Indian Journal of Orthopaedics Surgery最新文献

{"title":"Functional outcome of chronic osteomyelitis treated by sequestrectomy & saucerisation with antibiotic bead implantation","authors":"Vikash Kumar Jha, Tomin P Zacarias, Kaushik Bharali, Swapnaneel Dutta","doi":"10.18231/j.ijos.2024.017","DOIUrl":"https://doi.org/10.18231/j.ijos.2024.017","url":null,"abstract":"Chronic Osteomyelitis has been treated since inception of Orthopaedics, however a ideal treatment eliminating the disease doesn’t exist. Numerous treatment modalities & Surgical procedures have been tried with varied results, owing to the chronic nature of the infection, virulence of organism and complex pathogenesis. With time, the antibiotic delivery to target site has expanded to include effective oral agents and local therapy with antibiotics mixed in bone cement or use of biodegradable antibiotic impregnated materials. This study intends to obtain factors which influence the incidence of osteomyelitis in the population & also to know the common means of transmission of bony infection, further identification of the major areas of disease manifestations and means of eradication of the same by our procedure. We conducted a prospective randomized control study on patients diagnosed with chronic osteomyelitis in the age group of 4- 60 years. 30 patients were treated with sequestrectomy and saucerisation & dead space filling with biodegradable antibiotic impregnated calcium sulphate beads for local delivery of antibiotics. The calcium sulfate used in this study was The STIMULAN KIT. This bone void filler kit consists of surgical-grade calcium sulfate powder and a sodium chloride diluent with Vancomycin as the broad spectrum antibiotic.: Functional outcome was evaluated using Enneking Functional Evaluation System which is a 30 point system for both upper and lower limbs. X-rays were used to evaluate the dead space volume (in cc) and bone repair (in %). Each patients were followed up for minimum of six months. The mean score for functional outcome was found to be 29.93. In 18 patients osteomyelitis occurred by hematogenous spread (60%) by superficial skin infection, Mean age of 13 patients (43.3%) were in the age group of 4-10 years. 63.3% of affected individuals were male. Most common site of infection was found to be tibia (33.3%) & most of the culture report from infection site showed no growth(90%). Complications such as prolonged ooze was seen in 15.9% cases. On Statistical analysis of the functional outcome, p value was found to be significant < 0.001.Antibiotics containing beads (Stimulan Kit) is effective in the treatment of chronic osteomyelitis and in preventing the recurrence of infection. It is imperative to identify various factors responsible for the recurrence of infection. This may help clinicians predict the prognosis of the disease and minimise the risk of adverse outcomes.","PeriodicalId":407871,"journal":{"name":"Indian Journal of Orthopaedics Surgery","volume":"14 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141336359","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 functional outcome after ponseti method for congenital idiopathic clubfoot","authors":"Sureshbabu Manivannan, Shenbaghavalli Thanikai, Lakshmikanth Manickam E","doi":"10.18231/j.ijos.2024.019","DOIUrl":"https://doi.org/10.18231/j.ijos.2024.019","url":null,"abstract":"Congenital Talipes Equino Varus is a developmental deformation needing appropriate intervention for its correction, and the Ponseti technique is a conservative method used for its correction. This study aims to study the outcome of Ponseti correction using the Ponseti scoring system.Children entirely treated by the Ponseti method for idiopathic Clubfoot in a tertiary care hospital were studied from October 2016 to October 2018. Fifty-three children were recruited for the study. Ethical principles adhered to. Structured study proforma was administered after obtaining informed consent from the parent/guardian. Ponseti's scoring system was applied to study various outcomes. IBM SPSS version 22 was used for statistical analysis. Of 53 participants, 39 were male, and 14 were females. The mean total score in the study population was 82.36, with 30-98. Based on age at evaluation, the proportion of people with excellent outcomes was higher in the long-term group (30.76%), followed by the mid-term group (26.66%), and least in the short-term group (24%). Among the study participants, 24 (45.30%) had a Good (80-89) total score, 14 (26.4%) had an Excellent (90-100) total score, 9 (17%) had a Fair total score, and remaining 6 (11.3%) were had poor (<70) total score.Conservative methods like the Ponseti technique can be utilized in our country as a treatment option for Clubfoot, with follow-up assessments using the Ponseti scoring system.","PeriodicalId":407871,"journal":{"name":"Indian Journal of Orthopaedics Surgery","volume":"5 33","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141337093","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":"A systematic review on the impact of interventions on gene expression profiles of rheumatoid arthritis