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Editorial for WIROC 22 Issue

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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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Citizens Make Cities

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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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Clinical Outcome of Patella Stability after Fixation of Osteochondral Fracture in Acute Primary Traumatic Patella Dislocation Without MPFL Repair or Reconstruction

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Journal of Clinical Orthopaedics | Vol 7 | Issue 1 |  Jan-Jun 2022 | page: 110-115 | Mukesh Laddha, Anshul Pancholiya, Sahu Gaurav

DOI: 10.13107/jcorth.2022.v07i01.489

Author: Mukesh Laddha [1], Anshul Pancholiya [2], Sahu Gaurav [3]

[1] Department of Robotic Joint Replacement and Arthroscopy, RNH Hospital, Nagpur, Maharashtra, India.
[2] Department of Adult Reconstruction and Sports Medicine, RNH Hospital, Nagpur, Maharashtra, India.
[3] Department of Orthopaedic Surgery, Dhamtari Christian Hospital, Dhamtari, Chhattisgarh, India.

 

Address of Correspondence
Dr. Mukesh Laddha,
Department of Robotic Joint Replacement and Arthroscopy, RNH Hospital, Balraj Marg, Dhantoli, Nagpur, Maharashtra, 440012, India.
E-mail: drmsl1812@gmail.com

Abstract

Introduction: Conservative management is advisable for acute primary traumatic patella dislocation (PTPD). Surgical treatment is reserved for osteochondral fractures (OCF), medial patello femoral ligament (MPFL) avulsion/tear, compound injuries, and any underlying bony abnormalities requiring correction. MPFL repair (at avulsed site) or reconstruction along with underlying bony correction in PTPD is controversial. The purpose of this study is to evaluate patella stability after fixation of OCF in PTPD without performing MPFL repair or reconstruction, even in the presence of any underlying bony abnormalities.

Material and Methods: This is a retrospective study of eight patients who had PTPD with OCF along with MPFL injury who presented between 2016 and 2019. Pre-operative X-rays and MRI were done to assess the status of MPFL, identify the presence of OCF and to calculate Insall-Salvati index, Tibial Tuberosity-Trochlear groove distance and Trochlear dysplasia. All patients underwent surgery by open approach and OCF fixation by bioabsorbable pins or suture material. MPFL was neither repaired at avulsed site nor reconstructed and even no bony corrections were done.

Results: Average size of OCF fragments is 15*7 mm and all involving medial facet of patella. Lysholm score improved significantly from 32.8 to 94.8 and Kujala score from 49.1 to 96 at the end of 6 months. None of the patient had patella instability till latest follow-up, average follow-up period is 4.5 years (3–6 years). Clinically, apprehension test was negative in all cases with full ROM. Post-operative imaging including X-ray and MRI showed complete healing of the OCF along with complete healing/regeneration of MPFL with same pre-existing bony abnormalities if present preoperatively.

Conclusion: This study shows excellent patella stability and full knee function along with complete union of OCF and complete healing/regeneration of MPFL in PTPD even in the presence of underlying bony abnormality. Hence, in PTPD with OCF, there is no need to repair/reconstruct MPFL or to correct underlying bony pathology, only OCF fixation is required.

Keywords: Patella dislocation, traumatic osteochondral fracture, medial patello femoral ligament, Lysholm and Kujala score

References

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How to Cite this article: Laddha M, Pancholiya A, Gaurav S. Clinical outcome of patella stability after fixation of osteochondral fracture in acute primary traumatic patella dislocation without MPFL repair or reconstruction. Journal of Clinical Orthopaedics Jan-Jun 2022;7(1):110-115.

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A systematic review and meta-analysis: Postoperative outcome comparison of intramedullary nailing and external fixation in charcot neuroarthropathy

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Journal of Clinical Orthopaedics | Vol 7 | Issue 1 |  Jan-Jun 2022 | page: 60-63 | Cok Gde Oka Dharmayuda, Dewa Gede Bracika, Kenji Arnaya, Sri Mahadana, Putu Teguh Aryanugraha, Benedictus Deriano, Nariswati Anggapadmi Wiraputri, I Ketut Gede Surya Pranata

DOI:10.13107/jcorth.2022.v07i01.473

Author: Cok Gde Oka Dharmayuda [1], Dewa Gede Bracika [2], Kenji Arnaya [2], Sri Mahadana [2], Putu Teguh Aryanugraha [2], Benedictus Deriano [2], Nariswati Anggapadmi Wiraputri [2], I Ketut Gede Surya Pranata [2]

[1] Consultant of Orthopaedic and Traumatogy Department, Faculty of Medicine Udayana University, Indonesia.

