Indian Journal of Orthopaedics

BACKGROUND: Motocross is a high-risk form of motorbiking where serious injuries occur regularly, although little data have been collected to illustrate this relationship. Over 5 years, teams from RJAH Oswestry and RSH sought to demonstrate the impact of Motocross on orthopaedic presentation and workload. METHOD: Data were collected prospectively over 5 years including 615 orthopaedic injuries associated with both recreational and competitive motocross. RESULTS: An increase in injury and operation frequency was observed, young males were identified as the highest risk participant...

INTRODUCTION/BACKGROUND: Multiple medical and surgical treatments have been described in the early stages of Avascular Necrosis (AVN) of the femoral head which delay the disease progression. Similarly, multiple studies, trials, reviews, and systematic reviews exist for the various treatments described and their outcomes but with no consensus over which is superior. So in this study, we reviewed the systematic reviews of all the conservative therapies for AVN of the femoral head systematically to identify a single or a combination of non-surgical treatment choices in the initial stages of the disease...

There are various techniques used for tendon lengthening, of which Z-lengthening and sliding-lengthening are the most frequently performed. In patients with cerebral palsy, tendon lengthening may often be necessary at multiple sites. However, they can cause various complications, such as inaccurate extension, overextension, and a lack of tendon continuity. We modified the sliding-lengthening technique with a locking mechanism to address these issues. This technical note aims to describe the surgical technique and pitfalls associated with the modified sliding-lengthening approach and suture locking mechanism...

BACKGROUND: Midline surgical incision used in Total Knee Arthroplasty (TKA) is associated with iatrogenic injury to the infrapatellar branch of the saphenous nerve, which leads to neuropathic dermatitis around the healed surgical scar. There are very few studies with a limited number of cases that have reported this complication. We evaluated the incidence of neuropathic dermatitis and its implication for the functional outcome in TKA patients. METHODOLOGY: Patients who underwent primary TKA between 1 January 2010 and 31 August 2019 and presented in follow-up with sensory disturbances and skin lesions adjacent to the surgical incision were evaluated in this study...

INTRODUCTION: Fixation of plateau posterolateral fracture (PLF) is challenging because the fracture site is mostly covered by vital neurovascular structures. We operated on 15 cases of PLF using a direct lateral approach. This study aims to report on clinical results. MATERIAL AND METHODS: Between 2017 and 2019, 15 cases of PLFs were fixed with a direct lateral approach and a tricortical autologous bone graft from the iliac crest. A depression of more than 2 mm was indicated for the surgical treatment...

AIMS: Multiple studies have shown excellent clinical results in primary rotator cuff repairs; however, not much evidence is available in the literature on the outcomes of arthroscopic revision rotator cuff repairs. The purpose of this study was to report a cohort of patients who underwent revision arthroscopic rotator cuff repair and identify factors that may influence its outcomes. METHODS: We examined a cohort of 62 patients which underwent revision arthroscopic rotator cuff repair in a single UK institution with a minimum of 24 months follow-up...

INTRODUCTION: Tuberculosis of the hip joint is a debilitating disease that can result in severe joint destruction, eventually leading to painful arthritis of the hip. Total hip arthroplasty (THA) in patients with advanced arthritis offers a painless and mobile joint with good functional outcome but some aspects of THA in TB hip have been controversial in the past due to the concerns of disease reactivation, especially when disease activity is factored in. Various factors like timing of surgery, Antitubercular therapy (ATT) initiation timing, reactivation, complications etc needs to be evaluated very carefully before planning for such cases...

BACKGROUND: Considering various factors that influence meniscal repairability, Ortho One PROMT score (OPS) was proposed in 2019. With an increased understanding of factors influencing meniscal repair and by analysis of OPS predictions and repair results, a modified PROMT score (MPS) has been formulated. The objective of this study is to assess the superiority of MPS over OPS. METHODS: Age, chronicity, and pattern of tears were found to be important contributors to false-negative results of OPS...

OBJECTIVE: To evaluate the clinical efficacy of Percutaneous curved vertebroplasty (PCVP) for osteoporotic vertebral compression fracture of the thoracolumbar spine. METHODS: Retrospective analysis of 113 patients with osteoporotic vertebral compressive fractures (OVCFs) in our hospital from January 2017 to January 2020, a total of 120 diseased vertebrae, were divided into PCVP group (35 cases, 37 sections) and bilateral PVP(BVP) group (78 cases, 83 sections). To compare the distribution of baseline clinical data, pain relief (Visual Analog Scale, VAS), ODI (Oswestry Dability Index, ODI), operation time, intraoperative fluoroscopy, postoperative vertebral body re-fracture, and comparison of bone, and to compare the volume of cement penetration and the leakage rate of bone cement, etc...

BACKGROUND: Neck pain (NP) is common in all age groups and adversely affects the patients' entire lifestyle. There exists inconclusive evidence relating faulty craniocervical posture with pain-related disability. This review aims to determine whether sagittal head and neck posture differs in NP and pain-free subjects, to critically appraise the correlation of posture with NP. METHODS: Of 3796 articles identified at primary search from CINAHL, PubMed, Google Scholar, EMBASE, 26 were included based on eligibility criteria...

