported in the literature as a successful modality of treatment in OA knee without any significant adverse effect. We are reporting four cases of adverse events following intraarticular PRP injection. Two cases were mild inflammations while the other two were moderate to severe. All four patients recovered and the outcome was satisfactory compared to the pre-injection status. The exact cause for the reaction after PRP injection in the knee is not known. Further study is needed for the cause of the inflammatory reaction.","PeriodicalId":274774,"journal":{"name":"IP International Journal of Orthopaedic Rheumatology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129368705","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}
Ranjeet Choudhary, A. Agrawal, A. Garg, A. Inamdar, Shilp Verma
{"title":"Long-term clinical results of autologous Platelet Rich Plasma (PRP) in recalcitrant plantar fasciitis","authors":"Ranjeet Choudhary, A. Agrawal, A. Garg, A. Inamdar, Shilp Verma","doi":"10.18231/j.ijor.2021.004","DOIUrl":"https://doi.org/10.18231/j.ijor.2021.004","url":null,"abstract":"In recent years, biologic therapies such as platelet-rich plasma (PRP) have gained prominence in multiple orthopedics degenerative tendinopathy and ligamental pathology. This research aimed to assess the clinical effectiveness of autologous platelet-rich plasma injection in cases of recalcitrant plantar fasciitis (RPF) over a long period.A prospective observational study was performed on RPF that did not experience pain relief after three months of conservative therapy. Under sterile conditions, inject approximately 3ml of platelet-rich plasma mixed with 0.5ml lignocaine into the maximum tender point of the heel. Visual Analogue Score for Pain, the American Orthopedics Foot, and Ankle Society (AOFAS) Ankle, and Hind Foot Score at one month, three months, six months, one year, and two years after injection.A total of 60 patients of RPF which 23 (38.33%) were male, and the rest 37 (61.66%) were female. The mean age was 45 ± 7.25 and the mean duration of symptoms was 7.4 ± 2.1months. The mean VAS score was 7.92 ± 1.2 at pre-injection, was progressively reduced post-injection to 5.61 ± 1.56 at one month, 3.1 ± .83 at three months, and 2.4 ± .68 at six months and remained at low level 2.5 ± .92 at one year and 2.7 ± .56 at two years. The mean AOFAS score was 56.92 ± 13.24 at pre-injection, was progressively increased post-injection to 66.41± 10.26 at one month, 78.31 ± 12.64 at three months, and 90.54 ± 10.71 at six months and remained at a low level 89.24 ± 8.92 at one year and 87.54 ±10.56 at two years. Mean VAS and AOFAS scores showed statistically significant pain reduction and functional improvements at successive follow-ups till 6month (p<.05); the improvement remained stable and did not change significantly until the last appointment at 2year follow-up (p > 0.05).The outcomes of autologous PRP injection in recalcitrant plantar fasciitis are reliable, stable, and predictable in both long- and short-term follow-up. PRP injection is safer and not associated with serious complications as in the case of steroid injection.","PeriodicalId":274774,"journal":{"name":"IP International Journal of Orthopaedic Rheumatology","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114389212","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":"Synergistic effects of Vitamin D and magnesium in non-specific low back ache (nLBA) – A prospective comparative study","authors":"T. Saravanakumar, Prajwal Gs, Ashwin Gobbur","doi":"10.18231/j.ijor.2021.007","DOIUrl":"https://doi.org/10.18231/j.ijor.2021.007","url":null,"abstract":"Low back ache constitute a group of symptoms with no clear etiopathogenesis and pose a major difficulty for a health care professional to diagnose and treat the disease per se. Low back ache has become permanent disability for certain individuals and interferes with normal functioning of day-to-day life activities. This study was undertaken to establish the correlation and functional outcome between combination of Vitamin D & magnesium supplementation and Vitamin D supplementation for patients with non-specific low back ache. An observational comparative study was performed with 117 patients of non-specific low back ache from June 2019 to May 2020. Out of 117 patients, a total of 60 patients (Group A) were treated with a combination of Vitamin D supplementation along with magnesium tablets for 3 consecutive months and remaining 57 patients (Group B) were treated with Vitamin D supplementation for 3 consecutive months. Both the groups were followed up for 6 months for pain relief