Mucoid Degeneration of Anterior Cruciate Ligament – A Review of Literature

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Journal of Clinical Orthopaedics | Vol 9 | Issue 2 |  July-December 2024 | page: 38-43 | Sujit Korday , Pushkar Khandekar , Suhail Kantawala , Nicholas Antao

DOI: https://doi.org/10.13107/jcorth.2024.v09i02.658

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2024; The Author(s).

Submitted Date: 01 Nov 2024, Review Date: 10 Nov 2024, Accepted Date: 28 Nov 2024 & Published Date: 10 Dec 2024

Author: Sujit Korday  [1], Pushkar Khandekar [1], Suhail Kantawala [2], Nicholas Antao [2]

[1] Department of Orthopedics, V. N. Desai Hospital, Santacruz East, Mumbai, Maharashtra, India.
[2] Department of Orthopedics,Holy Spirit Hospital, Mahakali Caves Road, Andheri East, Mumbai, Maharashtra, India.

Address of Correspondence

Dr. Pushkar Khandekar,
Department of Orthopaedics, V. N. Desai Hospital, Santacruz East, Mumbai, Maharashtra, India.
E-mail: drpushkarkhandekar@gmail.com

Abstract

Mucoid degeneration of the anterior cruciate ligament (MD-ACL), once thought to be a rare entity, is seen not so uncommonly in present day orthopaedic practice. Several hypotheses attempt to explain this entity. Clinically, it presents as knee pain with limitation of flexion or extension. There is no specific test available to clinically diagnose MD-ACL. Magnetic Resonance Imaging (MRI) remains the imaging modality of choice to diagnose MD-ACL. Therefore, a high index of suspicion is necessary to be able to diagnose this condition. This article reviews the available literature about the etio-pathological aspects of MD-ACL, its clinical features, radiological and arthroscopic findings, as well as various treatment modalities available.
Keywords: Mucoid degeneration, anterior cruciate ligament, knee, arthroscopy, MRI.

References

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How to Cite this article: Korday S, Khandekar P, Kantawala S, Antao N. Mucoid Degeneration of Anterior Cruciate Ligament – A Review of Literature. Journal of Clinical Orthopaedics July-December 2024;9(2):38-43.

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Evolution of Femoral Neck Implants: In Search of the Perfect Implant

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Journal of Clinical Orthopaedics | Vol 9 | Issue 2 |  July-December 2024 | page: 01-05 | Sachin Kale, Arvind Vatkar, Sanjay Dhar, Pramod Bhor, Ashish Phadnis, Rohan Jayaram

DOI: https://doi.org/10.13107/jcorth.2024.v09i02.640

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2024; The Author(s).

Submitted Date: 11 Jul 2024, Review Date: 08 Aug 2024, Accepted Date: 12 Sep 2024 & Published Date: 10 Dec 2024

Author: Sachin Kale [1], Arvind Vatkar [2, 3], Sanjay Dhar [1], Pramod Bhor [2], Ashish Phadnis [4], Rohan Jayaram [1]

[1] Department of Orthopaedics, D.Y Patil School of Medicine and Hospital, Navi Mumbai, Maharashtra, India,
[2] Department of Orthopaedics, Fortis Hiranandani Hospital, Navi Mumbai, Maharashtra, India,
[3] Department of Orthopaedics, MGM Medical College, Navi Mumbai, Maharashtra, India
[4] Department of Orthopaedics, Jupiter Hospital, Thane, Maharashtra, India

Address of Correspondence

Dr. Sachin Kale
Professor and Head of Unit, Department of Orthopaedics, D.Y Patil School of Medicine and Hospital, Navi Mumbai, Maharashtra, India.
Email: sachinkale@gmail.com

Abstract

Femoral neck fractures have significant orthopedic difficulty, particularly in younger patients with high-energy trauma. The femoral neck system improves rotational stability, allows for controlled dynamic compression, and is less invasive than cannulated cancellous screws. However, steep learning curves, more significant starting expenditures, and more long-term data still need to be addressed. Emerging technologies, such as robotic-assisted surgeries and personalized implants created with artificial intelligence and 3D printing, can transform fracture therapy by boosting accuracy, lowering complications, and improving patient-specific care. Future advances will improve results and patient happiness.
Keywords: Femoral neck fractures, femoral neck system, cannulated screws, rotational stability, angular stability, minimally invasive surgery, fracture fixation, osteoporotic fractures, clinical outcomes, implant innovations.

How to Cite this article: Kale S, Vatkar A, Dhar S, Bhor P, Phadnis A, Jayaram R. Evolution of Femoral Neck Implants: In Search of the Perfect Implant. Journal of Clinical Orthopaedics July-December 2024;9(2):01-05.

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Robotic-Assisted Total Knee Replacement in a Patient with Severe Varus Deformity and High Cardiac Risk

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Journal of Clinical Orthopaedics | Vol 9 | Issue 2 |  July-December 2024 | page: 129-131 | Pramod Bhor, Sawankumar H. Pawar, Dnyanada Kutumbe, Arvind Vatkar, Sachin Kale

DOI: https://doi.org/10.13107/jcorth.2024.v09i02.696

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2024; The Author(s).