BACKGROUND: The purpose of our study was to compare the knee implant SIGMA to the ATTUNE knee implant in a cruciate-retaining (CR) fixed-bearing (FB) total knee replacement (TKR) surgery, with no patellar resurfacing. METHODS: We examined 40 patients (19 SIGMA; 21 ATTUNE) who underwent a TKR FB CR surgery, without patellar resurfacing, due to osteoarthritis, between August 2013 and July 2017. All surgeries were performed by a single surgeon. We performed a cross-sectional analytical study based on preoperative patient data and data collected in follow-up sessions...

INTRODUCTION: Informed consent documentation is often the first area of interest for lawyers and insurers when a medico-legal malpractice suit is concerned. However, there is a lack of uniformity and standard procedure for obtaining informed consent for total hip arthroplasty (THA). We aimed to develop a solution for this need for a pre-designed, evidence-based informed consent form for THA cases. MATERIALS AND METHODS: We extensively reviewed the literature on the medico-legal aspects of THA, medico-legal aspects of informed consent, and medico-legal aspects of informed consent in THA...

STUDY DESIGN: A retrospective cohort study. PURPOSE: To compare the outcomes of anterior decompression with bone grafting alone and anterior decompression with bone grafting and fixation. METHODS: 93 patients with minimum 2 year follow-up were included in the study. 50 patients had undergone anterior decompression with bone grafting without instrumentation (group 1) and 43 patients with instrumentation (group 2). Both groups were compared using their demographic data, vertebral level of involvement, neurological recovery and progression of kyphotic deformity...

BACKGROUND: We hypothesized the risk of prosthetic instability would be similar in patients treated for femoral neck fracture (FNF) comparatively to patients treated for osteoarthritis (OA) using a dual-mobility cup-total hip arthroplasty (DMC-THA). METHODS: One hundred and nine patients (109 hips), with a mean age of 69.6 ± 3 years (65-75 years), underwent DMC-THA using a posterolateral approach for a FNF (study group). Patients were matched for age and sex with 109 OA patients treated by the same procedure (control)...

BACKGROUND: Displaced intraarticular calcaneus fracture indicates surgical treatment. The current trend is open reduction and internal fixation with a plate or multiple screws through the sinus tarsi approach. Most postoperative protocols are prolonged non-weight bearing that causes a high socioeconomic burden. This study aims to determine the safety of the early weight-bearing protocol of screws-only fixation in calcaneal fracture. MATERIALS AND METHODS: Evaluate displaced intraarticular calcaneus fractures treated with screws-only technique via the sinus tarsi approach in our institution...

BACKGROUND: Osteosarcoma of the scapula is extremely rare. Hence, there is no consensus regarding its optimal management. In this study, we report the demographics, characteristic features, and outcomes of scapulectomy with or without scapular allograft reconstruction in a series of patients with primary scapular osteosarcoma. MATERIALS AND METHODS: Twelve patients with primary scapular osteosarcoma who were treated by scapulectomy with or without scapular allograft reconstruction (five and seven patients, respectively) were included...

BACKGROUND: Debate exists as to whether anterior-posterior spinal fusion (APSF), rather than posterior-only spinal fusion (PSF), provides benefit for treating severe thoracic adolescent idiopathic scoliosis (AIS). This systematic review and meta-analysis compare (1) Cobb angle correction, (2) complication and reoperation rate, (3) pulmonary function, (4) number of fused segments, and 5) patient-reported outcome measures (PROMs) in both groups. METHODS: Electronic databases were searched to identify studies that met the following inclusion criteria: comparative studies (level 3 or above), severe thoracic curves (≥ 70°), age ≤ 16, AIS aetiology, Lenke 1-4 curves and follow-up ≥ 1 year for ≥ 95% of patient population...

PURPOSE: The purpose of this systematic review aimed to investigate the clinical outcome of medial patellofemoral ligament (MPFL) reconstruction, MPFL repair and medial reefing for patients with first-time patellar dislocation. METHODS: Databases of PubMed, EMBASE, Cochrane Library and Web of Science were searched up to May 8, 2022. Only articles treating first-time patellar dislocation with MPFL reconstruction, MPFL repair and medial reefing were included in the analysis...

INTRODUCTION: The purpose of this study is to assess the effect of radial head/ neck injury in association with proximal ulna fractures. METHODS: Between 2006 and 2020, 107 patients presented to our academic medical center for treatment of a proximal ulna fracture and were enrolled into an IRB-approved database. Radiographs, injury details, and surgical interventions were retrospectively reviewed. Patients were classified as having an isolated proximal ulna fracture (PU), a PU fracture with an associated radial head dislocation (M-D), or a Monteggia fracture with an associated radial head fracture (M-V)...

INTRODUCTION: Microsurgical training is an asset for deployed military orthopaedic surgeons who frequently treat hand or nerve injuries in the field. The objective of this study was to evaluate a microvascular surgery simulation model intended to prepare residents prior to their enrolment in conventional microsurgery degree training. METHODS: An experimental study was conducted to evaluate technical progress and satisfaction of military surgical residents using a model based on Japanese noodles with four tests of increasing difficulty...