Malaysian Orthopaedic Journal最新文献

{"title":"Clinical Outcome of Arthroscopic Bankart Repair and Remplissage in Recurrent Anterior Shoulder Dislocation in Manual Workers.","authors":"D K Sharma, P Shetty, N Kumar, A Kankane, K Anant, R Jamwal","doi":"10.5704/MOJ.2507.013","DOIUrl":"10.5704/MOJ.2507.013","url":null,"abstract":"<p><strong>Introduction: </strong>Recurrent anterior shoulder dislocation is particularly more common among occupations involving the frequent use of the upper limb above shoulder height such as manual labour. The present study aims to investigate outcomes of arthroscopic Bankart repair and Remplissage in manual workers as few studies have been undertaken in this specific subgroup. The arthroscopic Bankart repair and Remplissage in treatment of recurrent anterior shoulder dislocation in manual workers has reduced recurrence rates and improved patient satisfaction.</p><p><strong>Materials and methods: </strong>A total of 36 patients underwent arthroscopic Bankart with Remplissage for recurrent anterior shoulder dislocation, enrolled between February 2022 to December 2023 considering various inclusion and exclusion criteria. Patients were evaluated in post op period for range of motion, oxford shoulder instability score and visual analogue score for pain at intervals of 6 and 12 months.</p><p><strong>Results: </strong>All patients enrolled had soft tissue with bony Bankart lesion with mean of glenoid bone loss (%) was 11.75% (±3.15%) and all participants had engaging Hill-Sachs lesion. The mean pre-operative OSIS was 19.56 (±2.17) and mean VAS was 5.53 (±0.56). In the post op evaluation, there was no clinically significant decrease in range of motion with mean loss of external rotation of 3.86 (±1.44) at 12 months. The mean OSIS increased to 41.0 and mean VAS decreased to 2.36 at 12 months follow-up which was statistically significant. There was no incidence of dislocation in post op period of 12 months.</p><p><strong>Conclusion: </strong>Arthroscopic Bankart repair and Remplissage in recurrent anterior shoulder dislocation in manual workers demonstrates significant improvements in functional outcomes, minimal post-operative range of motion restrictions, and stable shoulders at the 12-month follow-up, highlighting the efficacy and safety of the procedure.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":"19 2","pages":"99-107"},"PeriodicalIF":0.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12368457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-stage Acetabular Impaction Bone Grafting: A Case Report.","authors":"V Selvaratnam, V J Leong, S Gunainthran, S Chopra, A F Kassim","doi":"10.5704/MOJ.2507.015","DOIUrl":"10.5704/MOJ.2507.015","url":null,"abstract":"<p><p>Restoring bone loss in revision Total Hip Arthroplasty (THA) surgery is challenging. Acetabular impaction bone grafting (AIBG) allows the restoration of bone stock and normal hip biomechanics. AIBG is usually performed as a single-stage surgery with hip component implantation, as it is traditionally believed that adequate loading of the impacted graft is necessary for integration with the host bone thus preventing bone resorption. We present a case of a 73-year-old gentleman who presented with bilateral hip pain and reduced mobility. He was diagnosed with left THA aseptic loosening with acetabular protrusion and subsequently underwent a two-stage AIBG using irradiated femoral head allografts. The first stage was performed without acetabular loading, yet the allograft successfully integrated with the host bone. This is the first reported case of a two-stage AIBG demonstrating that acetabular loading may not be required for allograft integration to host bone. Therefore, AIBG may be performed as a two-stage procedure, when necessary, especially in the setting of complex revision hip surgeries and patients with poor bone stock.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":"19 2","pages":"117-120"},"PeriodicalIF":0.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12368456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment to: The Outcomes of Delayed Revascularization in Lower Extremity Vascular Injury: A Retrospective Cohort Study.","authors":"E Boga","doi":"10.5704/MOJ.2507.020","DOIUrl":"10.5704/MOJ.2507.020","url":null,"abstract":"","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":"19 2","pages":"140-141"},"PeriodicalIF":0.