Submitted Date: 10 Oct 2024, Review Date: 15 Nov 2024, Accepted Date: 20 Nov 2024 & Published Date: 10 Dec 2024

Author: Pramod Bhor [1], Sawankumar H. Pawar [1], Dnyanada Kutumbe [1], Arvind Vatkar [1], Sachin Kale [2]

[1] Department of Orthopaedics, Fortis Hiranadani Hospitals, Vashi, Navi Mumbai, Maharashtra, India.
[2] Department of Orthopaedics, D.Y Patil School of Medicine and Hospital, Navi Mumbai, Maharashtra, India,

Address of Correspondence

Dr. Sawankumar H. Pawar
Associate Consultant, Department of Orthopaedics, Fortis Hiranadani Hospitals, Vashi, Navi Mumbai, Maharashtra, India.
Email- drsawanortho@gmail.com

Abstract

Severe varus deformity of the knee is a complex condition that is managed with scrupulous pre-operative planning and intraoperative technique, more so in cardiac-risk patients. Robotic-assisted total knee replacement (TKR) has emerged as an exciting option for improving precision and better outcomes in complex cases. The authors report a case of Robotic-assisted TKR in a 65-year-old patient suffering from severe varus deformity of the knee and multiple significant cardiac comorbidities.
Keywords: Robotic assisted TKR, Severe varus deformity, Cardiac risk

References

1. Kochhar T, Thakral R. Role of robotics in total knee arthroplasty: A clinical review. J Orthop Surg 2020;28:1-7.
2. Marchand RC, Sodhi N. Does robotic arm-assisted TKA result in improved clinical outcomes? J Knee Surg 2019;32:1020-7.
3. Alrajeb R, Zarti M, Shuia Z, Alzobi O, Ahmed G, Elmhiregh A. Robotic-assisted versus conventional total knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials. Eur J Orthop Surg Traumatol. 2024 Apr;34(3):1333-1343. doi: 10.1007/s00590-023-03798-2. Epub 2023 Dec 22. PMID: 38133653; PMCID: PMC10980635.
4. van der List, J. P., Chawla, H., Joskowicz, L., & Pearle, A. D. (2016). Current state of computer navigation and robotics in unicompartmental and total knee arthroplasty: a systematic review with meta-analysis. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 24(11), 3482–3495. https://doi.org/10.1007/s00167-016-4305-9
5. Khlopas A, Chughtai M, et al. The learning curve associated with robotic total knee arthroplasty. J Arthroplast 2018;33:1761-7.

How to Cite this article: Bhor P, Pawar SH, Kutumbe D, Vatkar A, Kale S. Robotic-Assisted Total Knee Replacement in a Patient with Severe Varus Deformity and High Cardiac Risk. Journal of Clinical Orthopaedics July-December 2024;9(2):129-131.

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Spinal Gout: A Comprehensive Review of Clinical Features, Diagnostic Challenges, and Management Strategies in Spinal Gout

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Journal of Clinical Orthopaedics | Vol 9 | Issue 2 |  July-December 2024 | page: 35-37 | Sachin Kale, Arvind Vatkar, Sanjay Dhar, Pramod Bhor, Ashish Phadnis, Prakash Samant, Shivam Mehra

DOI: https://doi.org/10.13107/jcorth.2024.v09i02.656

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2024; The Author(s).

Submitted Date: 01 Aug 2024, Review Date: 28 Sep 2024, Accepted Date: 12 Oct 2024 & Published Date: 10 Dec 2024

Author: Sachin Kale [1], Arvind Vatkar [2], Sanjay Dhar [1], Pramod Bhor [3], Ashish Phadnis [4], Prakash Samant [1], Shivam Mehra [5]

[1] Department of Orthopaedics, D.Y Patil School of Medicine and Hospital, Navi Mumbai, Maharashtra, India,
[2] Department of Orthopaedics, MGM Medical College, Navi Mumbai, Maharashtra, India,
[3] Department of Orthopaedics, Fortis Hiranandani Hospital, Mumbai, Maharashtra, India,
[4] Department of Orthopaedics, Jupiter Hospital, Thane, Maharashtra, India.[5] Mehra Hospital and Research Institute, Lucknow, Uttar Pradesh, India,

Address of Correspondence

Dr. Arvind Vatkar,
Department of Orthopaedics, MGM Medical College, Navi Mumbai, Maharashtra, India.
E-mail: vatkararvind@gmail.com

Abstract

Spinal gout is an uncommon form of gout that is distinguished by the deposition of monosodium urate (MSU) crystals in the spine, resulting in severe pain and potential neurological impairments. Despite its rarity, spinal gout can be difficult to diagnose because of its vague symptoms and similarities to other spinal illnesses. This study delves into the epidemiology, clinical aspects, and diagnostic problems of spinal gout, focusing on the Indian setting. Diagnostic methods such as X-ray, computed tomography (CT), and magnetic resonance imaging are investigated, with a focus on dual-energy CT for identifying MSU deposits. The treatment options vary from conservative maintenance with non-steroidal anti-inflammatory drugs and urate-lowering medication to surgical intervention in situations of neurological damage.
Keywords: Spinal gout, tophaceous gout, lumbar spine, diagnostic challenges, hyperuricemia.

