Spine Symposium

Journal of Clinical Orthopaedics | Vol 7 | Issue 1 |  Jan-Jun 2022 | page: 2 | Dr. Ketan Badani, Dr. Kshitij Chaudhary

DOI: 10.13107/jcorth.2022.v07i01.455


Author: Dr. Ketan Badani [1], Dr. Kshitij Chaudhary [1]

[1] Department of Orthopaedics, PD Hinduja Hospital & Medical Research Centre, Mahim, Mumbai, India

Address of Correspondence
Dr. Kshitij Chaudhary,
Department of Orthopaedics, PD Hinduja Hospital & Medical Research Centre, Mahim, Mumbai, India.
Email: dr_kshitij.chaudhary@hindujahospital.com


Spine Symposium

Researchers have made tremendous advances in the knowledge surrounding the best practices and techniques and there has been an explosion of knowledge with regards variety of spine pathologies. There are newer insights and improvements in our understanding of diseases, radiological imaging, as well as surgical techniques. These advancements have helped us to improve outcomes and increase the safety in spine surgery.

This issue of the Journal of Clinical Orthopaedics carries a special spine symposium on various such clinical and technological advances in spine surgery. The articles provide current up to date evidence based review of common spinal problems encountered in practice. The focus of the symposium is on spinal tuberculosis, osteoporosis, trauma, spinal deformity imaging (EOS), and MIS surgeries for degenerative pathologies.

I hope the readers will find these well-researched articles useful to update their knowledge base regarding these spinal conditions.

Dr. Ketan Badani
Dr. Kshitij Chaudhary (Guest Editors)”


How to Cite this article: Badani K, Chaudhary K. Spine Symposium. Journal of Clinical Orthopaedics Jan-Jun 2022;7(1):2.

 


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Effective and Sustainable Syndesmotic Injury Repair using Endobutton and Fiber wire, in Bimalleolar Fractures

Journal of Clinical Orthopaedics | Vol 7 | Issue 1 |  Jan-Jun 2022 | page: 135-138 | Vaibhav J. Koli, Prakash D. Samant, Rohit M. Sane, Maitreya J. Patil, Pankaj K. Singh

DOI: 10.13107/jcorth.2022.v07i01.497


Author: Vaibhav J. Koli [1], Prakash D. Samant [1], Rohit M. Sane [1], Maitreya J. Patil [1], Pankaj K. Singh [1]

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

Address of Correspondence
Dr. Rohit M Sane,
Department of Orthopaedics, D Y Patil University School of Medicine, Nerul, Navi Mumbai, Maharashtra, India.
E-mail: dr.sanerohit@gmail.com


Abstract

Ankle fractures are the most frequent fractures accounting for 10% of all fractures, having an incidence of about 184/100,000 per year. Moreover, after external rotation or dorsiflexion injuries, syndesmotic disruption typically occurs at the ankle. The physiologic normality of the joint gets affected after a transverse syndesmotic screw fixation, which decreases the magnitude of motion at the lower extremes of the tibia and fibula, reducing contact forces between bones, and increasing stress on the crural interosseous membrane (which may lead to screw breakage). With this concern, we thus suggested to achieving a semi-rigid dynamic stabilization of the syndesmosis, using an endobutton and transosseous suture. We present a case of a 22-year-old active male who had a Lauge-Hansen pronation-abduction type injury. He was managed with an eight holes anatomical plate for lateral malleolus, two 65 mm CC screws with a washer for medial malleolus, and two endobuttons (one on the tibial and other on the fibular side) with transosseous sutures to provide stabilization of the syndesmosis. With this concern, we thus suggested achieving a semi-rigid dynamic stabilization of the syndesmosis, using an endobutton and transosseous suture; which can help in early mobilization, is cost effective, and prevent a second surgery for the removal of the syndesmotic screw.

Keywords: Endobutton, transosseous suture, suture anchor, syndesmotic injury, bimalleolar fractures


