Journal of Orthopaedic Diseases and Traumatology最新文献

{"title":"Effect of surgical approach on functional outcome and component positioning in total hip arthroplasty","authors":"Sreekanth Kashayi-Chowdojirao, Asif Hussain Khazi Syed, Sandeep Boddeda, Chandrasekhar Patnala","doi":"10.4103/jodp.jodp_37_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_37_22","url":null,"abstract":"Context: Total hip arthroplasty (THA) is commonly performed through a posterior or a direct lateral (Hardinge) approach, and each one has merits and demerits. Aims: The purpose of this study was to examine the difference between the lateral and posterior approaches with respect to functional outcome, component positioning, intraoperative blood loss, and patient satisfaction. Settings and Design: This is a prospective comparative study of short- to mid-term outcome of cementless THA using two approaches. Subjects and Methods: Seventy hips satisfying our inclusion criteria were selected, of which 21 hips operated by lateral approach in supine position were included in lateral approach group (LAG), and 49 hips operated by posterior approach in lateral position were included in posterior approach group (PAG). Functional assessment was performed 1 day before surgery, 1 year after surgery, and at the latest follow-up using Harris Hip score (HHS). Component positioning of acetabular cup and femoral stem was assessed in plain radiographs at the latest follow-up. Generic satisfaction questionnaire was used to measure satisfaction after THA at the latest follow-up. Radiographic measurements (cup inclination, cup version, and femoral stem tip position) were performed postoperatively using low-centered pelvic anteroposterior and cross-table lateral hip radiographs. Results: At an average of 3 years and 6 months of follow-up, the mean HHSs were 88.05 and 90.32, respectively, in LAG and PAG; the difference was not significant (P = 0.178). The average inclination of the cup in LAG was 37.9° and in PAG was 45.02° with a significant difference (P = 0.00027), both of which are in the normal range. The cups were significantly (P ≤ 0.0001) more anteverted in the PAG (average angle of 27.69° vs. 16.14°). The mean blood loss was significantly more in PAG (510 ml vs. 436.67 ml; P = 0.04). Majority of femoral stems in lateral approach had their tips directed posterior. Nineteen out of 21 LAG patients and 45 out of 49 PAG were very satisfied/satisfied with their outcomes after THA. Statistical Analysis Used: Data were collected using prestructured data forms and analyzed with unpaired Student's t-test with 95% confidence interval. Conclusions: There was no significant difference in functional outcome and patient satisfaction at short- to mid-term follow-up between both approaches. The cup anteversion was significantly more in PAG. For better conclusions, other factors (i.e. immediate postoperative pain, and long-term survival), combined anteversion and spinopelvic parameters, have to be included in the study with a larger sample size.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"6 1","pages":"27 - 31"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43594017","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":"Relevance of sonological evaluation in medial knee injuries and its comparison with magnetic resonance imaging findings – A prospective study","authors":"Gayathri Mohanan, K. Chandan, J. Unnikrishnan, S. Job","doi":"10.4103/jodp.jodp_23_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_23_22","url":null,"abstract":"Background: Ultrasonography offers several unique strengths over magnetic resonance imaging (MRI) that makes it a promising technique for the evaluation of certain disorders of the knee. Ultrasonography has higher spatial resolution than MRI, which may be helpful in evaluating the superficial structures and popliteal fossa of the knee in detail. Visualizing the medial collateral ligament (MCL) under ultrasound is relatively easy due to its superficial location, spanning from the medial femoral condyle to the medial tibial metaphysis. Meanwhile, MRI is expensive, not advisable to all due to its claustrophobia and ferromagnetic property. Ultrasound, on the other hand, is an inexpensive, widely available, and non-invasive technique which also allows dynamic imaging. Our objective is to assess the validity of ultrasound in the diagnosis of medial knee injuries in comparison with MRI findings. Materials and Methods: Patients attending the Department of Orthopaedics are referred to the Department of Radiodiagnosis of Government (TD) Medical College, Alappuzha, who were clinically suspected to have medial knee injury, during the study. This study was a prospective study. Prospective patients with clinically suspected medial knee injuries scheduled for MRI of the knee were evaluated by ultrasound examination before the MRI. Sonographic findings were then compared to MRI results. Results and Discussion: Sixty patients were enrolled in the study. 