References

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5. Singh JA. Racial and gender disparities among patients with gout. Curr Rheumatol Rep 2013;15:307.
6. Singh JA, Reddy SG, Kundukulam J. Risk factors for gout and prevention: A systematic review of the literature. Curr Opin Rheumatol 2011;23:192-202.
7. Choi HK, Stone JH. Epidemiology of gout. In: A Clinician’s Pearls & Myths in Rheumatology. Cham: Springer International Publishing; 2023. p. 513-7.
8. Schlesinger N. Diagnosis of gout. Minerva Med 2007;98:759-67.
9. Khanna I, Pietro R, Ali Y. What has dual energy CT taught us about gout? Curr Rheumatol Rep 2021;23:71.
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11. van Durme CM, Wechalekar MD, Landewé RB, Pardo Pardo J, Cyril S, van der Heijde D, et al. Non-steroidal anti-inflammatory drugs for acute gout. Cochrane Database Syst Rev 2021;12:CD010120.
12. Nazwar TA, Bal’afif F, Wardhana DW, Panjaitan C. Understanding spinal gout: A comprehensive study of 88 cases and their clinical implications. J Craniovertebr Junction Spine 2024;15:133-40.

How to Cite this article: Kale S, Vatkar A, Dhar S, Bhor P, Phadnis A, Samant P, Mehra S. Spinal Gout: A Comprehensive Review of Clinical Features, Diagnostic Challenges, and Management Strategies in Spinal Gout. Journal of Clinical Orthopaedics July-December 2024;9(2):35-37.

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Top 10 Things Orthopods Need to Know before Investing in Mutual Funds

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Journal of Clinical Orthopaedics | Vol 9 | Issue 2 |  July-December 2024 | page: 08-10 | Sachin Kale, Arvind Vatkar, Sanjay Dhar, Pramod Bhor

DOI: https://doi.org/10.13107/jcorth.2024.v09i02.644

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2024; The Author(s).

Submitted Date: 03 Oct 2024, Review Date: 10 Oct 2024, Accepted Date: 24 Nov 2024 & Published Date: 10 Dec 2024

Author: Sachin Kale [1], Arvind Vatkar [2, 3], Sanjay Dhar [1], Pramod Bhor [2]

[1] Department of Orthopaedics, D.Y Patil School of Medicine and Hospital, Navi Mumbai, Maharashtra, India,

[2] Department of Orthopaedics, Fortis Hiranandani Hospital, Navi Mumbai, Maharashtra, India,

[3] Department of Orthopaedics, MGM Medical College, Navi Mumbai, Maharashtra, India

Address of Correspondence

Dr Arvind Vatkar,

Department of Orthopaedics, Fortis Hiranandani Hospital, Vashi, Navi Mumbai, Maharashtra, India.
E-mail: vatkararvind@gmail.com.

Abstract

Investing in mutual funds may be intimidating for orthopedic surgeons, who are used to the complexity of surgery but are not usually familiar with financial markets. The Top 10 Things an Orthopaedic Surgeon Should Know Before Investing in Mutual Funds is a practical guide for surgeons to navigate the complex world of mutual funds efficiently. It covers important topics including identifying financial objectives, comprehending several types of funds (equity, debt, and hybrid), and determining risk tolerance at different phases of one’s career. The essay also describes the principle of compounding, defines financial jargon such as CAGR and XIRR, and distinguishes between direct and regular mutual fund programs. It also looks at theme and sectoral funds, emphasizing the need for diversity in risk management.
Keywords: Orthopedic investments, financial planning, mutual funds, power of compounding, thematic mutual funds, tax on mutual funds

 

How to Cite this article: Kale S, Vatkar A, Dhar S, Bhor P. Top 10 Things Orthopods Need to Know before Investing in Mutual Funds. Journal of Clinical Orthopaedics July-December 2024;9(2):08-10.

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Evaluation of Investigations Suitable To Stop Treatment in Spinal Tuberculosis

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Journal of Clinical Orthopaedics | Vol 9 | Issue 2 |  July-December 2024 | page: 11-16 | Vishal Kumar, Parth Bansal, Sarvdeep Singh Dhatt, Tensubam Tomthin Meetei, Arvind Vatkar, Sachin Kale

DOI: https://doi.org/10.13107/jcorth.2024.v09i02.646

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2024; The Author(s).