[2] Resident of Orthopaedic and Traumatogy Department, Faculty of Medicine Udayana University, Indonesia.

Address of Correspondence
Dr. Cok Gde Oka Dharmayuda,
Diponegoro St., Dauh Puri Klod, Kec. Denpasar Bar., Kota Denpasar, Bali 80113, Indonesia.
E-mail: suthenoandrew@gmail.com

Abstract

Charcot neuropathic osteoarthropathy or neuroarthropathy of the foot and ankle is due to sensory and motor neuropathies which lead to a chronic and progressive destruction of the foot architecture involving bones, joints, and soft tissues. The aim of the present study was to compare the results of EF and retrograde IMN in ankle arthrodesis for patients with Charcot neuroarthropathy of the ankle joint. This study conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement. Literature Search was done on using the databases of PubMed, EMBASE, and Cochrane Library were systematically retrieved. From the selected databases, 205 references were obtained. By screening the titles and abstracts, 48 references were excluded The remaining potentially relevant 12 studies underwent a detailed and comprehensive evaluation. Finally, five studies were included in our meta-analysis. Based on the report in this meta-analysis, IMN could showed better results compared to EF for Charcot joint arthrodesis, with IMN showing higher rate of fusion, and lesser risk of complication.

Keywords: Systematic Review, Meta-analysis, Charcot Neuroarthropathy, Intramedullary Nailing, External Fixation

References

  1. Yammine K, Assi C. Intramedullary nail versus external fixator for ankle arthrodesis in Charcot neuroarthropathy: A meta-analysis of comparative studies. J Orthop Surg (Hong Kong) 2019;27:1-7.
  2. Cianni L, Bocchi MB, Vitiello R, Greco T, de Marco D, Masci G, et al. Arthrodesis in the Charcot foot: A systematic review. Orthop Rev (Pavia) 2020;12 Suppl 1:8670.
  3. Dayton P, Feilmeier M, Thompson M, Whitehouse P, Reimer RA. Comparison of complications for internal and external fixation for charcot reconstruction: A systematic review. J Foot Ankle Surg 2015;54:1072-5.
  4. Almaadany FS, Samadov E, Namazov I, Jafarova S, Ramshorst GH, Pattyn P, et al. Mortality and pulmonary complications in patients undergoing surgery with perioperative sars-cov-2 infection: An international cohort study. Lancet 2020;396:27-38.
  5. Devries JG, Berlet GC, Hyer CF. A retrospective comparative analysis of charcot ankle stabilization using an intramedullary rod  with or without application of circular external fixator-utilization of the retrograde arthrodesis intramedullary nail database. J  Foot Ankle Surg 2012;51:420-5.
  6. Ettinger S, Plaass C, Claassen L, Stukenborg-Colsman C, Yao D, Daniilidis K. Surgical management of charcot deformity for the  Foot and ankle-radiologic outcome after internal/external fixation. J Foot Ankle Surg 2016;55:522-8.
  7. Richman J, Cota A, Weinfeld S. Intramedullary nailing and external ring fixation for tibiotalocalcaneal arthrodesis in charcot arthropathy. Foot Ankle Int 2017;38:149-52.
  8. Elalfy B, Ali AM, Fawzy SI. Ilizarov external fixator versus retrograde intramedullary nailing for ankle joint arthrodesis in diabetic charcot neuroarthropathy. J Foot Ankle Surg 2017;56:309-13.

 

How to Cite this article: Dharmayuda CGO, Bracika DG, Arnaya K, Mahadana S, Aryanugraha PT, Deriano B, Wiraputri NA, Pranata IKGS. A systematic review and meta-analysis: Postoperative outcome comparison of intramedullary nailing and external fixation in charcot neuroarthropathy. Journal of Clinical Orthopaedics Jan-Jun 2022;7(1):60-63.

