Indian Journal of Orthopaedics

PURPOSE: Quadriceps tendon disruption post-total knee arthroplasty (TKA) is rare. Existing reconstruction procedures use allografts or synthetic meshes with varied success. This study evaluates outcomes with autogenous peroneal tendon grafts, a cost-effective alternative, compared to synthetic polypropylene mesh for quadriceps reconstruction. METHODS: 16 patients who underwent extensor mechanism reconstruction between 2017 and 2021were retrospectively analysed. Parameters evaluated included type of reconstruction, extensor lag, IKDC (International Knee Documentation Committee) Score and AOFAS-Hindfoot-score (American Orthopaedic Foot and Ankle Society)...

BACKGROUND: The advent of tissue engineering and regenerative medicine has introduced innovative approaches to treating degenerative and traumatic injuries, particularly in cartilage, a tissue with limited self-repair capabilities. Among the various stem cell sources, umbilical cord-derived mesenchymal stromal cells (UC-MSCs) have garnered significant interest due to their non-invasive collection, minimal ethical concerns, and robust regenerative potential, particularly in cartilage regeneration...

PURPOSE: This study investigates the radiological outcomes of robotic-assisted total hip arthroplasty (RATHA) compared to manual total hip arthroplasty (mTHA), addressing the ongoing debate on the effectiveness of RATHA in achieving superior implant positioning accuracy. METHODS: A prospective cohort of 212 patients (103 robotic, 109 manual) underwent THA and were evaluated for postoperative radiological outcomes, focusing on the inclination and anteversion angles of the acetabular cup...

INTRODUCTION: Patients living in high altitudes are often deprived of total knee arthroplasty (TKA) due to logistic reasons, economic, and social challenges in performing surgical procedures for management of knee pain. Surgical procedures in high-altitude dwellers have associated risk of deep venous thrombosis/pulmonary embolism (DVT/PE). In patients undergoing these procedures at lower altitudes, return to high altitudes can cause high-altitude pulmonary edema (HAPE). We share our experience of performing TKA in high-altitude dwellers by setting up a surgical camp at 11,000 feet...

INTRODUCTION: The purpose of this study is to establish the correlation of clinically measured carrying angle with four radiological angles, i.e., Humerus-Elbow-Wrist angle (HEWA), Humero-ulnar angle, Metaphyseal-Diaphyseal angle, and Baumann's angle, and to find out which of the above-mentioned angles co-relates best with the clinically measured carrying angle. METHODS: We studied 100 patients in the age group of 2-12 years after Ethics committee approval and informed consent from parents...

INTRODUCTION: Rehabilitation after Total Knee Arthroplasty (TKA) often includes proprioceptive exercises to prevent falls, but studies on proprioceptive training have yielded conflicting findings. This study aims to explore impact of proprioceptive training on functional performance after TKA. METHODS: Eighty patients who underwent unilateral TKA were randomly assigned to a proprioceptive exercise (PE) group or a routine exercises (RE) group. The PE group received proprioceptive exercises in addition to routine physiotherapy...

UNLABELLED: Operating room fires are considered 'never events'; they are uncommon but can prove to be potentially damaging to the humans involved and the expensive operating room instrumentation. Research indicates that significant knowledge gaps exist in orthopaedic community relating to fire prevention, fire safety and fire management. A 24-year-old male patient with clavicle fracture was planned for surgical fixation. A nerve block procedure was performed. Skin preparation was done with 10% betadine scrub and surgical spirit...

PURPOSE: To examine the frequency of patellofemoral joint (PFJ) osteoarthritis (OA) and its symptoms in the long-term course of open-wedge high tibial osteotomy (OWHTO). METHODS: We analyzed 113 joints of 91 patients. OA and osteonecrosis (ON) developed in 91 and 22 joints, after an average postoperative period of 127.5 ± 19.5 months. For X-ray evaluation, the standing femorotibial angle (FTA), % mechanical axis (%MA), Caton-Deschamps index (CDI), patellar tilt angle (TA), lateral patellar shift (LPS), and PFJ space width (medial [MJS] and lateral [LJS]) were analyzed...

INTRODUCTION: Knee osteoarthritis (OA) is a prevalent condition that significantly impacts the quality of life, often leading to the need for knee replacement surgery. Accurate and timely identification of knee degeneration is crucial for effective treatment and management. Traditional methods of diagnosing OA rely heavily on radiological assessments, which can be time-consuming and subjective. This study aims to address these challenges by developing a deep learning-based method to predict the likelihood of knee replacement and the Kellgren-Lawrence (KL) grade of knee OA from X-ray images...

