Indian Journal of Orthopaedics

Medial patellar instability (lateral patellofemoral ligament tear) is a rare condition which is commonly associated with lateral release for lateral patellar instability. LPFL is a lateral stabilizer of the patellofemoral joint. Reconstruction of LPFL is necessary to provide stability to the patella-femoral joint in patients with instability. We describe a novel technique of trans-osseous reconstruction of LPFL to gain stability and have better graft incorporation. A doubled peroneus longus graft is inserted into the patellar tunnel and secured with an endo button on the anteromedial aspect of the patella; the other end is then inserted into the insertional point on the femur and secured with an interference screw...

BACKGROUND: Arthroscopic knee procedures are one amongst the common surgical interventions for problems in the knee. It is technically more demanding than an open procedure and is associated with several potential complications. During arthroscopy procedures, several technical challenges may arise, and even experienced surgeons may encounter new issues. However, careful attention to the surgical technique can help prevent or resolve them. METHODOLOGY: The study was conducted on all patients who underwent knee arthroscopy procedure during study period...

BACKGROUND: Total knee arthroplasty (TKA) for Charcot arthropathy of the knee is considered controversial because of its higher complication rate compared with that of TKA for osteoarthritis. In this study, we investigated the clinical outcomes, survival rates, and complications of primary TKA for Charcot arthropathy. METHODS: We conducted a retrospective analysis of nine patients (12 knees) with Charcot arthropathy who underwent TKA. The mean age of the patients was 63...

INTRODUCTION: The treatment of Lisfranc injuries continues to evolve with time. The purpose of this study was to report early outcomes of patients with Lisfranc ligamentous injuries treated with the Arthrex InternalBrace, which has benefits to other previously described techniques. MATERIALS AND METHODS: We retrospectively identified 15 adult patients with Lisfranc injuries that were treated via open reduction internal fixation with the Arthrex InternalBrace (Naples, Fl)...

BACKGROUND: Vitamin D deficiency is widely prevalent among the elderly, posing significant health risks. This study aims to determine the global prevalence of vitamin D deficiency in the elderly. METHODS: A systematic review and meta-analysis was conducted, examining databases including Scientific Information Database (SID), Medline (PubMed), ScienceDirect, Scopus, Embase, and Google Scholar until January 2023. The publication bias of the studies was assessed using the I 2 test of heterogeneity and the Egger test...

PURPOSE: This study aimed to examine the influence of unintended facet arthrodesis on the therapeutic effectiveness of the dynamic neutralization system (Dynesys). METHODS: This retrospective study enrolled consecutive patients who underwent posterior decompression and dynamic stabilization for lumbar spondylosis or spinal stenosis. Follow-up assessments included lumbar radiography, lumbar vertebral computerized tomography (CT), visual analog scale (VAS), and Oswestry disability index (ODI)...

PURPOSE: Malnourished adults with knee osteoarthritis (OA) have a lower propensity for physical activities, leading to post-surgical stress and poorer clinic-functional outcomes. The study is aimed to propose an integrative screening procedure for patients and to identify a subset of patients who are undernourished or at risk of undernutrition in the Indian population. METHODS: A hospital-based cross-sectional study was conducted at a tertiary care, a university-level teaching hospital for seven months, which included knee OA patients above the age of 45 years, and the following criteria were evaluated anthropometric measurement and blood biochemical parameters and nutritional scoring system...

INTRODUCTION: We present a new surgical technique of Krackow suture combined with vertical Nice knot for the treatment of inferior patellar fractures and report the clinical results. PATIENTS AND METHODS: Seventeen consecutive patients admitted with inferior patellar fractures over a 2-year period from June 2019 to February 2022 were prospectively enrolled. The AO classification was 34-A1. All patients underwent open reduction and fixation with Krackow sutures in combination with vertical Nice knot...

BACKGROUND: Open debridement remains the gold standard for the clinical treatment of post-traumatic elbow stiffness. However, postoperative complications, such as re-contraction and heterotopic ossification of the elbow joint, are highly prevalent. Hinged external fixation appears to offer the potential for greater improvement of joint function and reduction of complications. The purpose of this article is to provide the latest evidence on the effectiveness and safety of hinged external fixation combined with open debridement for the treatment of post-traumatic elbow stiffness...

BACKGROUND: Reconstructions of the proximal femur after massive resections represent one of the main challenges in orthopedic oncology. Among the possible treatments, megaprostheses represent one of the most used and reliable reconstructive approaches. Although literature about their outcomes has flourished through the last decades, a consensus rehabilitative treatment is still far from being established. MATERIALS AND METHODS: We evaluated the functional results of all our oncologic cases treated between 2016 and 2022 that could follow our standardized post-operative rehabilitative approach, consisting in progressive hip mobilization and early weight-bearing...