References

  1. Shibuya N, Davis ML, Jupiter DC. Epidemiology of foot and ankle fractures in the United States: An analysis of the National Trauma Data Bank (2007 to 2011). J Foot Ankle Surg 2014;53:606-8.
  2. Court-brown CM, Mcbirnie J, Wilson G. Adult ankle fractures: an increasing problem? Acta Orthop Scand 1998;69:43-7.
  3. Hsu RY, Lee Y, Hayda R, Digiovanni CW, Mor V, Bariteau JT. Morbidity and mortality associated with geriatric ankle fractures: A medicare Part A claims database analysis. J Bone Joint Surg Am 2015;97:1748-55.
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  5. Parlamas G, Hannon CP, Murawski CD, Smyth NA, Ma Y, Kerkhoffs GM, et al. Treatment of chronic syndesmotic injury: A systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc 2013;21:1931-9.
  6. Cha SD, Kwak JY, Gwak HC, Ha DJ, Kim JY, Kim UC, et al. Arthroscopic assessment of intra-articular lesion after surgery for rotational ankle fracture. Clin Orthop Surg 2015;7:490-6.
  7. Schepers T, van der Linden H, van Lieshout EM, Niesten DD, van der Elst M, et al. Technical aspects of the syndesmotic screw and their effect on functional outcome following acute distal tibiofibular syndesmosis injury. Injury 2014;45:775-9.
  8. van den Bekerom MP, Hogervorst M, Bolhuis HW, van Dijk CN. Operative aspect of the syndesmotic screw: Review of current concepts. Injury 2008;39:491-8.
  9. Schepers T. To retain or remove the syndesmotic screw: Areview of literature. Arch Orthop Trauma Surg 2011;131:879-83.
  10. Passias BJ, Korpi FP, Chu AK, Myers DM, Grenier G, Galos DK, et al. Safety of early weight bearing following fixation of bimalleolar ankle fractures. Cureus. 2020;12:e7557.
  11. Seitz WH Jr., Bachner EJ, Abram LJ, Postak P, Polando G, Brooks DB, et al. Repair of the tibiofibular syndesmosis with a flexible implant. J Orthop . Trauma 1991;5:78-82.
  12. Thornes B, Shannon F, Guiney AM, Hession P, Masterson E. Suture-button syndesmosis fixation: Accelerated rehabilitation and improved outcomes. Clin Orthop Relat Res 2005;431:207-12.
  13. Thornes B, Walsh A, Hislop M, Murray P, O’Brien M. Suture-endobutton fixation of ankle tibio-fibular diastasis: A cadaver study. Foot Ankle Int 2003;24:142-6.
  14. Yuen CP, Lui TH. Distal tibiofibular syndesmosis: Anatomy, biomechanics, injury and management. Open Orthop J 2017;11:670-7.
  15. Miller AN, Paul O, Boraiah S, Parker RJ, Helfet DL, Lorich DG. Functional outcomes after syndesmotic screw fixation and removal. J Orthop Trauma 2010;24:12-6.
  16. Moon YJ, Kim DH, Lee KB. Is it necessary to remove syndesmotic screw before weight-bearing ambulation? Medicine (Baltimore) 2020;99:e19436.
  17. Ræder BW, Stake IK, Madsen JE, Frihagen F, Jacobsen SB, Andersen MR, et al. Randomized trial comparing suture button with single 3.5 mm syndesmotic screw for ankle syndesmosis injury: Similar results at 2 years. Acta Orthop 2020;91:770-5.

 

How to Cite this article: Koli VJ, Samant PD, Sane RM, Patil MJ, Singh PK. Effective and Sustainable Syndesmotic Injury Repair using Endobutton and Fiber wire, in Bimalleolar Fractures Journal of Clinical Orthopaedics Jan-Jun 2022;7(1):135-138.

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Recent trends in foot and ankle orthopaedics for an Indian perspective

Journal of Clinical Orthopaedics | Vol 7 | Issue 1 |  Jan-Jun 2022 | page: 53-55 | Pascal DeNiese

DOI:10.13107/jcorth.2022.v07i01.469


Author: Pascal DeNiese [1]

[1] Department of Orthopaedics, Holy Spirit Hospital, Mumbai, Maharashtra, India.

Address of Correspondence
Dr. Pascal DeNiese,
Department of Orthopaedics, Holy Spirit Hospital, Mumbai, Maharashtra, India.
E-mail: drdeniese@gmail.com


Abstract

Foot and ankle orthopaedics in India is a rapidly growing and relatively new field being pursued by the Orthopaedic surgeon in view of the pateints recognizing the need for specialized treatment. The article attempts to guide the orthopaedic surgeon with a few commonly occurring conditions with evidence based medicine. This narrative review was performed following a literature search in the Pubmed database and Medline using the mentioned keywords. Related articles were then reviewed.