Submitted Date: 13 Jul 2024, Review Date: 09 Aug 2024, Accepted Date: 14 Sep 2024 & Published Date: 10 Dec 2024

Author: Vishal Kumar [1], Parth Bansal [1], Sarvdeep Singh Dhatt [1], Tensubam Tomthin Meetei [1], Arvind Vatkar [2], Sachin Kale [3]

[1] Department of Orthopaedics, PGIMER, Chandigarh, India
[2] Orthopaedics Department, Fortis Hiranandani Hospital, Vashi, Apollo Hospital, Navi Mumbai, Belapur, Maharashtra, India.
[3] Department of Orthopaedics, D.Y Patil School of Medicine and Hospital, Nerul, Navi Mumbai, Maharashtra, India.

Address of Correspondence

Dr. Arvind Vatkar,
Department of Orthopaedics, MGM Medical college, Nerul, Navi Mumbai, Maharashtra, India.
E-mail: vatkararvind@gmail.com

Abstract

Spinal tuberculosis is the most common extrapulmonary manifestation of tuberculosis and accounts for half of the cases of skeletal tuberculosis and 2% of all tuberculosis cases. The prevalence of spinal tuberculosis is widespread in an endemic county such as India where many people live under poor socioeconomic demographics. It is still a major cause of morbidity and economic loss as it generally affects the productive age groups and the deformities of spinal tuberculosis can have long-lasting effects on the affected population. Detection of drug-resistant strains is another worrying factor that contributes to the reemergence of spinal tuberculosis as a major cause of concern as it can lead to prolonged treatment and failure if not properly addressed on time. There is no proper gold standard investigation to reliably detect the endpoint of treatment in spinal tuberculosis and there is a lack of consensus regarding the exact duration of antitubercular therapy. This remains a gray area even today. This review article aims to look into some of the investigations that can help determine the endpoint of treatment with a special focus on magnetic resonance imaging (MRI) and positron emission tomography scan (MRI scan).
Keywords: Spinal tuberculosis, magnetic resonance imaging scan, positron emission tomography scan

References

1. Misra UK, Warrier S, Kalita J, Kumar S. Spinal neuroradiology MRI findings in Pott’s spine and correlating clinical progress with radiological findings. Neuroradiology 2020;62:825-32.
2. Jain AK, Rajasekaran S, Jaggi KR, Myneedu VP. Tuberculosis of the spine. J Bone Joint Surg Am 2020;102:617-28.
3. Sharma SK, Ryan H, Khaparde S, Sachdeva KS, Singh AD, Mohan A, et al. Index-TB guidelines: Guidelines on extrapulmonary tuberculosis for India. Indian J Med Res 2017;145:448-63.
4. Ansari S, Amanullah M, Ahmad K, Rauniyar RK. Pott’s spine: Diagnostic imaging modalities and technology advancements. N Am J Med Sci 2013;5:404-11.
5. Skoura E, Zumla A, Bomanji J. Imaging in tuberculosis. Int J Infect Dis 2015;32:87-93.
6. Rajasekaran S, Soundararajan DC, Shetty AP, Kanna RM. Spinal tuberculosis: Current concepts. Glob Spine J 2018;8(4 suppl):96S-108.
7. Garg RK, Somvanshi DS. Spinal tuberculosis: A review. J Spinal Cord Med 2011;34:440-54.
8. Currie S, Galea-soler S, Barron D, Chandramohan M, Groves C. MRI characteristics of tuberculous spondylitis. Clin Radiol 2011;66:778-87.
9. Jain AK, Sreenivasan R. Magnetic resonance evaluation of tubercular lesion in spine. Int Orthop 2012;36:261-9.
10. Rivas-Garcia A, Sarria-Estrada S, Torrents-Odin C, Casas-Gomila L, Franquet E. Imaging findings of Pott’s disease. Eur Spine J 2013;22 (Suppl 4):567-78.
11. Lee IS, Lee JS, Kim SJ, Jun S, Suh KT. Fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography imaging in pyogenic and tuberculous spondylitis: Preliminary study. J Comput Assist Tomogr 2009;33:587-92.
12. Kimizuka Y, Ishii M, Murakami K, Ishioka K, Yagi K, Ishii K, et al. A case of skeletal tuberculosis and psoas abscess: Disease activity evaluated using F-fluorodeoxyglucose positron emission tomography-computed tomography. BMC Med Imaging 2013;13:37.
13. Vorster M, Sathekge MM, Bomanji J. Advances in imaging of tuberculosis: the role of 18F-FDG PET and PET/CT. Curr Opin Pulm Med 2014;20:287-93.
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15. Mittal S, Jain AK, Chakraborti KL, Aggarwal AN, Upreti L, Bhayana H. Evaluation of healed status in tuberculosis of spine by fluorodeoxyglucose-positron emission tomography/computed tomography and contrast magnetic resonance imaging. Indian J Orthop 2019;53:160-8.
16. Dureja S, Sen IB, Acharya S. Potential role of F18 FDG PET-CT as an imaging biomarker for the noninvasive evaluation in uncomplicated skeletal tuberculosis: A prospective clinical observational study. Eur Spine J 2014;23:2449-54.
17. Kim SJ, Kim IJ, Suh KT, Kim YK, Lee JS. Prediction of residual disease of spine infection using F-18 FDG PET/CT. Spine 2009;34:2424-30.
18. Fuster D, Tomás X, Mayoral M, Soriano A, Manchón F, Cardenal C, et al. Prospective comparison of whole-body 18 F-FDG PET/CT and MRI of the spine in the diagnosis of haematogenous spondylodiscitis. Eur J Nucl Med Mol Imaging 2015;42:264-71.
19. Jain TK, Sood A, Basher RK, Battacharya A, Mittal BR, Aggarwal AK. “Pine tree” appearance on 18F-FDG PET/CT MIP image in spinal tuberculosis. Rev Esp Med Nucl Image Mol 2017;36:122-3.
20. Bassetti M, Merelli M, Di Gregorio F, Siega PD, Screm M, Scarparo C, et al. Higher fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) uptake in tuberculous compared to bacterial spondylodiscitis. Skeletal Radiol 2017;46:777-83.
21. Liu W, Li X, Yin J, Li X, Wang X. Diagnostic value of (18) F-FDG PET/CT in extrapulmonary tuberculosis. J South Med Univ 2013;33:1083.
22. Jeon I, Kong E, Kim SW. Simultaneous 18F-FDG PET/MRI in tuberculous spondylitis: Independent method for assessing therapeutic response – case series. BMC Infect Dis 2019;19:845.