patients","authors":"Muhammad Shaham N, P. Das, Ijasul Haque M, Manish Khanna","doi":"10.18231/j.ijos.2024.015","DOIUrl":"https://doi.org/10.18231/j.ijos.2024.015","url":null,"abstract":"Rheumatoid arthritis (RA) is an autoimmune inflammatory disease with a poorly known aetiology. Although the primary characteristic of RA is inflammation, other biological systems are implicated in various phases of the disease. Interventions and their impact on gene expression in active RA patients is currently playing a significant role in the development of specific treat to target techniques. The present study aims toevaluate the effect of various reported interventions on gene expression in rheumatoid arthritis patients. Publicly available English databases, PubMed and Google Scholar, were queried from 2020 to 2023. We mined a total of 1970 research documents, of which 8 articles were selected based on the inclusion and exclusion criteria. The review analyzed therapeutics, including anti-TNF alpha-blockers, GM-CSF blockers, Chemokine receptor blockers and herbal Ginger in RA treatment and prediction of responders and non-responders based on gene expression analysis. However, due to the mixed-use of samples, experimental methodologies, analysis tools and genes studied in the studies, our comparison is inconclusive in determining effective therapy. The study highlights the necessity of harmonization in order for gene expression profiles to be effectively used as a clinical tool in RA patients' personalized medication.","PeriodicalId":407871,"journal":{"name":"Indian Journal of Orthopaedics Surgery","volume":"4 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141336482","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":"A prospective study of functional outcome and deformity correction after Total Knee arthroplasty in valgus deformity of knee","authors":"D. A. Mehta, Taher Muzaffar Hussain, Batul Dawoodi","doi":"10.18231/j.ijos.2024.026","DOIUrl":"https://doi.org/10.18231/j.ijos.2024.026","url":null,"abstract":": Total knee arthroplasty (TKA) has been particularly challenging in patients who present with valgus knee deformity, which constitutes about 10% of cases. The current study seeks to review the functional and radiological outcomes of patients treated with TKA.: A total of 40 knees in 30 patients with valgus deformity were the subjects of the current study. Most of them (38 knees) had a medial parapatellar approach, while two underwent an anterolateral approach. We assessed the outcome with the Knee Society score (KSS), the Visual Analogue Scale (VAS) for pain, and the radiological alignment through the Hip Knee Ankle Axis (HKA). The measurements are done in 6-week, 3-month, 6-month, and months of an immediate post-operative.: There is a very clear improvement in all these measures. The KSS knee scores improved from 54 preoperatively to 92 in one year (p < 0.01), and the KSS functional scores also improved significantly from 52 to 87 (p < 0.01). The pain intensity scores clearly decreased from the preoperative average of 5.30 to 0 postoperatively (p < 0.001). Radiologically, there was improved alignment, with HKA angles decreasing from 9.12 preoperatively to 6.25 postoperatively.: TKA significantly improved the functional outcome and reduced pain among patients presenting with a valgus knee deformity. This resulted from a clear improvement seen in the KSS, VAS, and HKA measures. The study continues to show the effectiveness of TKA in improving clinical outcomes among these difficult groups of patients.","PeriodicalId":407871,"journal":{"name":"Indian Journal of Orthopaedics Surgery","volume":"3 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141336448","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":"Comparative study of functional outcome in single plating and dual plating of unstable distal femur fractures","authors":"Anish Vernekar, Waulden DeMelo, Ajmal Abdulla, Nehal Salgaokar, G. Vargaonkar","doi":"10.18231/j.ijos.2024.016","DOIUrl":"https://doi.org/10.18231/j.ijos.2024.016","url":null,"abstract":"Fractures of the distal femur remain challenging to treat as satisfactory outcome demands anatomical articular reduction, rigid and stable internal fixation along with early range of motion. The purpose of our study is to evaluate the functional outcome in patients with unstable fractures of the distal femur treated with single versus dual plating.: The study was a prospective study of 40 patients. The study was a prospective study of 40 patients (30 male and 10 female) with unstable fractures of the distal femur admitted to Goa medical college between June 2019 to June 2021 treated with open reduction and internal fixation of the distal femur with locked plates. After admission patients were subjected to routine pre operative evaluation and x-rays along with CT scan with 3 D reconstruction. During surgery, after lateral plating patients were subjected to varus stress test on table. If found to be positive, medial plate was applied. Medial plating was also advocated if medial cortex was found to be deficient due to severe communition or bone loss. Patients were followed up for an average of 10 months and knee function was evaluated evaluated using Sanders Functional Evaluation Knee Score. Out of the 40 patients treated with plating, 24 were treated with single lateral plate and 16 were treated with medial as well as lateral plate. Out of the 16 treated with dual plating, 2 were open fractures treated by staged procedure (lateral plating and subsequent medial plating with iliac crest bone graft via a separate medial incision after a period of 10 weeks following primary surgery). 