Keywords: Foot and ankle orthopaedics, Syndesmotic injuries, Ankle instability, Internal bracing, Standing CT Scans, Plantar fasciitis, Ankle arthroplasty, Ankle arthroscopy


References

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  3. Batra AV, Nicholson D, Rao P, Sullivan JO. Clinical outcomes of the open modified brostrom procedure with internal brace augmentation for lateral ankle instability. Orthop Muscular Syst 2018;7:257.
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  5. de Cesar Netto C, Schon LC, Thawait GK, da Fonseca LF, Chinanuvathana A, Zbijewski WB, et al. Comparison between weightbearing and nonweightbearing measurements using cone-beam computed tomography. J Bone Joint Surg Am 2017;99:e98.
  6. Johannsen FE, Herzog RB, Malmgaard-Clausen NM, Hoegberget-Kalisz M, Magnusson SP, Kjaer M. Corticosteroid injection is the best treatment in plantar fasciitis if combined with controlled training. Knee Surg Sports Traumatol Arthrosc 2019;27:5-12.
  7. Peerbooms JC, Lodder P, den Oudsten BL, Doorgeest K, Schuller HM, Gosens T. Positive effect of platelet-rich plasma on pain in plantar fasciitis: A double-blind multicenter randomized controlled trial. Am J Sports Med 2019;47:3238-46.
  8. Norvell DC, Ledoux WR, Shofer JB, Hansen ST, Davitt J, Anderson JG, et al. Effectiveness and safety of ankle arthrodesis versus arthroplasty: A prospective multicenter study. J Bone Joint Surg Am 2019;101:1485-94.
  9. Veljkovic AN, Daniels TR, Glazebrook MA, Dryden PJ, Penner MJ, Wing KJ, et al. Outcomes of total ankle replacement, arthroscopic ankle arthrodesis, and open ankle arthrodesis for isolated non-deformed end-stage ankle arthritis. J Bone Joint Surg Am 2019;101:1523-9.
  10. Blanco-Rivera J, Elizondo-Rodríguez J, Simental-Mendía M, Vilchez-Cavazos F, Peña-Martínez VM, Acosta-Olivo C. Treatment of lateral ankle sprain with platelet-rich plasma: A randomized clinical study. Foot Ankle Surg 2019;26:750-4.
  11. Rowden A, Dominici P, D’Orazio J, Manur R, Deitch K, Simpson S, et al. Double-blind, randomized, placebo-controlled study evaluating the use of platelet-rich plasma therapy (PRP) for acute ankle sprains in the emergency department. J Emerg Med 2015;49:546-51.
  12. Shah R, Bandikalla VS. Role of arthroscopy in various ankle disorders. Indian J Orthop 2021;55:333-41.
  13. Panikkar KV, Taylor A, Kamath S, Henry AP. A comparison of open and arthroscopic ankle fusion. Foot Ankle Surg 2003;9:169-72.

 

How to Cite this article: DeNiese P. Recent trends in foot and ankle orthopaedics for an Indian perspective. Journal of Clinical Orthopaedics Jan-Jun 2022;7(1):53-55.

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MIS-TLIF: Technical Note, Learning Goals behind Case Selection during Early Part of Learning Curve and Clinical Outcomes in First 150 Cases

Journal of Clinical Orthopaedics | Vol 7 | Issue 1 |  Jan-Jun 2022 | page: 85-93 | Umesh Srikantha, Parichay Perikal, Akshay Hari, Yadhu Lokanath, Deepak Somasundaram, Nirmala Subramaniam, Ravi Gopal Varma


Author: Umesh Srikantha [1], Parichay Perikal [1], Akshay Hari [1], Yadhu Lokanath [1], Deepak Somasundaram [1], Nirmala Subramaniam [1], Ravi Gopal Varma [1]

[1] Department of Neurosurgery, Aster CMI Hospital, Bengaluru, Karnataka, India

[2] Department of Neurosurgery, Ramaiah Medical College and Hospitals, Bengaluru, Karnataka, India

 

Address of Correspondence
Dr. Umesh Srikantha,
Department of Neurosurgery, Aster CMI Hospital, Bengaluru, Karnataka, India.
E-mail: umeshsrikantha@gmail.com


Abstract

Introduction: Minimally Invasive Transforaminal Lumbar Interbody Fusion (MIS-TLIF) has been shown to offer several advantages over conventional (open) TLIF and is being increasingly employed by young surgeons early in their careers. It is important to know the appropriate technique and the correct cases to be selected in the early phase to achieve good outcomes during the learning curve. A detailed and illustrative technical note along with a guide for case selection at different phases of experience has been presented in this article.

Methods: The first consecutive single surgeon series of 150 MIS-TLIF cases done over 4 years between 2012 and 2015 were considered for analysis. Demographic and peri-operative data and previously documented follow-up were collected from case records. Telephonic questionnaire and consultation were done to collect latest status, any procedures/surgeries done elsewhere for issues related to index procedure. Results were stratified as Group 1 – first 25 cases; Group 2 – 26–75 cases; Group 3 – 76–150 cases.