How to Cite this article: Kumar V, Bansal P, Dhatt SS, Meetei TT, Vatkar A, Kale S. Evaluation of Investigations Suitable To Stop Treatment in Spinal Tuberculosis. Journal of Clinical Orthopaedics July-December 2024;9(2):11-16.

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Assessment of Knowledge, Attitude, and Practice Toward Materiovigilance Among the Health Care Workers in Mumbai: A Questionnaire-Based Study

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Journal of Clinical Orthopaedics | Vol 9 | Issue 2 |  July-December 2024 | page: 83-87 | Sachin Kale, Deepak Langade, Vaishali Thakare, Anant Patil, Sonali Das, Arvind Vatkar

DOI: https://doi.org/10.13107/jcorth.2024.v09i02.676

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2024; The Author(s).

Submitted Date: 10 Oct 2024, Review Date: 28 Oct 2024, Accepted Date: 15 Nov 2024 & Published Date: 10 Dec 2024

Author: Sachin Kale [1], Deepak Langade [2], Vaishali Thakare [2], Anant Patil [2], Sonali Das [1], Arvind Vatkar [3]

[1] Department of Orthoaedics, Dr. DY Patil Medical College and Hospital, Navi Mumbai, Maharashtra, India.

[2] Department of Pharmacology, Dr. DY Patil Medical College and Hospital, Navi Mumbai, Maharashtra, India.

[3] Department of Orthopaedics, MGM Hospital, Navi Mumbai, Maharashtra, India.

Address of Correspondence

Dr. Sonali Das,

Department of Orthopaedics, Dr. DY Patil Medical College and Hospital, Navi Mumbai, Maharashtra, India.

Email- drsonalidas@hotmail.com

Abstract

Introduction: Materiovigilance is an organized method for locating, obtaining, recording, and evaluating any unfavorable occurrences associated with medical devices to protect a patient’s health by preventing recurrences. Recent advancements in science and technology have led to a significant expansion in the role of medical devices in the healthcare delivery system. This questionnaire-based cross-sectional study was conducted among physicians and nurses in a teaching hospital that offers tertiary care and is part of the MvPI MDAE reporting system.

Case report: Among the participants, the worst performers were junior nurses, with 66.7% unaware of the term materiovigilance itself, and the best performers were professors, at 73.5%. Participants self-rated their knowledge, and 31.0% considered it average regarding the subject. However, only 53% of respondents were aware of MvPI systems in their institution, and 60.5% were aware of the reporting process.

Conclusion: This study shows that our tertiary care teaching institute’s medical practitioners lack sufficient materiovigilance knowledge. A campaign of ongoing materiovigilance awareness among healthcare practitioners and nurses, however, would enhance their understanding and inspire them to report MDAEs.

Keywords: Materiovigilance, healthcare, awareness, questionnaire.