73.3% of the study population were male and most of them belonged in their 2nd and 3rd decades. Most of the injuries were left-sided (60%) and majority (65%) presented for radiological evaluation within 1 week–1 month of history of injury. The accuracy of ultrasound in the diagnosis of MCL and medial meniscus injuries were 86.7% and 85%, respectively. Ultrasonography demonstrated 89.6% sensitivity and 75% specificity for MCL injuries and 85.3% sensitivity and 84.6% specificity for medial meniscus tears. The most frequent knee finding in this study was joint effusion which was seen in 50 (83.3%) of patients. Conclusion: Ultrasonography gives high accuracy and specificity in the detection of MCL and medial meniscal injuries. Ultrasound may have a role as the initial rapid imaging modality in patients with suspected MCL or medial meniscus injuries, and it may serve as an effective low-cost screening tool for patients with medial meniscal or MCL injuries and avoid performing the high-cost MRI.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"6 1","pages":"7 - 12"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45398351","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":"Ten years' follow-up for cemented hip arthroplasty in patients <60 years of age with standardization of cementing technique: A multicentric study","authors":"Imran Sajid, Javed Jameel, Sukhvinder Singh, Suryakant Singh, Ankit Varshney, Sabeel Ahmad","doi":"10.4103/jodp.jodp_12_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_12_22","url":null,"abstract":"Introduction: Total hip arthroplasty (THA) is the preferred treatment for persistent disability due to hip pathologies and restoration of normal functions. Although there is a general consensus of using un-cemented implants for adults and elderly with good bone quality and cemented for senior citizen population, implant choice for middle aged group of 40 years to 60 years is still a subject of debate, especially in financial constrained situations. In our study, we have determined the implant survivorship and functional outcomes of cemented THA in patients between 40 and 60 years of age, at the minimum follow-up of 10 years with emphasis on standardization of cementing technique. Materials and Methods: This is a retrospective study including 25 patients who had undergone cemented hip arthroplasty. Data were collected from five different surgical centres, whose orthopedic surgeons had common surgical training and were following a common cementing technique. Results: Mean Harris Hip Score of 25 hips at final follow-up was 90 and Visual Analog Scale 1.88. The functional outcome was good to excellent at final follow-up in 89% hips. There was a significant improvement in pain and activity level after surgery (P < 0.001) and maintained at the final follow-up. Conclusion: Our series provides evidence for utility of cemented hip implants in low functional demand patients along with emphasizing the importance of a good cementing technique for the long-term survival of cemented hip arthroplasty in the age group of 40–60 years.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"5 1","pages":"138 - 144"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44813993","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":"Posteromedial tibial plateau fractures – Functional outcome of posteromedial buttress plating with precontoured locking plate using modified lobenhoffer approach","authors":"J. Unnikrishnan, K. Chandan, V. Bindulal","doi":"10.4103/jodp.jodp_22_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_22_22","url":null,"abstract":"Posterior tibial plateau fractures have a complex intra-articular fracture pattern, representing approximately 1.2% of all fractures. The occurrence of the posteromedial shear fragment is relatively common in high-energy tibial plateau fractures. Aims and Objectives: To study the role of posteromedial plating in the management of complex tibial plateau fractures with a posteromedial fragment. Materials and Methods: Only patients with posteromedial fracture patterns alone are taken into account. Twenty cases above 20 years of age, from the patient, admitted to Government Medical College, Thrissur, with posteromedial fragment in tibial plateau fractures that were operated were undertaken for the study. The patients were followed up for 2 years. Results: Of the 20 patients with posteromedial tibial plateau fractures from X-ray and computed tomography scan of the knee joint, all patients were treated with precontoured posteromedial buttress plating using single anatomical locking plate. We analyzed patients with Rasmussen scoring postoperatively. In our analysis, among 20 patients, the functional score was excellent in 14, good in 5, fair in 1, and poor in none. There was one patient with compartment syndrome who had developed a mild surgical site infection that later resolved. No excessive collapse is seen postoperatively since locked plate is used. Four patients had transient paraesthesia of the saphenous nerve; both resolved completely.