Results: The major indication for surgery in group 1 was either Grade 1 spondylolisthesis or lumbar canal stenosis with concomitant axial symptoms. The incidence of relatively complex cases (Grade 2 or 3 listhesis; Revision cases; Multilevel cases) increased with each successive group. As expected, the operative time (calculated for only single-level cases) improved with time. The overall rate of peri-operative complications was higher in group 2 as compared to groups 1 and 3, predominantly due to an increased incidence of intra-operative dural tears in group 2. Symptomatic screw malposition was detected in five screws, all were managed conservatively. The median duration of follow-up for the entire group was 39 months (Range – 1–119 months). Eighty-two (55%) patients had follow-up of more than 1 year while 31 (20.6%) patients had follow-up of more than 7 years. Around 80–85% of patients at each point of follow-up assessment had a successful outcome (McNab 4 and 5). The re-operation rate for index level problems or adjacent segment was 2.6%, only one of which was done at the author’s center.

Conclusions: Minimally invasive TLIF is a safe and effective procedure with favorable long-term results and acceptable complication rates. Though technically challenging in initial phases, a good understanding of the technique and principles of minimally invasive spine surgery along with fulfilling helpful pre-requisites and appropriate case selection as mentioned in this article, will help to smoothen the learning curve and avoid unfavorable outcomes in early stages.

Keywords: Minimally Invasive, transforaminal lumbar interbody fusion, learning curve, long-term outcome, case selection, minimally invasive transforaminal lumbar interbody fusion


References

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How to Cite this article: Srikantha U, Perikal P, Hari A, Lokanath Y, Somasundaram D, Subramaniam N, Varma RG. MIS-TLIF: Technical Note, Learning Goals behind Case Selection during Early Part of Learning Curve and Clinical Outcomes in First 150 Cases. Journal of Clinical Orthopaedics Jan-Jun 2022;7(1):85-93.

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Uncemented Total Knee Replacement – Rediscovering the Past

Journal of Clinical Orthopaedics | Vol 7 | Issue 1 |  Jan-Jun 2022 | page: 126-134 | Nandan N Rao, Abhishek Shashikant Patil, Kunal R Bansal

DOI: 10.13107/jcorth.2022.v07i01.495


Author: Nandan N Rao [1], Abhishek Shashikant Patil [2], Kunal R Bansal [3]

[1] Chief Consultant in Arthroscopy and Sports Medicine, Unity Hospital, Surat, Gujarat, India.
[2] Consultant Joint Replacement Surgeon, Joints for Life Clinic, Pune, Maharashtra, India.
[3] Consultant Joint Replacement Surgeon, Pune, Maharashtra, India.

 

Address of Correspondence
Dr. Abhishek Shashikant Patil,
203. Tower B. Downtown City vista, Fountain Road, Ashok Nagar, Kharadi – 411 014, Pune, Maharashtra, India.
E-mail: abhipatortho@gmail.com


Abstract

Total knee replacements (TKR) both cemented and uncemented were developed almost simultaneously in the 1980’s. Cemented TKR found favor among the surgeons due to its technical ease and early failure of uncemented TKR due to poor design. In the past two decades; however, interest has been generated in uncemented TKR both because of design improvements which, in turn, has led to better results, especially in young active, obese, and geriatric but active patients where cemented TKR’s have been found to have increased failure rates. Active research is ongoing to refine the designs of uncemented TKR and future holds promise for this re-emerging technique and implant. This review helps to summarize the reasons for increasing interest in uncemented TKR, the newer designs and their results and the future developments expected.

Keywords: Uncemented total knee replacement, cementless total knee replacement


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How to Cite this article: Patil AS, Rao NN, Bansal KR. Uncemented Total Knee Replacement-Rediscovering the Past. Journal of Clinical Orthopaedics Jan-Jun 2022;7(1):126-134.