References

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2. Jefferys DB. The regulation of medical devices and the role of the medical devices agency. Br J Clin Pharmacol 2001;52:229-35.
3. Global Harmonization Task Force (Revision of GHTF/SG1/N29:2005). Definition of the Terms ‘Medical Device’ and ‘In Vitro Diagnostic (IVD) Medical Device’. Study Group 1 of the Global Harmonization Task Force Endorsed. GHTF/SG1/N071:2012. The Global Harmonization Task Force; 2012. Available from: https://www.imdrf.org/sites/default/files/docs/ghtf/final/sg1/technical-docs/ghtf-sg1-n071-2012-definition-of-terms-120516.pdf#search=
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7. Feigal DW, Gardner SN, McClellan M. Ensuring safe and effective medical devices. N Engl J Med 2003;348:191-2.
8. Mazeau V, Grenier-Sennelier C, Paturel DX, Mokhtari M, Vidal-Trecan G. Telephone survey of hospital staff knowledge of medical device surveillance in a Paris hospital. Eval Health Prof 2004;27:398-409.
9. Alsohime F, Temsah MH, Hasan G, Al-Eyadhy A, Gulman S, Issa H, et al. Reporting adverse events related to medical devices: A single center experience from a tertiary academic hospital. PLoS One 2019;14:e0224233.
10. Nabi N, Rehman S. A study on knowledge, attitude and practices among healthcare professionals regarding the adverse drug reaction monitoring and reporting at a tertiary care teaching hospital. Bangladesh J Med Sci 2022;21:648-58.
11. Mirel S, Colobatiu L, Fasniuc E, Boboia A, Gherman C, Mirel V. Materiovigilance and Medical Devices. In: International Conference on Advancements of Medicine and Health Care through Technology. Cluj-Napoca, Romania; 2019. p. 101-6. Available from: https://link.springer.com/chapter/10.1007/978-3-319-07653-9_21
12. Gagliardi AR, Ducey A, Lehoux P, Turgeon T, Ross S, Trbovich P, et al. Factors influencing the reporting of adverse medical device events: Qualitative interviews with physicians about higher risk implantable devices. BMJ Qual Saf 2018;27:190-8.
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17. Coyle YM, Mercer SQ, Murphy-Cullen CL, Schneider GW, Hynan LS. Effectiveness of a graduate medical education program for improving medical event reporting attitude and behavior. Qual Saf Health Care 2005;14:383-8.

How to Cite this article: Kale S, Langade D, Thakare V, Patil A, Das S, Vatkar AJ. Assessment of Knowledge, Attitude, and Practice Toward Materio-vigilance among the Health Care Workers in Mumbai: A Questionnaire Based Study. Journal of Clinical Orthopaedics July-December 2024;9(2):83-87.

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Uncommon Inferior Shoulder Dislocation in the Emergency Department

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Journal of Clinical Orthopaedics | Vol 9 | Issue 2 |  July-December 2024 | page: 122-125 | Mansoor Malnas, Bhavya Patwa, Parag Munshi

DOI: https://doi.org/10.13107/jcorth.2024.v09i02.692

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2024; The Author(s).

Submitted Date: 18 Aug 2024, Review Date: 20 Sep 2024, Accepted Date: 22 Sep 2024 & Published Date: 10 Dec 2024

Author: Mansoor Malnas [1], Bhavya Patwa [1], Parag Munshi [1]

[1] Department of Orthopaedics, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India

Address of Correspondence

Dr. Mansoor Malnas,

Department of Orthopaedics, Bombay Hospital Institute of Medical Sciences, 12, New Marine Lines, Mumbai – 400 020, Maharashtra, India.

E-mail: malnasmansoor@gmail.com

Abstract

Introduction: Inferior shoulder dislocations, also known as luxatio erecta, are a rare subset of shoulder dislocations, accounting for <1% of cases encountered in emergency settings. This unique injury involves the inferior displacement of the humeral head below the glenoid cavity, often resulting from a downward force applied to an abducted arm. Clinically, luxatio erecta presents with the arm fixed in an abducted, overhead position, and is frequently associated with additional injuries, such as rotator cuff tears,
fractures, or neurovascular compromise.
Case Report: This case report details the presentation, diagnosis, management, and outcomes of a 52-year-old male with an inferior shoulder dislocation complicated by a fracture of the greater tuberosity following a fall. Initial reduction attempts in the emergency department were unsuccessful, necessitating reduction under general anesthesia. A post-reduction CT scan revealed a displaced greater tuberosity fracture, which was subsequently stabilized through surgical fixation and rotator cuff repair.
Conclusion: This case underscores the critical importance of early recognition, appropriate imaging, and individualized treatment planning to ensure optimal recovery in cases of luxatio erecta with concomitant injuries.
Keywords: Luxatio erecta, greater tuberosity fracture, shoulder dislocation, closed reduction under anesthesia, inferior shoulder dislocation.

References

1. Enger M, Skjaker SA, Melhuus K, Nordsletten L, Pripp AH, Moosmayer S, et al. Shoulder injuries from birth to old age: A 1-year prospective study of 3031 shoulder injuries in an urban population. Injury 2018;49:1324-9.
2. Farrar NG, Malal JJ, Fischer J, Waseem M. An overview of shoulder instability and its management. Open Orthop J 2013;7:338-46.
3. Neviaser RJ, Wilson JH, Lievano A. Inferior (luxatio erecta) dislocation of the humerus. J Bone Joint Surg 1983;65:658-61.
4. Boffano M, Mortera S, Piana R, Bait C. Luxatio erecta humeri: A systematic review of the literature and a report of 4 cases. J Shoulder Elbow Surg 2013;22:1484-9.
5. Budoff JE. In: Trumble TE, Budoff JE, Cornwall R, editors. Core Knowledge in Orthopaedics, Hand, Elbow and Shoulder. Philadelphia, PA: Elsevier Science; 2006.
6. Yang AP, Behn A, Jahangir A, Zuckerman JD. Shoulder dislocations: Evaluation and treatment. J Am Acad Orthop Surg 2017;25:179-87.
7. Murty A, Veluvolu PK. Inferior shoulder dislocation: Case report and review of the literature. Trauma Case Rep 2016;2:36-8.
8. Mallina R, Chan S, Williams R. Inferior shoulder dislocation (luxatio erecta): A review of the literature and a case study. Shoulder Elbow 2013;5:298-300.
9. Dogan SK, Ayhan C, Caglar O. Inferior shoulder dislocation (luxatio erecta humeri) with accompanying rotator cuff tear and brachial plexus injury. Orthop Rev 2017;9:7101.