assessed by VAS score and functional improvement in quality of life assessed by Oswestry Low Back Pain Disability Questionnaire. A significant difference was noted in the Group A compared to Group B which demonstrates an additive effect on the combination used in them. When analysing the change in parameters compared to the pre-interventions state both the groups showed significant improvements. However, upon analysis of the correlation between the parameters with regard to the change among the groups, we noted that Group A showed significant correlation with respect to the Calcium and Vit-D level improvement out of the intervention upon the observed results. Treatment of non-specific low back ache with vitamin-D and magnesium shows synergistic effects with significant improvement in the functional outcomes and the pre-intervention metabolic parameters.","PeriodicalId":274774,"journal":{"name":"IP International Journal of Orthopaedic Rheumatology","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122895355","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":"Correlation of knee society score and oxford knee score in patients with moderate to severe osteoarthritis of the knee","authors":"Uma Phalswal, V. Pandey, Ashok Kumar, A. Elhence","doi":"10.18231/j.ijor.2021.005","DOIUrl":"https://doi.org/10.18231/j.ijor.2021.005","url":null,"abstract":"Osteoarthritis (OA) of the knee is a degenerative, non-inflammatory joint condition marked by articular cartilage disintegration and the growth of new bone (osteophytes) at the joint surfaces and borders. It impairs one's ability to function and makes one disabled. It is the most common rheumatic disease. Because the Knee is a weight-bearing joint and a crutch joint, it is the most usually afflicted joint by Osteoarthritis.A Correlational study was conducted to find out the correlation between Knee Society Score (KSS) and Oxford Knee Score (OKS) on 142 Osteoarthritis Knees. Purposive sampling was used to collect data from the Orthopaedics OPD at AIIMS Jodhpur from October to December 2018.On evaluation, the mean age of the patients was 60.19±1.01. Bilateral Knee Osteoarthritis affected about 42% of the patients. Approximately half of the patients were obese. Only 34% of patients had compliance in physiotherapy. Analgesics and massage treatment are used by about 76% of the patients to relieve knee pain. In the Knee Society Score, the majority of the patients (82.4%) had a bad knee condition, with a mean score of 49.07±1.06. In OKS, about half of the patients (46.5%) had Moderate to Severe Knee Osteoarthritis, with a mean score of 22.69±7.09. The correlation coefficient between the Knee Society Score and the Oxford Knee Score is 0.660. As a consequence of the analysis, both scales have almost the same outcome, indicating that they are moderately associated. The Knee Society Score is highly associated with occupation and physiotherapy, whereas the Oxford Knee Score is significantly related to the patients' age alone. According to the study, there is a moderate correlation between the Knee Society Score (KSS) and the Oxford Knee Score (OKS). These scores should be included during the diagnosis of Knee Osteoarthritis for improved patient care.","PeriodicalId":274774,"journal":{"name":"IP International Journal of Orthopaedic Rheumatology","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128107141","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}
A. Agrawal, A. Inamdar, Ranjeet Choudhary, P. Raj, Shilp Verma
{"title":"Bilateral idiopathic club foot in baby of a rheumatoid mother: A rare case report and its management","authors":"A. Agrawal, A. Inamdar, Ranjeet Choudhary, P. Raj, Shilp Verma","doi":"10.18231/j.ijor.2021.011","DOIUrl":"https://doi.org/10.18231/j.ijor.2021.011","url":null,"abstract":"Congenital clubfoot has a multifaceted etiology, with several hypotheses offered in its etiopathogenesis. The clubfoot has rarely been reported in babies born to women who have rheumatoid arthritis (RA). We present a rare case of a 31-year-old lady with RA on disease-modifying anti-rheumatoid drugs who delivered a child with bilateral congenital clubfoot. She had previously been using Methotrexate, Hydroxychloroquine, and Sulfasalazine regularly, but Methotrexate was stopped seven months before pregnancy. A full-term female baby was born through the cesarean section with bilateral clubfoot deformity and a modified Pirani score of eight out of 10. The deformity correction was done with the Ponseti serial casting method. The final modified Pirani score was two out of ten. In newborns born to rheumatoid arthritis mothers, the