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"5 1","pages":"180 - 184"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43454425","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":"Total contact casting: A forgotten art in the management of neuropathic foot ulcers","authors":"Manikumar Chemboli, R. Rao, Sivananda Pathri, Chandana Pathri, V. Paka","doi":"10.4103/jodp.jodp_14_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_14_22","url":null,"abstract":"Background: Neuropathic ulcers affect a patient's ambulation and are the leading cause of nontraumatic amputations. Offloading (reduction of pressure) is the key to success in managing these ulcers. Total contact casting (TCC) is considered as the gold standard of treatment for managing neuropathic foot ulcers (NFU). However, this method is less frequently used in the present-day ulcer management due to the lack of skill and laborious nature of work involved. Aim: This study aims to explore the merits and demerits of this technique and understand its relevance in modern times in managing NFUs. Patients and Methods: A total of 24 patients with NFU of different etiologies presented to outpatient unit between August 2018 and August 2020 were included in this prospective case series. All the patients were treated with TCCs applied at weekly intervals, until the ulcer healed completely. Results: Primary outcomes measured were number of casts required which reflected the time of healing in weeks. The mean number of castings required for each centimeter of ulcer healing was 2.310 cast time duration with a 91.66% percentage of success rate. Ulcers in all the patients healed on or before 16 weeks with a mean duration of healing of 58 days after commencement of treatment. Conclusion: It offers attractive healing rates in the management of NFUs and is associated with fewer manageable low-risk complications. Surgeons should incorporate this casting method as part of standard care of NFU to produce early healing and avoid major complications secondary to poor wound healing.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"5 1","pages":"151 - 156"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47256694","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":"Early outcomes of ultra-congruent insert in cruciate-retaining total knee arthroplasty: A prospective study","authors":"S. Jaura, P. Tiwari, H. Kaur, Nitish Bansal","doi":"10.4103/jodp.jodp_13_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_13_22","url":null,"abstract":"Introduction: The exponents of cruciate-retaining (CR) total knee arthroplasty (TKA) assert that the retention of posterior cruciate ligament (PCL) preserves more normal knee kinematics, femoral rollback on the tibia during flexion, greater stabilization of the prosthesis, and improved position sense as compared to PCL resection TKA. However, one has to shift to the posterior stabilized (PS) femoral component with box and accompanying cam postpolyethylene, especially in cases where PCL is too attenuated to be functional or too tight predisposing to accelerated polyethylene wear. To minimize both the cam mechanism polyethylene wear and the bone sacrifice due to the intercondylar box cut, the ultra-congruent (UC) inserts have been developed that are characterized by a high anterior wall and a deep-dished plate, promising good stability without cam mechanism. Materials and Methods: We did a prospective study to clinically evaluate the short-term results of the patients who underwent TKA using cemented posterior CR implants and UC inserts. PCL was required to be released either partially or completely in all the study patients. Thirty patients were evaluated preoperatively and postoperatively after 12 months with the new Knee Society Knee Scoring System (2011) and the findings were statistically analyzed. Results: There was a statistically significant postoperative improvement in flexion (from mean of 87.69° to 111.53°, P = 0.000), objective knee indicators (33.53 ± 8.51–70.84 ± 4.91, P = 0.000), patient satisfaction scores (7.48 ± 2.12–21.53 ± 4.26, P = 0.000), and the functional activities score (32.53 ± 5.12–69.02 ± 6.36, P = 0.000). We did not note any disadvantage of CR TKA with UC insert and no patient underwent an early revision for instability. Conclusion: Using UC insert in CR TKA is a reliable procedure that has decreased the dependence on the PS designs.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"5 1","pages":"145 - 150"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70813062","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":"Tips and tricks of suprapatellar nailing of tibial fractures and its indications","authors":"W. Ahmed, Ashutosh Kumar, Rishabh Kumar, A. Shankar, Rakesh Kumar","doi":"10.4103/jodp.jodp_19_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_19_22","url":null,"abstract":"","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"5 1","pages":"195 - 196"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43459889","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":"Functional outcome of distal end radius fractures managed with variable-angle locking plates: A prospective study","authors":"Manikandan Kumarasamy, K. Kumar, A. Akashdeep, K. Uma Anand","doi":"10.4103/jodp.jodp_7_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_7_22","url":null,"abstract":"Introduction: Management of distal end radius intraarticular fractures is difficult to manage and these fractures account for 10% of all fractures. Multiple