How to Cite this article: Malnas M, Patwa B, Munshi P. Uncommon Inferior Shoulder Dislocation in the Emergency Department. Journal of Clinical Orthopaedics July-December 2024;9(2):122-125.

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Bilateral Supracondylar Humerus Fracture in an Infant – A Rare Case Report and Review of Literature

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Journal of Clinical Orthopaedics | Vol 9 | Issue 2 |  July-December 2024 | page: 126-128 | Deepak Jain, Janhavi Bhende, Aditya More, Tushar Agrawal

DOI: https://doi.org/10.13107/jcorth.2024.v09i02.694

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2024; The Author(s).

Submitted Date: 10 Jul 2024, Review Date: 09 Aug 2024, Accepted Date: 13 Sep 2024 & Published Date: 10 Dec 2024

Author: Deepak Jain [1], Janhavi Bhende [1], Aditya More [1], Tushar Agrawal [1]

[1] Department of Orthopaedics, MGM Institute of Health Sciences, Navi Mumbai, Maharashtra, India

Address of Correspondence

Deepak Jain,

Department of Orthopaedics, MGM Institute of Health Sciences, Navi Mumbai, Maharashtra, India

E-mail: deepaksjain1993@gmail.com

Abstract

Supracondylar humerus fractures are the most common elbow injuries seen in the pediatric population. Predominantly they are unilateral injuries, and bilateral injuries are exceedingly rare. Here we present a unique case of a bilateral atypical supracondylar humerus fracture seen in a 7-month-old boy after he suffered a fall from the bed. These injuries occur infrequently, and it requires keen clinical suspicion to identify them.
Keywords: Bilateral, supracondylar, humerus, atypical, remodeling.

References

1. Cheng JC, Ng BK, Ying SY, Lam PK. A 10-year study of the changes in the pattern and treatment of 6,493 fractures. J Pediatr Orthop 1999;19:344-50.
2. Dimeglio A. Growth in pediatric orthopaedics. In: Morrissy RT, Weinstein SL, editors. Lovell and Winters’s Pediatric Orthopaedics. 6th ed. Philadelphia, PA: Lippincott­Williams and Wilkins; 2006. p. 35-65.
3. Otsuka NY, Kasser JR. Supracondylar fractures of the humerus in children. J Am Acad Orthop Surg 1997;5:19-26.
4. Tandon T, Shaik M, Modi N. Paediatric trauma epidemiology in an urban scenario in India. J Orthop Surg (Hong Kong) 2007;15:41-5.
5. Landin LA, Danielsson LG. Elbow fractures in children. An epidemiological analysis of 589 cases. Acta Orthop Scand 1986;57:309-12.
6. Cheng JC, Lam TP, Maffulli N. Epidemiological features of supracondylar fractures of the humerus in Chinese children. J Pediatr Orthop B 2001;10:63-7.
7. Naik P. Remodelling in children’s fractures and limits of acceptability. Indian J Orthop 2021;55:549-59.
8. Nikolić H, Bukvić N, Tomašić Z, Bosak A, Cicvarić T. Bone remodeling after supracondylar humeral fracture in children. Coll Antropol 2014;38:601-4.
9. Gamble JG, Vorhies JS. Remodeling of sagittal plane malunion after pediatric supracondylar humerus fractures. J Pediatr Orthop 2020;40:e903-9.
10. Ding BT, Wong KP. An unusual case of bilateral pediatric flexion-type supracondylar humeral fractures. Vis J Emerg Med 2022;29:101498.
11. Alanazi B, Fakeeha J, Pasha A, Alqulaiti H, Alharbi H, Mahmoud J. Bilateral supracondylar humerus fracture in pediatric after a fall on an outstretched hand. Case Rep Orthop 2019;2019:4893563.
12. Guo M, Xie Y, Su Y. Open reduction of neglected supracondylar humeral fractures with callus formation in children. J Pediatr Orthop 2020;40:e703-7.
13. Tiwari A, Kanojia RK, Kapoor SK. Surgical management for late presentation of supracondylar humeral fracture in children. J Orthop Surg (Hong Kong) 2007;15:177-82.

How to Cite this article: Jain D, Bhende J, More A, Agrawal T. Bilateral Supracondylar Humerus Fracture in an Infant – A Rare Case Report and Review of Literature. Journal of Clinical Orthopaedics July-December 2024;9(2):126-128.