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Current Trends in Degenerative Cervical Myelopathy

Journal of Clinical Orthopaedics | Vol 7 | Issue 1 |  Jan-Jun 2022 | page: 9-19 | Nandan Marathe, Shivakumar Bali, Rudra Prabhu, Harsh Agarwal, Atif Naseem, Akash Shakya, Ayush Sharma

DOI:10.13107/jcorth.2022.v07i01.459


Author: Nandan Marathe [1], Shivakumar Bali [2], Rudra Prabhu [3], Harsh Agarwal [4], Atif Naseem [4], Akash Shakya [4], Ayush Sharma [4]

[1] Department of Orthopaedics, Consultant Spine Surgeon, Chaitanya Spine Clinic, India

[2] Department of Orthopaedics, ASSI Spine Fellow, Stavya Spine Hospital and Research Institute, India

[3] Department of Orthopaedics, Lokmanya Tilak Municipal Medical College and General Hospital, India

[4] Department of Orthopaedic and Spine surgery Dr. Babasaheb Ambedkar Central Railway Hospital, India

 

Address of Correspondence
Dr. Ayush Sharma- D. Ortho, DNB, MS, Dip SICOT,
Department of Orthopaedic and Spine Surgery, Dr. Babasaheb Ambedkar Central Railway Hospital, Pune, India.
E-mail: drayush@gmail.com


Abstract

Advances in patient selection, surgical techniques, and postoperative care have facilitated spine surgeons to manage complex spine cases with shorter operative times, reduced hospital stay and improved outcomes. We focus this article on a few areas which have shown maximum developments in management of degenerative cervical myelopathy and also throw a glimpse into the future ahead. Imaging modalities, surgical decision making, robotics and neuro-navigation, minimally invasive spinal surgery, motion preservation, use of biologics are few of them. Through this review article, we hope to provide the readers with an insight into the present state of art in cervical myelopathy and what the future has in store for us.

Keywords: Cervical myelopathy, DTI, ADR, hybrid, laminoplasty, JOA


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How to Cite this article: Marathe N, Bali S, Prabhu R, Agarwal H, Naseem A, Shakya A, Sharma A. Current Trends in Degenerative Cervical Myelopathy. Journal of Clinical Orthopaedics Jan-Jun 2022;7(1):9-19.

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Posterolateral Approach to the Thoracic Spine for Spinal Tuberculosis: A Technical Note and an Analysis of Results

Journal of Clinical Orthopaedics | Vol 7 | Issue 1 |  Jan-Jun 2022 | page: 40-46 | Gautam Zaveri

DOI:10.13107/jcorth.2022.v07i01.465


Author: Gautam Zaveri 

[1] Department of Spine Surgery, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India

 

Address of Correspondence
Dr. Gauta Zaveri,
Department of Spine Surgery, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India.
E-mail: gautamzaveri1969@gmail.com


Abstract

Surgical pathologies in the thoracic spine are principally located anteriorly within the vertebral body resulting in vertebral body destruction, kyphotic deformity, and anterior or anterolateral compression of the spinal cord. Adequate decompression of the neural elements and vertebral body reconstruction requires access to the anterior spinal column. The posterolateral approach through a posterior midline incision allows circumferential spinal cord decompression, anterior column reconstruction, correction of thoracic kyphosis, and posterior spinal stabilization to be safely performed through a single incision, at a single sitting with excellent outcomes.

Keywords: Thoracic spine tuberculosis, Posterolateral approaches, Transpedicular approach, Costotransversectomy approach


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  15. Rajasekaran S, Soundarapandian S. Progression of kyphosis in tuberculosis of the spine treated with anterior arthrodesis. J Bone Joint Surg Am 1989;71:1314-23.
  16. Moon MS, Woo YK, Lee KS, Ha KY, Kim SS, Sun DH. Posterior instrumentation and anterior interbody fusion for tuberculous kyphosis of dorsal and lumbar spines. Spine (Phila Pa 1976) 1995;20:1910-6.
  17. Yilmaz C, Selek HY, Gurkan I, Erdemli B, Korkusuz Z. Anterior instrumentation for the treatment of spinal tuberculosis. J Bone
    Joint Surg Am 1999;81:1261-7.
  18. Lubelski D, Abdullah KG, Steinmetz MP, Masters F, Benzel EC, Mroz TE, et al. Lateral extracavitary, costotransversectomy, and transthoracic thoracotomy approaches to the thoracic spine: Review of techniques and complications. J Spinal Disord Tech 2013;26:222-32.
  19. Hardaker WT, Cook WA Jr., Friedman AH, Fitch RD. Bilateral transpedicular decompression and Harrington rod stabilization in the management of severe thoracolumbar burst fractures. Spine (Phila Pa 1976)1992;17:162-71.
  20. Stillerman CB, Chen TC, Day JD, Couldwell WT, Weiss MH. The transfacet pedicle-sparing approach for thoracic disc removal: Cadaveric morphometric analysis and preliminary clinical experience. J Neurosurg 1995;83:971-6.
  21. Zhang P, Peng W, Wang X, Luo C, Xu Z, Zeng H, et al. Minimum 5 year follow up outcomes for single stage transpedicular debridement, posterior instrumentation and fusion in the management of thoracic and thoracolumbar spinal tuberculosis in adults. Br J Neurosurg 2016;30:613-20.
  22. Garg B, Kandwal P, Nagraja UB, Goswami. A, Jayaswal A. Anterior versus posterior for surgical treatment of thoracolumbar tuberculosis. Indian J Orthop 2012;46:165-70.