3 of the patients treated with single lateral plate showed a varus collapse upon weight bearing 12 weeks post op. It was found that dual plating resulted in high union rates, early post op mobilisation due to more rigid fixation and less chances of varus collapse. However, overall when functional.","PeriodicalId":407871,"journal":{"name":"Indian Journal of Orthopaedics Surgery","volume":"11 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141336707","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":"Does 4 column classification of upper tibia fracture gives you better idea of fixation and impact on clinical outcome-analysis of 50 cases?","authors":"Abhishek Trymbak Shinde, G. Gadekar, Tanmay Rajkumar Fulwadwa, Avinash Meharsingh Harchand","doi":"10.18231/j.ijos.2024.029","DOIUrl":"https://doi.org/10.18231/j.ijos.2024.029","url":null,"abstract":"The management of proximal tibia fracture has underdone significant changes in the recent years, while the main goals remain same i.e. to achieve a smooth articular surface, mechanical axis and joint stability. Recent advances in computed tomography and MRI based imaging have led to better understanding and classification of fracture and therefore better planning for treatment.This is a prospective analysis of the proximal tibia fracture managed as per 4 column 10 segment concept in view of functional outcomes. Radiological and functional outcomes using knee society score of the proximal tibia fractures operated and classified as per computed tomography based 4 column 10 segment concept were studied at 6 weeks, 3 months, 6 months and 9 months from year 2019 to 2022.Mean age of population sustaining proximal tibia fracture among males was 43.90 years and females was 48.71y with 86% predilection for male and 14% for female. Involvement of right tibia was 50 % in comparison to left tibia which was 46%, while 4% patients had involvement of both limbs. Distribution of proximal tibia fracture ; zero column -7.69%, one column- 55.77%, two column-21.15%, three column-15.38% average knee society score for proximal tibia fracture at the end of 9 months (knee score, function score) 87.65;79.54.Single incident of superficial infection was encountered managed with debridement and parenteral antibiotics. Single incident of surgical site infection managed with implant removal, debridement and parenteral antibiotics as per culture sensitivity. Single incident of common peroneal nerve palsy was encountered repaired with extended Lobenhoffer approach.Recent computed tomography based classification are very useful for fixation and deciding most suited surgical approach for proximal tibia fractures to achieve a smooth articular surface, mechanical axis and joint stability. Still, a long-term study with large study group is needed to confirm the usefulness of the same.","PeriodicalId":407871,"journal":{"name":"Indian Journal of Orthopaedics Surgery","volume":"84 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141338227","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":"Does the suprapatellar nailing technique address the issue of malunion in segmental tibial fractures?","authors":"Sunil Dhondiram Magadum, Ramprasad Jasti, Prithvi Mohandas, Akilesh Kumar Nandipalli, Mahesh Karthik Ragavan","doi":"10.18231/j.ijos.2024.027","DOIUrl":"https://doi.org/10.18231/j.ijos.2024.027","url":null,"abstract":": Segmental tibia fractures are caused by high-velocity trauma. They are often associated with soft tissue and other systemic injuries leading to higher complications rates. In this study, we aimed to analyse the clinical, functional and radiological outcome including the incidence of malunion in these fracture following suprapatellar nailing. We retrospectively analysed 55 patients from January 2016 to January 2020 who underwent suprapatellar nailing using two different nailing systems at a single tertiary care trauma centre. Periodic follow-ups were done to evaluate the union rates, the functionality of the limb and associated complications like malunion. Average time of union overall was 26 weeks with closed fractures healing at an average of 22 weeks and open fractures healing at an average of 33 weeks. The average functional score using LEFS at the end of one year was 86% with 89% of the patients having good to excellent functional outcome. We had 22 cases of the delayed union out of which only 5 cases required secondary procedures to aid in the union. Malalignment was noted in 1 case. All fractures included in this study eventually healed at the final follow up. Anterior