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Atypical Presentation of Gout: Idiopathic Retrocalcaneal Pain in 400 Patients

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Journal of Clinical Orthopaedics | Vol 9 | Issue 2 |  July-December 2024 | page: 58-62 | Shivam Mehra, Nindiya Kapoor Mehra, Arvind J. Vatkar, Kamal Mehra, Bharat Veer Manchanda, Sachin Kale

DOI: https://doi.org/10.13107/jcorth.2024.v09i02.666

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2024; The Author(s).

Submitted Date: 05 Aug 2024, Review Date: 25 Aug 2024, Accepted Date: 11 Oct 2024 & Published Date: 10 Dec 2024

Author: Shivam Mehra [1], Nindiya Kapoor Mehra [1], Arvind J. Vatkar [2], Kamal Mehra [1], Bharat Veer Manchanda [3], Sachin Kale [4]

[1] Mehra Hospital and Research Institute, Lucknow, Uttar Pradesh, India,
[2] MGM Medical College, Nerul, Navi Mumbai, Maharashtra, India,
[3] Arthritis and Breast Care Centre, Kurukshetra, Haryana, India,
[4] Department of Orthopaedics, Dr D Y Patil School of Medicine, Nerul, Navi Mumbai, India

Address of Correspondence

Dr. Shivam Mehra,
Mehra Hospital and Research Institute, Lucknow – 226012, Uttar Pradesh, India.
E-mail: drshivammehra@gmail.com

Abstract

Introduction: Idiopathic retrocalcaneal pain is frequently linked to overuse injuries or inflammation around the Achilles tendon and surrounding bursae. However, systemic conditions such as gout, characterized by monosodium urate crystal deposition, can also present as retrocalcaneal pain. Gout commonly affects the first metatarsophalangeal joint, but atypical presentations like retrocalcaneal involvement are increasingly recognized. This study aims to assess the presentation, diagnosis, and treatment outcomes of gout in patients presenting with idiopathic retrocalcaneal pain.
Materials and Methods: This retrospective study analysed clinical data from 400 patients diagnosed with gout and presenting with idiopathic retrocalcaneal pain between 2019 and 2023 at a tertiary care centre. Diagnosis was based on clinical examination, serum uric acid levels, imaging, and in some cases, synovial fluid analysis. Patient demographics, diagnostic methods, and treatment outcomes, including pain (VAS) and functionality (FADI) scores, were evaluated.
Results: Of the 400 patients, 290 (72.5%) were male, and 110 (27.5%) were female, with a mean age of 56.8 ± 12.3 years. Pre-existing gout was present in 58% of patients, and serum uric acid levels were elevated in 75%. Synovial fluid analysis, performed in 65 patients, confirmed monosodium urate crystals in 92.3% of cases. Treatment resulted in significant reductions in pain (VAS: 7.8 ± 1.4 to 3.2 ± 1.1, p < 0.05) and improved functionality (FADI: 58.4 ± 5.7 to 85.7 ± 6.3). Recurrence of symptoms occurred in 25% of patients, particularly in those who did not adhere to urate-lowering therapy.
Conclusion: This study emphasizes the importance of considering gout in the differential diagnosis of idiopathic retrocalcaneal pain. Early diagnosis and appropriate management can lead to favourable outcomes and lower recurrence rates. Clinicians should remain vigilant for atypical presentations of gout to prevent prolonged discomfort and functional impairment.
Keywords: Idiopathic retrocalcaneal pain, gout, hyperuricemia, monosodium urate crystals, Achilles tendon, atypical gout, urate-lowering therapy

References

1. Duran E, Bilgin E, Ertenli Aİ, Kalyoncu U. The frequency of Achilles and plantar calcaneal spurs in gout patients. Turkish Journal of Medical Sciences. 2021;51(4):1841-8.
2. Sarkar D, Hoque TM. Association of High Serum Uric Acid with Retrocalcaneal Buristis. International Journal of Medical Science and Health Research. 2019;3(3):ISSN:2581-3366.
3. Yates B. The painful foot. Merriman’s Assessment of the Lower Limb. 3th. Ed. Edinburgh: Elsevier. 2009:469-98.
4. Aronow MS. Posterior heel pain (retrocalcaneal bursitis, insertional and noninsertional Achilles tendinopathy). Clinics in podiatric medicine and surgery. 2005;22(1):19-43
5. Pascual E, Sivera F. Time required for disappearance of urate crystals from synovial fluid after successful hypouricaemic treatment relates to the duration of gout. Annals of the rheumatic diseases. 2007 Aug 1;66(8):1056-8.
6. Sarkar¹ D, Hoque TM. Association of High Serum Uric Acid with Retrocalcaneal Buristis.

How to Cite this article: Mehra S, Mehra NK, Vatkar AJ, Mehra K, Manchanda BV, Kale S. Atypical Presentation of Gout: Idiopathic Retrocalcaneal Pain in 400 Patients. Journal of Clinical Orthopaedics July-December 2024;9(2):58-62.

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