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Thoracolumbar kyphosis in siblings of Mucopolysaccharidosis: A case report

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Journal of Clinical Orthopaedics | Vol 7 | Issue 1 |  Jan-Jun 2022 | page: 116-121 | Sharvin Sheth, Amit Jhala

DOI: 10.13107/jcorth.2022.v07i01.491

Author: Sharvin Sheth [1], Amit Jhala [1]

[1] Department of Spine Surgery, HCG Hospitals, Ahmedabad – 380006, India

 

Address of Correspondence
Dr. Amit Jhala,
Consultant Spine Surgeon and Chief, Department. of Spine Surgery, HCG Hospitals, Mithakali 6-roads, Ahmedabad, 380006, India.
E-mail: acjhala@gmail.com

Abstract

Mucopolysaccharidosis (MPS) is a group of inherited metabolic disorders caused due to abnormal storage of mucopolysaccharides in different tissues of the body. They are autosomal recessive disorders, except MPS II which has an X-linked recessive pattern. Musculoskeletal manifestations occur due to disturbance in bone remodeling and improper development of ossification centers. Thoracolumbar kyphosis is the most common spinal pathology resulting from abnormal vertebral end plate ossification and growth arrest as well as hypotonia and spinal musculature imbalance. The increased life span as a result of medical treatment and lack of osseous penetration of enzyme replacement has raised the issue of thoracolumbar dysplasia and resultant deformity. Here, we discuss a case report of progressive thoracolumbar spinal deformity in two siblings suffering from MPS who underwent spine deformity correction surgeries, and literature review for the same.

Keywords: Mucopolysaccharidosis, spine deformity, scoliosis correction

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How to Cite this article: Sheth S, Jhala A. Thoracolumbar Kyphosis in Siblings of Mucopolysaccharidosis: A Case Report.. Journal of Clinical Orthopaedics Jan-Jun 2022;7(1):116-121.

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Navigate and Succeed: MI-Transforminal Lumbar Interbody Fusion with Three-Dimensional Navigation

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Journal of Clinical Orthopaedics | Vol 7 | Issue 1 |  Jan-Jun 2022 | page: 28-39 | Arvind G Kulkarni, Pradhyumn Rathi, Pritem A Rajamani

DOI:10.13107/jcorth.2022.v07i01.463

Author: Arvind G Kulkarni [1], Pradhyumn Rathi [1], Pritem A Rajamani [1]

[1] Mumbai Spine Scoliosis and Disc Replacement Centre, Bombay Hospital, Mumbai, Maharashtra, India

Presented work performed at Saifee Hospital, Mumbai, India

Address of Correspondence
Dr. Arvind G Kulkarni,
Mumbai Spine Scoliosis and Disc Replacement Centre, Bombay Hospital, Mumbai, Maharashtra, India.
E-mail: drarvindspines@gmail.com

Abstract

Introduction: Lumbar Interbody Fusion (TLIF) has become a popular technique for achieving segmental interbody fusion and minimal access approach has its advantages. We have described the various Components in Spine Navigation Systems and how they have evolved in time and also describing our technique in detail. We have discussed on the advantages and disadvantages of the minimal access and use of Navigation.

Method: The authors ventured to assess the impact of 3D navigation in 117 patients that were treated with single level 3D navigated MI-TLIF in evaluating, Navigation setting time , Radiation exposure, Disc space preparation, Cage placement, Accuracy of pedicle screw placement, Cranial facet violation and Evaluation of canal decompression.

Result: Total time taken for setting up of navigation was 46.65±9.45 min. Average Radiation exposure was 5.69 mSv. In our study, the amount of disc removed was 75% in the ipsilateral anterior, 81% in ipsilateral posterior, 63% in contralateral anterior and 43% in contralateral posterior quadrants. The cage position was central in 87 patients, contralateral antero-central in six patients and ipsilateral postero-central in eight patients. The mean intraoperative blood loss was 89.65 ± 23.67 ml. Regarding accuracy 95.6% showed grade 0 and 4.4% had Grade 1 pedicle breach. Only 25 out of 408 pedicle screws (6.1%) violated the cranial facet joint. The navigation array probe was utilized to verify the adequacy of decompression and to confirm the anatomical landmarks. In our study, no surgical site infection was seen.

Conclusion: We find MIS to be associated with less post-operative infection rates as compared to open techniques. With 3D navigation, MIS becomes safer and highly accurate. MIS-TLIF with 3D navigation have satisfactory clinical outcomes and fusion rates with the additional benefits of less initial postoperative pain, less blood loss, earlier rehabilitation, and shorter hospitalization. MIS–TLIF with 3D navigation is a more cost-effective treatment than MIS-TLIF with fluoroscopy.

Keywords: Lumbar Vertebrae, Minimally Invasive Surgical Procedures, Neuronavigation, Spinal Fusion

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How to Cite this article: Kulkarni AG, Rathi P, Rajamani PA. Navigate and Succeed: MI-Transforminal Lumbar Interbody Fusion with Three-Dimensional Navigation. Journal of Clinical Orthopaedics Jan-Jun 2022;7(1):28-39.