 

How to Cite this article: Zaveri G. Posterolateral Approach to the Thoracic Spine for Spinal Tuberculosis: A Technical Note and an Analysis of Results. Journal of Clinical Orthopaedics Jan-Jun 2022;7(1):40-46.

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Editorial for WIROC 22 Issue

Journal of Clinical Orthopaedics | Vol 7 | Issue 1 |  Jan-Jun 2022 | page: 1 | Dr. Nicholas Antao, Dr. Ashok Shyam

DOI: 10.13107/jcorth.2022.v07i01.453


Author: Dr. Nicholas Antao [1], Dr. Ashok Shyam [2]

[1] Department of Orthopaedics, Hill Way Clinic, Hill N Dale Building, 4th Floor, Hill Road, Bandra West, Mumbai, Maharashtra, India
[2] Department of Orthopaedics, Sancheti Institute for Orthopaedics and Rehablitation, Pune, India

Address of Correspondence
Dr. Nicholas Antao
Head of Department of Orthopaedics, Holy Spirit Hospital, Mahakali Road, Andheri (E), Mumbai – 400093, Maharashtra, India.
Email: narantao@gmail.com


Editorial for WIROC 22 Issue

The 2019 WIROC issue featured the first symposium on surgical site infections, spearheaded by Dr. Gautam Zaveri. Our symposium in the 2022 WIROC issue, the brainchild of Dr. Vishall Kundnani and team, features a special on spine pathology. It has contributions from stalwarts of spinal surgery all over India in the form of case reports, review articles, original articles, imaging and diagnostic tests, meta-analysis, arthroscopy-assisted spinal surgery, and current trends in spinal surgery. It provides insight into the challenges associated with the diagnosis and management of various spinal ailments, which can cause our patients significant distress.

Our four guest editorials include heart-warming messages from Dr. S. Gawhale, Bombay Orthopedic Society President, Dr. Kushall Kundnani, Dr. K. Badani, and Dr. Kshitij Chaudhary. We are fortunate that Dr. Bhaskar Anand, winner of Indian Society of Hand Surgery Award for lifetime achievement, has contributed his rich experience in dealing with CLUB hand. We feature a highly informative review article on management of the 1st time shoulder dislocators as well as an inspiring research article on newer concepts in the 1st time patellar dislocators. An original article summarizing the technique of Arthroscopic Latarjet management of shoulder instability is particular enlightening as it simplifies a difficult surgery in a succinct manner.

The landscape of joint replacement surgery is ever changing with newer techniques of uncemented knee joint replacement receiving positive reviews in meta-analyses. Therefore, we have also featured an article on cementless knee replacement, which is an eye opener to the progress of science and technology. An article on the severity of violence of irate patient relatives toward doctors is frightening, but thought provoking. It guides the reader on how to take various preventive measures when faced with aggression and violence. The role of ultrasonography of the hip reveals how hip pathologies can be identified in their infancy, especially in the neonatal setting. Finally, a potpourri of articles in trauma of the foot and ankle is both stimulating and informative.

I am certain our readers will be enriched by the information discussed in this issue and utilize the knowledge gained to provide the
best evidence-based care to their patients.

Dr. Nicholas Antao.
Dr. Ashok Shyam.


How to Cite this article: Antao N, Shyam AK. Editorial for WIROC 22 Issue. Journal of Clinical Orthopaedics Jan-Jun 2022;7(1):1.


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EOS – A new frontier in spine imaging

Journal of Clinical Orthopaedics | Vol 7 | Issue 1 |  Jan-Jun 2022 | page: 3-8 | Bhavuk Garg, Pulak Vatsya

DOI: 10.13107/jcorth.2022.v07i01.457


Author: Bhavuk Garg [1], Pulak Vatsya [1]

[1] Department of Orthopedics, All India Institute of Medical Sciences, New Delhi, India

 

Address of Correspondence
Dr. Bhavuk Garg,
Department of Orthopedics, All India Institute of Medical Sciences, New Delhi, India.
E-mail: drbhavukgarg@gmail.com


Abstract

EOS is a new tool in the armamemtarium of orthopedicians. Its ability to give a standing 3 dimesnionla image of the spine, has made it an indespenisble tool, specially for spine surgeons. Scoliosis is a 3 dimesnional deformity with multiple compensatory mechanisms being applied at the level of the pelvis and lower limbs as well as in spine. Operating on such patients needs thorough understanding of the 3D anatomy. EOS, provides this along with its low radiation dose, quick scan time and ability to repeat test multiple times if needed. The uses of this modality is on the rise, and as awareness and accessibility to EOS increases, so will the diversity of uses of this tool. Spine surgeons need to understand and use EOS for planning of their surgeries more compared to orther specializations of orthopaedics. EOS is truly a game-changer for spine imaging.