INTRODUCTION: Hip arthroplasty, including hemiarthroplasty and total hip arthroplasty is a common surgical procedure for patients suffering from hip joint disorders with an aim of complication free early return to activities of daily living. Various minimally invasive surgical approaches have been described to achieve this aim including a relatively new SPAIRE approach. This case series shows our technique of hip arthroplasty using the SPAIRE technique with the help of conventional instruments in an Indian Scenario at a tertiary care center in Eastern India along with our short-term functional outcomes till a follow up period of 6 months...

BACKGROUND: Delirium poses a significant challenge in musculoskeletal trauma patients, particularly the elderly, contributing to elevated morbidity and mortality. Despite unclear pathogenesis, various risk factors have been identified. This prospective observational study, conducted in a tertiary center, aims to estimate delirium incidence and identify associated risk factors in adult patients undergoing lower limb trauma surgeries. METHODS: Between August 2021 and December 2022, 150 patients with lower limb trauma admitted for surgery were included...

INTRODUCTION: Osteoporosis is a significant and growing global public health problem, projected to increase in the next decade. The Singh Index (SI) is a simple, semi-quantitative evaluation tool for diagnosing osteoporosis with plain hip radiographs based on the visibility of the trabecular pattern in the proximal femur. This work aims to develop an automated tool to diagnose osteoporosis using SI of hip radiograph images with the help of machine learning algorithms. METHODS: We used 830 hip X-ray images collected from Indian men and women aged between 20 and 70 which were annotated and labeled for appropriate SI...

INTRODUCTION: Hydatid disease is uncommon in Humans. It rarely affects the bones and joints (0.5-4%). Frequent sites of bony involvement are vertebrae, pelvic bones, upper end of long bones e.g. humerus, femur and tibia. MATERIAL AND METHODS: We report a case of 41-year old female with primary Hydatid cyst of the entire right femur. Patient complaint of severe pain and was non ambulatory since the last 2 months. RESULTS: Here, single staged Total Right Femur Replacement was done under General Anaesthesia...

BACKGROUND: Giant cell tumor of bone (GCTB) is the most common primary tumor of proximal fibula. Because of its close proximity to vascular structures, common peroneal nerve (CPN) and attachment of lateral collateral ligament (LCL), proximal fibulectomy poses unique challenges. We analyzed oncological and functional outcome of patients who underwent proximal fibulectomy for GCTB of proximal fibula. MATERIAL AND METHODS: Between January 2006 and December 2020, 23 patients underwent proximal fibulectomy for GCTB of proximal fibula, four were recurrent tumors...

No abstract text is available yet for this article.

BACKGROUND: Computed tomography (CT) based three-dimensional templating is increasingly being used to predict implant sizes in total knee arthroplasty (TKA). However, the existing data is heterogeneous, and the majority of studies lack adequate statistical power. This study investigated whether preoperative CT-based planning in robot-assisted TKA (RA-TKA) helps in predicting the accurate size of implant used. METHODS: This is a single-center retrospective study of 632 consecutive RA-TKA surgeries...

BACKGROUND: Valgus knee deformity poses great challenges in total knee arthroplasty (TKA) and requires precision in balancing of soft tissue and implant component positioning. The surgical approach used for TKA has a determinantal impact on intraoperative soft tissue balancing, postoperative knee function, and complications. We executed a systematic review and meta-analysis of current literature, which included a maximum number of studies with quantitative analysis of all possible outcomes to substantiate the current evidence of the advantage of lateral versus medial approach in TKA for valgus knee deformity...

BACKGROUND AND AIMS: Regenerative orthopedics involves approaches like stem cell therapy, platelet-rich plasma (PRP) therapy, the use of biological scaffold implants, tissue engineering, etc. We aim to present a scoping review of the role of artificial intelligence (AI) in different treatment approaches of regenerative orthopedics. METHODS: Using the PRISMA guidelines, a search for articles for the last ten years (2013-2024) on PubMed was done, using several keywords...

BACKGROUND: The straight and thin design of the CLS Spotorno stem makes it prone for coronal plane mal-alignment, with potential for cortical impingement; reactive osteogenesis and thigh pain have been documented in this situation with some stems. The literature is scarce about the effect of distal mal-alignment with this particular stem, and its relationship with thigh pain, functional outcomes and stem survival. We assessed functional outcomes with incidence of varus/valgus CLS stem alignment, and correlated stem subsidence of these thin stems with hip scores...

BACKGROUND: The aim of this study was to investigate the factors affecting patient-reported outcomes after bicruciate-stabilized total knee arthroplasty (BCS TKA) in patients. METHODS: We retrospectively examined 122 knees with primary varus knee osteoarthritis that underwent BCS TKA. This study analyzed preoperative, intraoperative, and postoperative predictors of patient satisfaction and persistent postsurgical pain following BCS TKA at 1 year after surgery...