BACKGROUND: Prosthetic loosening and infection are still common complications after joint replacement. Over the past few years, single-photon emission computed tomography-computed tomography (SPECT/CT) was widely used and showed unique value based on the combination of anatomic and metabolic information of foci. However, its performance in differentiating between prosthetic loosening and periprosthetic infection after joint replacement is still the focus of clinicians and deserves further investigation...

INTRODUCTION: The use of imageless navigation in total hip arthroplasty (THA) is frequently associated with prolonged surgical times, predominantly during the learning period. The purpose of the present study was to characterize the learning period of a novel imageless navigation system, specifically as it related to surgical time and acetabular navigation accuracy. MATERIALS AND METHODS: This was a retrospective observational study of a consecutive group of 158 patients who underwent primary unilateral THA for osteoarthritis by a team headed by a single surgeon...

INTRODUCTION: Hip impingement from slipped epiphysis and idiopathic cam is well known but not fully differentiated. Idiopathic cam can be a result of an undiagnosed slip. The mechanism of remodeling of slipped epiphysis deformity has also been controversial. The causes of recurrent femoral head deformity and new impingement beyond progression of the slip have not been studied. MATERIALS AND METHODS: A consecutive series of hips treated by arthroscopic femoral neck osteoplasty for impingement from slipped epiphysis were compared with a series of hips treated for idiopathic cam impingement...

BACKGROUND: The role of prophylactic pinning of the contralateral hip in unilateral SCFE is well established in patients with risk factors for developing contralateral slip. The effect of prophylactic pinning on the growth and morphology of the hip is not well documented in the literature. We aimed to study the effect of prophylactic pinning on the residual growth and morphology of the proximal femur. MATERIALS & METHODS: The institutional database was searched for all unilateral SCFE cases for the period 2011 to 2020...

PURPOSE: Antimicrobial cement spacer (ACS) placement has been a cornerstone of two-stage management of prosthetic hip and knee infection. Pharmacokinetic modelling has described peak systemic antibiotic concentrations within the first 24-48 h post-operatively, followed by rapid clearance. A few studies have, however, identified detectable tobramycin levels in patients with a post-operative decline in creatinine clearance. Our study sought to determine how frequently detectable serum tobramycin levels occurred within the first 72 h following ACS placement in all patients regardless of baseline or subsequent changes in renal function, whether these levels correlated with tobramycin spacer dosage, creatinine clearance, or potential nephrotoxicity risk factors, and whether any patients developed acute kidney injury within the 14-day post-operative period...

INTRODUCTION: There is no consensus in literature on the surgical treatment of patients with Crowe type III/IV patients. Each arthroplasty procedure has its own advantages and disadvantages. In this study by placing the acetabular cup between the true and false acetabulum, we aimed to share our experience about criteria of patient selection, surgical technique, and mid-term results of THA (total hip arthroplasty) in which the risk of dislocation was minimized using a standard-sized acetabular cup...

AIMS: This study aimed to establish a nomogram model for predicting the probability of postoperative deep vein thrombosis (DVT) risk in patients with hip fractures. METHODS: 504 patients were randomly assigned to the training set and validation set, and then divided into a DVT group and a non-DVT group. The study analysed the risk factors for DVT using univariate and multivariate analyses. Based on these parameters, a nomogram model was constructed and validated...

INTRODUCTION: Orthopaedic surgeons are among the most frequent users of radiation and are often exposed to X-Ray radiation regularly. There is an overall unsatisfactory level of knowledge, attitude, and practices regarding the same among surgeons. This study aimed to assess the practices among orthopaedic surgeons regarding radiation and its hazards in India. METHODOLOGY: This questionnaire-based survey was conducted between March and September 2022. The questionnaire broadly assessed the knowledge, awareness, and practices among orthopaedic surgeons regularly exposed to X-ray radiation...

AIM: To evaluate the functional outcomes of patients undergoing arthroscopic arthrolysis of the knee and find the ideal timing for arthrolysis to achieve maximum range of motion (ROM) of the knee. METHODS: All patients who underwent arthroscopic arthrolysis for post-operative joint stiffness following surgery for injuries around knee joint at a tertiary care centre from 2009 to 2023 were included in this study. The patients' details such as primary injury, time interval between the index surgery and arthrolysis, improvement in knee range of ROM and Lysholm score from prior to arthrolysis to last follow-up post arthrolysis were retrieved from hospital database and analysed...

[This corrects the article DOI: 10.1007/s43465-023-01037-8.].