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Suprascapular Neuropathy

/in , /by

Journal of Clinical Orthopaedics | Vol 6 | Issue 2 |  Jul-Dec 2021 | page: 23-31 | Rahul Singh, Ashish Babhulkar

Author: Rahul Singh [1], Ashish Babhulkar [1]

[1] Department of Shoulder and Sports Injuries, Deenanath Mangeshkar Hospital, Pune, Maharashtra, India

Address of Correspondence
Dr. Rahul Singh,
Department of Shoulder and Sports Injuries, Deenanath Mangeshkar Hospital, Pune – 411 004, Maharashtra, India.
E-mail: rahulortho85@gmail.com

Abstract

Suprascapular neuropathy (SSN) is often missed or neglected. Although the occurrence is rare, it is for this reason that one needs to be aware of the correct clinical skill sets and investigations to nail the diagnosis. SSN pathologies are being diagnosed with increasing frequency in high probability groups like athletes, massive rotator cuff tear with fatty infiltration, labral tear and subsequent cyst formation. With better understanding of the pathology, management of SSN has also improved in recent decades. With the advancement in electrodiagnostic modalities, SSN can be more reliably diagnosed now. The article highlights the aetiology and the points of compression, clinical picture to trigger the need for an EMG and the results of Arthroscopic decompression.

Keywords: Suprascapular neuropathy, paralabral cyst, transverse scapular notch, spinoglenoid notch, peripheral neuropathy

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    85. Memon M, Kay J, Ginsberg L, Simunovic N, Bak K, Lapner P, et al. Arthroscopic management of suprascapular neuropathy of the shoulder improves pain and functional outcomes with minimal complication rates. Knee Surg Sports Traumatol Arthrosc 2018;26:240-66.
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Guest Editorial: Covid and Orthopaedics.

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Journal of Clinical Orthopaedics | Vol 6 | Issue 2 |  Jul – Dec 2021 | page: 1 | Dr. B. Shivashankar, Dr. Terrence Jose Jerome

Author: Dr. B. Shivashankar [1], Dr. Terrence Jose Jerome [1]

[1] Consultant Orthopaedic Surgeon and Traumatologist, Iyer Orthopaedic Centre, 103, Railway Lines, SOLAPUR- 413001, Maharashtra, India

Address of Correspondence
Dr. B Shivashankar,
Consultant Orthopaedic Surgeon and Traumatologist, Iyer Orthopaedic Centre, 103, Railway Lines, SOLAPUR- 413001, Maharashtra, India.
Email: drbshivashankar@gmail.com

Covid and Orthopaedics

It would be too early to say that we have surpassed COVID-19 and immature to say that we have conquered it. What would be apt is we learn from our experience and the sore failures that mellowed this pestilence. Many times, we have lost our dear and near ones.

Sometimes it flooded us with frustration, anger, and sadness over the virus and its powerful impact on our lives. But what surprises us is that the squirreling pandemic unified us to emerge more vibrant and optimistic. Also, we have seen a paradigm shift in outpatient consultations, elective operating procedures, and the beneficial use of telemedicine during such odd times.

Additionally, we focused our educational vibes on webinars and online discussion forums. Slowly we recuperated and excelled in all the stages of the pandemic and managed to live with it. The practice of medicine has taken its ordinary discourse and started its previous practicing style. The World Health Organization has efficiently wiped all the myth busters (HCQ, Ivermectin, bleach, antibiotics, vitamins, etc.) about the covid and illustratively narrated the safety norms (masks, sanitizers) [1].

Orthopedic surgeons’ practices have also resurged from the dreadful pandemic and its gloomy cower. As usual, we have started elective surgeries, found better ways to deliver healthcare, and formulated innovative action measures. This gave birth to more daycare surgeries and minimally invasive procedures, which could be the modern practice too. In the meanwhile, we always performed a standard pre-screening for COVID and efficiently treated all elective surgeries. We allocated more resources, segregated COVID-positive patients from the screening, and treated them at home quarantine/ dedicated facilities. Though fear was a deterrent, we performed all emergency procedures following pre and postoperative preventive measures.   

The webinars have been swapped to physical conferences and we are ready for a face-face meet. Various national and international conferences rejiggered into hybrid mode and encouraged in-person meetings, matching the standard safety norms. However, we are always cautious with time-tested quarantine, social distancing, wearing masks, and washing hands.