knee pain was reported in 3.6% of the cases.: We recommend suprapatellar nailing in all segmental tibial fractures irrespective of the type of injury as it reduced the rate of malunion and anterior knee pain, without compromising on union rates and functional outcome.","PeriodicalId":407871,"journal":{"name":"Indian Journal of Orthopaedics Surgery","volume":"3 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141336197","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":"Localised tenosynovial giant cell tumour of the infrapatellar fat pad mimicking an intra-articular loose body – A case report","authors":"Jung Syn Chong, Zhuang Li Lim, Lye Hock Tan, Sazali Salleh","doi":"10.18231/j.ijos.2023.037","DOIUrl":"https://doi.org/10.18231/j.ijos.2023.037","url":null,"abstract":"Tenosynovial giant cell tumour is a benign lesion which presence in the infrapatellar fat pad is uncommon. Herein, we report a unique case of a young female patient who presented with a loose body sensation at the knee. Surgery revealed a localized swelling in the infrapatellar fat pad which was treated with an open excisional biopsy of the mass. Diagnosis of giant cell tumour is confirmed by histopathological examination.","PeriodicalId":407871,"journal":{"name":"Indian Journal of Orthopaedics Surgery","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121085479","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":"Comparison of sub trochanteric femur fracture treatment with intra medullary proximal femur nail versus proximal femur nail with trochanteric support plate","authors":"R. N. Sonkar, Ajay Singh Thakur, Satwik Thareja, Sachin Patel","doi":"10.18231/j.ijos.2023.027","DOIUrl":"https://doi.org/10.18231/j.ijos.2023.027","url":null,"abstract":": Comparison of sub trochanteric femur fracture treatment with intramedullary proximal femur nail vs intramedullary proximal femur nail augmented with trochanteric support plate.: Two groups were divided from 50 patients to 25 in each and first were treated with PFN and the other with a combination of PFN plus trochanteric support plate.: At the end of 6 months all except 2 patient from group 1 mobilized unassisted while all the patient from group 2 got mobilized unassisted. Based on harries hip score.: Intramedullary fixation with intra medullary proximal femur nail plus trochanteric support plate.is feasible for the treatment of subtrochanteric femur fracture. Intraoperative reduction and surgical skill are important for the clinical outcome and the patients.","PeriodicalId":407871,"journal":{"name":"Indian Journal of Orthopaedics Surgery","volume":"194 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123538271","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":"Combined intravenous and intraarticular tranexamic acid compared with intraarticular use alone in total knee arthroplasty: A randomized controlled trial","authors":"R. Minaei, Seyed Morteza Kazemi, Seyyed Mehdi Hoseini, A. Mirahmadi, Pooya Hosseini-Monfared, Maryam Salimi","doi":"10.18231/j.ijos.2023.032","DOIUrl":"https://doi.org/10.18231/j.ijos.2023.032","url":null,"abstract":": Total knee arthroplasty is associated with high rates of blood loss during and after the surgery. Tranexamic acid is an antifibrinolytic agent that effectively reduces total blood loss in total knee arthroplasty and minimizes the need for blood transfusion and transfusion-related complications. However, the most efficacious route of tranexamic acid administration has not been established. Therefore, in this study, we aimed to compare combined intravenous and intraarticular tranexamic acid with intraarticular use alone in patients undergoing total knee arthroplasty.In this randomized, double-blind clinical trial, 104 patients scheduled for primary unilateral Total knee arthroplasty were randomized to one of the two intervention groups. The combined intravenous and intraarticular group received 15 mg/kg (Max dose of 1 g) of intravenous tranexamic acid along with 15 mg/kg (Max dose of 1 g) of tranexamic acid administered intraarticularly after the capsule and retinaculum closure. Total blood loss was calculated using the drop in hemoglobin at post-operative day 3. The transfusion rate and incidence of thromboembolic events were evaluated.Total blood loss in patients receiving combined intravenous and intraarticular tranexamic acid was not significantly different from that in patients receiving only intraarticular tranexamic acid (926 ± 312 ml vs 905 ± 348 ml, p value= 0.824). There were no complications like thromboembolic events or wound infection. In conclusion, the intraarticular administration of tranexamic acid is an equally effective route as combined intravenous and intraarticular use of tranexamic acid in total knee arthroplasty, and hence to avoid potential complications of systemic TXA use, we recommend using the intraarticular only tranexamic acid in total knee arthroplasty.","PeriodicalId":407871,"journal":{"name":"Indian Journal of Orthopaedics Surgery","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126656925","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}