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12368444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strategic Integration of Surgical Techniques for Knee Preservation: A Case Report.","authors":"A Jaramillo-Quiceno, P A Sarmiento-Riveros, R D Arias-Perez, O A Mejia-Bustamante, R D Guzman-Benedek","doi":"10.5704/MOJ.2507.016","DOIUrl":"10.5704/MOJ.2507.016","url":null,"abstract":"<p><p>Different surgical techniques are used to preserve knee articular cartilage deterioration; however, combining these techniques can be challenging. This case study describes a 35-year-old man with bilateral genu varum malalignment and left knee pain, diagnosed with a grade IV chondral lesion in the lateral femur, a complex lateral meniscus lesion, and a radial tear in the medial meniscus. The patient underwent a valgus-producing tibial osteotomy, lateral osteochondral allograft transplantation, and lateral meniscal allograft transplantation using a 3D model of the proximal tibia. Seventeen months post-operatively, he experienced torsional trauma, leading to a tear of the transplanted meniscus posterior root and an anterior cruciate ligament injury. Subsequent surgical exploration revealed evidence of chondroprotective changes, including femoral osteochondral allograft healing and biomechanical integration of the transplanted meniscus, as indicated by the lateral meniscus root tear development. This case highlights the potential of combining these surgical procedures to achieve biomechanical integration of the transplanted meniscus, contributing to cumulative chondroprotective effects.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":"19 2","pages":"121-126"},"PeriodicalIF":0.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12368449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Functional and Radiological Outcomes of Fixed Angle versus Variable Angle Volar Locking Compression Plates in Managing Intra-articular Fractures of Distal End Radius.","authors":"D K Garg, H Sakale, A C Agrawal, B Kar, E Pandiyarajan, S K Yadav","doi":"10.5704/MOJ.2507.002","DOIUrl":"10.5704/MOJ.2507.002","url":null,"abstract":"<p><strong>Introduction: </strong>Distal end radius fractures are common upper extremity fractures often requiring surgical intervention for instability. This study compares the functional and radiological outcomes of fixed angle versus variable angle volar locking compression plates in managing these fractures.</p><p><strong>Materials and methods: </strong>A prospective randomized study was conducted at AIIMS, Raipur, from July 2020 to December 2022. Patients aged 18-60 years with complete intra-articular distal end radius fractures (AO Type 23C1, 23C2, 23C3) were included. Sixty-four patients were randomized into two groups: one receiving fixed angle plates (Group 1) and the other variable angle plates (Group 2). Functional outcomes were assessed using the Mayo wrist score, and radiological outcomes were evaluated with the Sarmiento modification of Lindstrom's criteria. Statistical analysis was performed using IBM SPSS 22.0, with p-values <0.05 considered significant.</p><p><strong>Results: </strong>At 3 months, the variable angle group had significantly higher Mayo wrist scores (63.12 ± 11.81) compared to the fixed angle group (48.75 ± 11.90, p=0.005). This trend continued at 6 months (75.93 ± 9.16 vs. 64.37 ± 14.59, p=0.025) and 1 year (91.87 ± 7.27 vs. 81.25 ± 16.17, p=0.044). Radiologically, the variable angle group demonstrated better volar tilt restoration at all follow-up points (p<0.001 at 3 months, p=0.001 at 6 months, p=0.004 at 1 year). Complication rates were similar between groups.</p><p><strong>Conclusion: </strong>Variable angle volar locking compression plates offer superior functional outcomes and better volar tilt restoration compared to fixed angle plates for unstable distal end radius fractures. Both types exhibited similar complication rates.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":"19 2","pages":"9-17"},"PeriodicalIF":0.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12368446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Multiple Dosing Effects of Platelet-Rich Plasma on Cartilage Regeneration in Knee Osteoarthritis: Randomised, Placebo-Controlled Trial.","authors":"A Saraf, A Hussain, V Mahipal, T Agarwal, A Kush","doi":"10.5704/MOJ.2503.003","DOIUrl":"https://doi.org/10.5704/MOJ.2503.003","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of this study was to evaluate clinical and biochemical efficacy of autologous intraarticular (IA) platelet rich plasma (PRP) compared to saline and to measure effectiveness of single and multiple doses given at monthly intervals for Kellgren-Lawrence (K-L) grade II, III knee osteoarthritis (KOA).