Keywords: EOS, 3dimesnional scans, scoliosis surgery, spine radiographs, novel methods


References

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  2. Wybier M, Bossard P. Musculoskeletal imaging in progress: The EOS imaging system. J Bone Spine 2013;80:238-43.
  3. Melhem E, Assi A, El Rachkidi R, Ghanem I. EOS (®) biplanar X-ray imaging: Concept, developments, benefits, and limitations. J Child Orthop 2016;10:1-14.
  4. Garg B, Mehta N, Bansal T, Malhotra R. EOS® imaging: Concept and current applications in spinal disorders. J Clin Orthop Trauma 2020;11:786-93.
  5. Al-Aubaidi Z, Lebel D, Oudjhane K, Zeller R. Three-dimensional imaging of the spine using the EOS system: Is it reliable? A comparative study using computed tomography imaging. J Pediatr Orthop B 2013;22:409-12.
  6. Delin C, Silvera S, Bassinet C, Thelen P, Rehel JL, Legmann P, et al. Ionizing radiation doses during lower limb torsion and anteversion measurements by EOS stereoradiography and computed tomography. Eur J Radiol 2014;83:371-7.
  7. Luo TD, Stans AA, Schueler BA, Larson AN. Cumulative radiation exposure with EOS imaging compared with standard spine radiographs. Spine Deform 2015;3:144-50.
  8. Vidal C, Ilharreborde B, Azoulay R, Sebag G, Mazda K. Reliability of cervical lordosis and global sagittal spinal balance measurements in adolescent idiopathic scoliosis. Eur Spine J 2013;22:1362.
  9. Newton PO, Fujimori T, Doan J, Reighard FG, Bastrom TP, Misaghi A. Defining the “three-dimensional sagittal plane” in thoracic adolescent idiopathic scoliosis. J Bone Joint Surg Am 2015;97:1694-701.
  10.  Parvaresh KC, Osborn EJ, Reighard FG, Doan J, Bastrom TP, Newton PO. Predicting 3D thoracic kyphosis using traditional 2D radiographic measurements in adolescent idiopathic scoliosis. Spine Deform 2017;5:159-65.
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  12. Ferrero E, Mazda K, Simon AL, Ilharreborde B. Preliminary experience with SpineEOS, a new software for 3D planning in AIS surgery. Eur Spine J 2018;27:2165-74.
  13.  Lau LC, Hung AL, Chau WW, Hu Z, Kumar A, Lam TP, et al. Sequential spine-hand radiography for assessing skeletal maturity with low radiation EOS imaging system for bracing treatment recommendation in adolescent idiopathic scoliosis: A feasibility and validity study. J Child Orthop 2019;13:385-92.
  14. Somoskeöy S, Tunyogi-Csapó M, Bogyó C, Illés T. Accuracy and reliability of coronal and sagittal spinal curvature data based on patient-specific three-dimensional models created by the EOS 2D/3D imaging system. Spine J 2012;12:1052-9.
  15.  Ilharreborde B, Ferrero E, Alison M, Mazda K. EOS microdose protocol for the radiological follow-up of adolescent idiopathic scoliosis. Eur Spine J 2016;25:526-31.
  16. Ilharreborde B, Dubousset J, Skalli W, Mazda K. Spinal penetration index assessment in adolescent idiopathic scoliosis using EOS low-dose biplanar stereoradiography. Eur Spine J 2013;22:2438-44.
  17. Wade R, Yang H, Mckenna C, Faria R, Gummerson N, Woolacott N. Asystematic review of the clinical effectiveness of EOS 2D/3D X-ray imaging system. Eur Spine J 2013;22:296-304.
  18. Hirsch C, Ilharreborde B, Mazda K. EOS suspension test for the assessment of spinal flexibility in adolescent idiopathic scoliosis. Eur Spine J 2015;24:1408-14.
  19. Labelle H, Aubin CE, Jackson R, Lenke L, Newton P, Parent S. Seeing the spine in 3D: How will it change what we do? J Pediatr Orthop 2011;31 Suppl 1:S37-45.
  20. Le Huec JC, Demezon H, Aunoble S. Sagittal parameters of global cervical balance using EOS imaging: Normative values from a prospective cohort of asymptomatic volunteers. Eur Spine J 2015;24:63-71.
  21. Haidekker MA, Andresen R, Werner HJ. Relationship between structural parameters, bone mineral density and fracture load in lumbar vertebrae, based on high-resolution computed tomography, quantitative computed tomography and compression tests. Osteoporos Int 1999;9:433-40.
  22. Sapin-De Brosses E, Jolivet E, Travert C, Mitton D, Skalli W. Prediction of the vertebral strength using a finite element model
    derived from low-dose biplanar imaging: Benefits of subject-specific material properties. Spine (Phila Pa 1976)
    2012;37:E156-62.
  23.  Sapin E, Briot K, Kolta S, Gravel P, Skalli W, Roux C, et al. Bone mineral density assessment using the EOS low-dose X-ray device: A feasibility study. Proc Inst Mech Eng H 2008;222:1263-71.
  24. Moltó A, Freire V, Feydy A, Paternotte S, Maksymowych WP, Benhamou M, et al. Assessing structural changes in axial spondyloarthritis using a low-dose biplanar imaging system. Rheumatology 2014;53:1669-75.
  25.  Illés T, Tunyogi-Csapó M, Somoskeöy S. Breakthrough in three-dimensional scoliosis diagnosis: Significance of horizontal plane view and vertebra vectors. Eur Spine J 2011;20:135-43.
  26. McKenna C, Wade R, Faria R, Yang H, Stirk L, Gummerson N, et al. EOS 2D/3D X-ray imaging system: A systematic review and economic evaluation. Health Technol Assess 2012;16:1-188.
  27. Bouloussa H, Dubory A, Seiler C, Morel B, Bachy M, Vialle R. A radiolucent chair for sitting-posture radiographs in  non-ambulatory children: Use in biplanar digital slot-scanning. Pediatr Radiol 2015;45:1864-9.
  28.  Faria R, McKenna C, Wade R, Yang H, Woolacott N, Sculpher M. The EOS 2D/3D X-ray imaging system: Acost-effectiveness analysis quantifying the health benefits from reduced radiation exposure. Eur J Radiol 2013;82:e342-9.