club foot deformity was effectively treated with serial Ponseti corrective casts, as was idiopathic clubfoot in babies born to non-rheumatoid mothers. Our findings validate the Ponseti serial casting method for these kinds of patients.","PeriodicalId":274774,"journal":{"name":"IP International Journal of Orthopaedic Rheumatology","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132452752","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":"Excellent outcome of a patient with acute back pain and osteoporotic fracture- A case report","authors":"S. Nallasivan, R. Vignesh, Arunkumar Govindarajan","doi":"10.18231/j.ijor.2021.012","DOIUrl":"https://doi.org/10.18231/j.ijor.2021.012","url":null,"abstract":"Rheumatoid arthritis is one of the common inflammatory diseases affecting predominantly women. Steroids and anti-inflammatory drugs have been used for decades in managing this condition. Long term steroids have potentially devastating consequences in any multisystem disease and commonly described side effects include Cushing’s syndrome, diabetes and osteoporosis. Fragility fractures are more common in these patients.We report a patient with back pain and osteoporotic vertebral collapse whose neurological weakness was diagnosed and surgical fixation was done to help the patient improve dramatically. Steroids cause an osteoporotic collapse of the vertebra i.e. fragility fracture and appropriate timely intervention would result in an excellent outcome. Collaboration with other specialists greatly helped to get the treatment early even during this covid pandemic.","PeriodicalId":274774,"journal":{"name":"IP International Journal of Orthopaedic Rheumatology","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126656259","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}
A. Anwar, Shilp Verma, A. Agarwal, Ranjeet Choudhary, A. Garg
{"title":"A better functional outcome with platelet rich plasma compared with local steroid injection in tennis elbow","authors":"A. Anwar, Shilp Verma, A. Agarwal, Ranjeet Choudhary, A. Garg","doi":"10.18231/j.ijor.2021.006","DOIUrl":"https://doi.org/10.18231/j.ijor.2021.006","url":null,"abstract":"Lateral epicondylitis commonly referred to as 'tennis elbow,' is mainly observed in the 3rd and 4th decade of life in around 2% -3% of the population. Treatment modalities for lateral epicondylitis include analgesics, immobilization, tennis elbow brace, local steroid infiltration, and ultrasound therapy. Recent studies have explored the effectiveness of platelet-rich plasma (PRP) injections in lateral epicondylitis. We used the block randomization technique. Two groups were prepared with 30 patients in each group. One group of patients received PRP and the other received local steroid injection. Patients were evaluated at the time of procedure and immediately after the procedure, at six weeks, three months, and six months, using the visual analog score and Liverpool's elbow score. At the end of 6 months, follow-up patients in the PRP injection group show good clinical and functional compare to the steroid group of patients. PRP and local corticosteroid injection provide symptomatic relief in the treatment of lateral epicondylitis. PRP infiltration gives better results in pain relief and functional activities with statically significant values when compared with corticosteroid injections.","PeriodicalId":274774,"journal":{"name":"IP International Journal of Orthopaedic Rheumatology","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132861564","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}
Girinivasan Chellamuthu, S. Muthu, Madhan Jeyaraman, M. Khanna
{"title":"When surgeons wanted to go beyond their scalpels! – The philosophy of orthopaedic rheumatology","authors":"Girinivasan Chellamuthu, S. Muthu, Madhan Jeyaraman, M. Khanna","doi":"10.18231/j.ijor.2021.001","DOIUrl":"https://doi.org/10.18231/j.ijor.2021.001","url":null,"abstract":"Girinivasan Chellamuthu 1, Sathish Muthu 1,2,3,*, Madhan Jeyaraman 1,3,4, Manish Khanna 5 1Orthopaedic Research Group, Coimbatore, Tamil Nadu, India 2Dept. of Orthopaedics, Government Medical College & Hospital, Dindigul, Tamil Nadu, India 3Research Scholar, Sharda University, New Delhi, India 4Dept. of Orthopaedics, School of Medical Sciences & Research, Sharda University, New Delhi, India 5Dept. of Orthopaedics, Prasad Institute of Medical Sciences, Lucknow, Uttar Pradesh, India","PeriodicalId":274774,"journal":{"name":"IP International Journal of Orthopaedic Rheumatology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114057060","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}