</p><p><strong>Material and methods: </strong>A total of 130 patients were randomised into 4 groups; PRP-1 (n=36), PRP-2 (n=34), PRP-3 (n=32) and saline (NS) (n=28), after approval from institute ethics committee (reference number: TMU/IEC/20-21/091) and was conducted in accordance with Helsinki declaration. Groups PRP-1, PRP-2, PRP-3 received single, double and triple injections of PRP whereas NS group received single saline (0.9%) injection. Assessment of outcome scores (visual analogue scale [VAS] and Western Ontario and McMaster Universities Arthritis Index [WOMAC]) was done at baseline and three, six, nine months post intervention. Serum collagen 2-1 (Coll2-1) estimation at baseline and nine months post-therapy was used for biochemical assessment.</p><p><strong>Results: </strong>Improvement in VAS and WOMAC was statistically significant and clinically meaningful (Minimal clinically important change [MCIC]; >12% of baseline and ≥2cm difference in mean for WOMAC and VAS, respectively) for groups PRP-1, PRP-2 and PRP-3 in comparison to saline (P<0.05), at every follow-up. PRP groups also exhibited a significant decrease in serum Coll2-1 at 9 months (P<0.05). On comparison among the PRP groups, multiple doses (groups PRP-2 and PRP-3) produced significantly better clinical results than single dose (group PRP-1) (P<0.05), whereas the difference in Coll2-1 levels was significant for group PRP-1 vs PRP-3 only (P<0.05).</p><p><strong>Conclusion: </strong>PRP results in clinically significant amelioration of functional and pain scores as well as significant reduction in serum levels of Coll2-1 in K-L grade II, III KOA over nine months. These benefits can be accentuated by multiple doses given one month apart.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":"19 1","pages":"11-20"},"PeriodicalIF":0.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-operative Traction in Severe Rigid Kyphoscoliosis - CT-based Navigation Pelvic Pin Insertion in Halo-Pelvic Traction: A Case Report.","authors":"K S Tan, P Devarani, C Saturveithan, Cyw Chan, A Saw","doi":"10.5704/MOJ.2503.014","DOIUrl":"https://doi.org/10.5704/MOJ.2503.014","url":null,"abstract":"<p><p>Neglected severe rigid kyphoscoliosis can lead to rapid curve progression, presenting a challenge for surgical correction and carrying higher risks of mortality, morbidity, and neurological injury, potentially resulting in permanent paralysis. Halo-pelvic traction (HPT) has been reported to be effective in improving curve flexibility, assisting the surgical correction process, and reducing the likelihood of neurological complications. We report the case of a 15-year-old girl with mosaic Turner syndrome and severe kyphoscoliosis, who experienced progressive curve progression (from 41° to 158°) over a span of 6 years. Preoperative halo gravity traction (HGT) was unsuccessful. To address this deformity, HPT was performed with CT-based navigation for pelvic pin insertion, considering her relatively small pelvis and pelvic obliquity. This technique allowed for precise pin placement, reducing the risk of injury to major arteries, nerves, and abdominal/pelvic organs, while enabling the creation of a more versatile halo-pelvic frame designed to enhance patient comfort and mobility. The patient underwent weekly distraction using HPT for 4 weeks, during which her coronal Cobb angle reduced from 158° to 103° and her kyphotic angle decreased from 90° to 64°. With this notable improvement in the primary spinal curvature, we proceeded with posterior spinal fusion. Notably, this approach obviated the need for vertebral column resection. As a result, we achieved a correction rate of 53.8% in the coronal Cobb angle and 55.6% in the kyphotic angle without neurological injury.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":"19 1","pages":"113-118"},"PeriodicalIF":0.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addition of Modified Lemaire Lateral Extra-Articular Tenodesis in a Single stage Revision Anterior Cruciate Ligament Reconstruction using Peroneus Longus Tendon: A Prospective Study.","authors":"S S Sonarkar, A Stanley, S Kumar-Singh, R Garg, A Narula, M Raj","doi":"10.5704/MOJ.2503.004","DOIUrl":"https://doi.org/10.5704/MOJ.2503.004","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of this study is to assess the outcomes of patients that underwent single-stage revision ACL reconstruction (ACLR) with peroneus longus tendon (PLT), augmented with lateral extra-articular tenodesis (LET) using the modified Lemaire technique.