How to Cite this article: Garg B, Vatsya P. EOS – A New Frontier in Spine Imaging. Journal of Clinical Orthopaedics Jan-Jun 2022;7(1):3-8.

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Citizens Make Cities

Journal of Clinical Orthopaedics | Vol 7 | Issue 1 |  Jan-Jun 2022 | page: 139-142 | Sandeep Kelshikar, Lata Ghanshamnani, Leena Kelshikar

 DOI:10.13107/jcorth.2022.v07i01.499


Author: Sandeep Kelshikar [1], Lata Ghanshamnani [2], Leena Kelshikar [3]

[1] Department of Orthopaedics, Dr Kelshikar’s Orthopaedic Hospital, Thane, India

[2] DOMS Ophthalmology, Senses Eye & ENT Hospital, Thane, India

[3] Anaesthesiology, Dr Kelshikar’s Orthopaedic hospital, Thane, India

Address of Correspondence
Dr. Sandeep Kelshikar,
Department of Orthopaedics, Dr Kelshikar’s Orthopaedic Hospital, Thane, India.
Email: kelshikarshospital@gmail.com


Citizens Make Cities

A smart & sustainable city is built by active participation of its citizens. Ever growing cities need efficient resource management.

We doctors are trained to deliver our best with limited resources at our disposal. Medical training enables us to analyze, priorities and design out of the box solutions to give best results in toughest situations.

So as doctors when we started a not for profit organization, RNisarg foundation we knew we would be able to give our best.
With the vision to make cities livable, focus area chosen were:

• Waste
• Road safety

Both issues have deep rooted connect with planet health and thereby human health. At RNisarg Foundation, innovative projects are designed to bring unknowingly right behavioral change in society. Basic right to clean air, water and soil are worked on through awareness and working tools for the citizens to live by.

 

Founders
Dr. Lata Ghanshamnani, MS, DNB, DOMS

Dr. Leena Kelshikar, MBBS, D.A

Dr. Veena Angadi, M.Sc, M.Phil

Dr. Sandeep Kelshikar MS, D. Ortho

Dr. Kamal Ghanshamnani, MS

 


How to Cite this article: Kelshikar S, Ghanshamnani L, Kelshikar L. Citizens make Cities. Journal of Clinical Orthopaedics Jan-Jun 2022;7(1):139-142.

 


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