treatment options ranging from conservative to internal fixation, of which volar plate fixation has emerged as an effective method of internal fixation in comparison with other fixed-angle locking plates as they ensure proper restoration of the articular surfaces and anatomical alignment. Materials and Methods: A hospital-based prospective study was conducted on 14 patients with distal end radius fractures admitted in our hospital from January 2019 to December 2019. Patients with distal end radius fractures treated with variable-angle locking plate were included and were followed-up minimum of 6 months. The results were analyzed based on radiological parameters and Mayo Wrist Score (MWS). Results: Of 14 patients, 11 were male patients and three were female patients. Seven patients had right-sided fracture whereas remaining seven patients had left-sided fractures. All 14 patients were treated with variable-angle locking plate. Among 14 patients, 12 patients achieved union by 12 weeks, only two patients achieved union by 24 weeks. Ten patients had excellent results while four patients had a good outcome based on MWS. All patients in our study had painless union without any complications. Conclusion: The use of variable-angle locking plates in distal end radius fractures helps to maintain perfect anatomical reduction, early mobilization, and better postoperative outcome.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"5 1","pages":"132 - 137"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44538841","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":"Traumatic sternoclavicular joint dislocation - A case series and discussion of methods of management","authors":"C. Karan, VN Ravish, T. Channappa, G S Raju, M. Jayaram","doi":"10.4103/jodp.jodp_35_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_35_22","url":null,"abstract":"Traumatic sternoclavicular (SC) joint injuries account for <3% of all traumatic joint injuries. Instability of the SC joint (SCJ) is a difficult problem to treat and can present with gross limitations in activities. Prompt diagnosis and intervention are imperative in the management of these fracture dislocations. We present three cases of posttraumatic SCJ dislocation treated conservatively and two cases treated with open reduction and internal fixation with reconstruction plate and its functional outcome and discuss the various modes of management of these dislocations.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"5 1","pages":"190 - 194"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49030332","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 effect of preoperative rehabilitation on the outcome of anterior cruciate ligament reconstruction","authors":"S. Srinivasalu, Anoop Pilar, S. Manohar, Jobins Joseph, M. Mohan, R. Amaravathi","doi":"10.4103/jodp.jodp_25_22","DOIUrl":"https://doi.org/10.4103/jodp.jodp_25_22","url":null,"abstract":"Background and Objectives: Internal knee injuries account for nearly 45% of sports-related injuries, with anterior cruciate ligament (ACL) injury being the most prevalent. ACL injury is associated with pain, instability of the joint, muscle weakness, functional limitation, poor quality of life, and an increased risk of knee-related osteoarthritis. Preoperative exercise rehabilitation physiotherapy program is often performed to prepare the knee for reconstruction surgery and to maximize the outcomes of rehabilitation. The objective of our study was to evaluate the effects of preoperative rehabilitation on the outcome of ACL reconstruction (ACLR) using the International Knee Documentation Committee (IKDC) score, Tegner Lysholm score, Knee Injury and Osteoarthritis Outcome Score (KOOS), patients' symptoms, including tenderness, effusion, and range of motion limitations. Materials and Methods: Thirty patients with ACL injury were included in this study after obtaining informed consent and followed up till 12 months. A detailed history and evaluation were done. All patients who met the inclusion criteria were randomly allocated into two groups, one receiving a course of preoperative rehabilitation of 12 weeks, and one who were taken up for surgery without preoperative rehabilitation. Pre- and postsurgery, each of these groups was assessed at 3-, 6-, and 12-month intervals using the IKDC, KOOS, and Tegner Lysholm scores. Results: On analysis, it was found that the mean IKDC, KOOS, and Tegner Lysholm scores increased significantly for all patients from preoperative to postoperative 12 months. There was a statistically significant difference between the prehab and non-prehab groups, in each of these scores, with the prehab group having better functional scores. Conclusion: It was found that in individuals with ACL tear, arthroscopic ACLR improved the functional outcome, and among these patients, it was found that individuals who received preoperative rehabilitation fared better in terms of functional score assessment.","PeriodicalId":34809,"journal":{"name":"Journal of Orthopaedic Diseases and Traumatology","volume":"5 1","pages":"167 - 172"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43751752","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}