</p><p><strong>Material and methods: </strong>All the 18 patients underwent arthroscopic single-stage revision ACLR using autologous PLT with an additional modified Limier LET procedure. Patients were thoroughly assessed pre- and post-operatively by the Lachman test, the pivot shift test, and the side-to-side difference by the Rolimeter. Functional evaluation was done with the help of the Lysholm score, the IKDC subjective score, Tegner score, VAS score, MARX activity rating scale and The American Orthopaedic Foot and Ankle Society (AOFAS) score. Post-operatively, patient satisfaction, return to sport, and physical activity were also recorded. SPSS ver. 22.0 software was used. Wilcoxon test, paired and unpaired t-tests were used to compare variables. Statistical significance was determined by a two-sided p-value <0.05.</p><p><strong>Results: </strong>Regarding subjective evaluations; post-operative residual laxity, and return to sport and physical activity, all of the patients demonstrated excellent results. Post-operatively, there was significant improvement in the anterior knee laxity. According to the Marx Activity Rating Scale, the extent of sports engagement was significantly increased at 18 months following surgery (p<0.001). According to the AOFAS score (p=0.38), there were no documented significant donor site morbidities.</p><p><strong>Conclusion: </strong>Single-stage revision ACLR using PLT with an additional modified Lemaire LET procedure results in a significant reduction in residual knee laxity with good clinical outcomes and a high return to play and physical activity.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":"19 1","pages":"21-30"},"PeriodicalIF":0.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combinational Periprosthetic Hip Joint Infection and Fracture: A Two-Stage Revision with Long Femoral Stem Spacers.","authors":"T V Duong, T B Duong, D T Tu, Nqt Quyen, H Tan, Tnk Hung","doi":"10.5704/MOJ.2503.005","DOIUrl":"https://doi.org/10.5704/MOJ.2503.005","url":null,"abstract":"<p><strong>Introduction: </strong>Periprosthetic joint infection combined with periprosthetic fracture rarely occurs simultaneously. Once all components of the periprosthetic joint infection were removed, antibiotic spacers were placed. Moreover, periprosthetic fractures require fixing. We use a long femoral stem spacer molded intra-operatively via a self-design metal mold as a novel treatment method for the periprosthetic fracture combined with infection.</p><p><strong>Material and methods: </strong>The study reviewed 12 patients who underwent two-stage revision arthroplasty with long femoral stem spacers over 6 years. During a minimum of two years of follow-up, the outcomes were evaluated, including reinfection rates, reimplantation rates, and re-operation rates, as well as the success rate based on the MSIS criteria.</p><p><strong>Results: </strong>Twelve patients underwent two-stage revision with a long femoral stem spacer between stages. A mean follow-up period of 9.58 months followed infection (range 2 to 28 months). In 11 patients (91.67%), the infection was eradicated. There was one patient (8.33%) who required a second 2-stage revision and subsequently cleared their infection. The long femoral stem spacer was repeated in three patients (25%). After eradicating the infection, 9 patients (75%) underwent 2nd stage revision, on average 8.56 months after the first stage. At an average of 27.92 months (range 8 - 65 months) post-operatively, three (25%) long femoral stem spacers remained in place.</p><p><strong>Conclusion: </strong>Using long femoral stem spacers, both periprosthetic joint infections and periprosthetic fractures can be treated simultaneously. In the cases with multiple organisms, we mixed one pack of bone cement with 2g of Vancomycin and 2g of Meropenem, resulting in satisfactory results.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":"19 1","pages":"31-38"},"PeriodicalIF":0.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative Patient Blood Management in Orthopaedics and Traumatology.","authors":"S Ibrahim","doi":"10.5704/MOJ.2503.001","DOIUrl":"10.5704/MOJ.2503.001","url":null,"abstract":"","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":"19 1","pages":"1-2"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}