We need to focus on the future and have preferences in all aspects. The orthopaedics and allied specialty residents have spent most of their time in covid wards, managing the acute crises in hospitals and teaching institutions. It’s high time for us to redirect them to the orthopaedic units and spend time improving their patient care skills to become efficient independent budding surgeons. Notably, we must make dramatic arrangements for the residents and train them with an innovative curriculum. It’s time to roll up our sleeves, march forward metaphorically, get vaccinated, and persuade our colleagues and fellow citizens to get vaccine shots aiming for herd immunity. If not now, then when?

There has been few silver linings too due to the pandemic. The healthcare spending by government has increased by many folds and everyone is now aware of the importance of basic necessities like medicines, oxygen, ventilators, etc. Many new players who were not in healthcare industries earlier have jumped to manufacture ventilators, PPE Kits and other paraphernalia required in medical industry. Definitely over the years we shall have more indigenisation in the equipment required as well as better equipped hospitals. Over all we shall be more atmanirbhar or self-reliant as far as our health care industry is considered.

Though a return to pre-pandemic normalcy is a mire, for the destined future, our patients and we should continue wearing masks in the hospitals and follow WHO standard safety measures.

Future conferences encourage in-person meetings with mandatory vaccination. Virtual options can be kept for colleagues who are not vaccinated or unable due to various strong reasons. Widespread vaccination is the only specific or reliable method to assuage the fear and stop the raging virus.

As we have transited many waves of the pandemic, we must provide reassurance and promote vaccination and continued social distancing for the greater good of the public. We are still positive and looking ahead with sceptical and unpredictable reality in the coming years. At the same time, we humans are inheritably bound to personal touch and socialization.

We all know that freedom comes with risk, and long-lasting adaptations to the new future are necessary. Eliminating the virus and achieving herd immunity and returning to normalcy is the expected norm, but without risk, is there hope? We are all in together and have emerged more robust than ever in combating this virus.

 

Reference

  1. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks (Last accessed on 6th November 2021).
How to Cite this article: Shivashankar B, Jerome TJ. Covid and Orthopaedics. Journal of Clinical Orthopaedics Jul-Dec 2021;6(2):1.

 

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En bloc Extraction Technique in Total Hip Arthroplasty for Avascular Necrosis Treated with Non-vascular Fibular Autografts

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Journal of Clinical Orthopaedics | Vol 6 | Issue 2 |  Jul-Dec 2021 | page: 32-34 | Vikram I Shah, Javahir A Pachore, Gautam M Shetty, Amish Kshatriya, Ashish Sheth, Kalpesh Shah

Author: Vikram I Shah [1], Javahir A Pachore [2], Gautam M Shetty [3,4], Amish Kshatriya [1], Ashish Sheth [1], Kalpesh Shah [1]

[1] Department of Orthopaedic Surgery, Shalby Hospitals, Ahmedabad, Gujarat, India

[2] Department of Hip Arthroplasty, Shalby Hospitals, Ahmedabad, Gujarat, India.

[3] Knee and Orthopaedic Clinic, Mumbai, Maharashtra, India.

[4] Head of Research, AIMD Research, India.

Address of Correspondence
Dr. . Javahir A Pachore,
Department of Hip Arthroplasty, Shalby Hospitals, Ahmedabad, Gujarat, India
E-mail: japachore@rediffmail.com

Abstract

Performing a total hip arthroplasty (THA) in the presence of a previous fibular graft can be technically challenging and may be associated with complications. We describe a novel method of “en bloc extraction” of the fibular graft during THA to facilitate complete removal of the graft and adequate femoral preparation. This en bloc extraction technique is safe and effective for complete removal of fibular graft during THA performed in patients with non-vascularized fibula grafting for avascular necrosis.

Keywords: Avascular necrosis, fibular graft, total hip arthroplasty, hip, conversion arthroplasty

References

1. Pachore JA, Vaidya SV, Thakkar CJ, Bhalodia HK, Wakankar HM. ISHKS joint registry: A preliminary report. Indian J Orthop 2013;47:505-9.
2. Zhao DW, Yu XB. Core decompression treatment of early-stage osteonecrosis of femoral head resulted from venous stasis or artery blood supply insufficiency. J Surg Res 2015;194:614-21.
3. Nally FJ, Zanotti G, Buttaro MA, Dilernia FD, Mansilla I, Comba FM. THA conversion rate comparing decompression alone, with autologous bone graft or stem cells in osteonecrosis. Hip Int 2018;28:189-93.
4. Wei BF, Ge XH. Treatment of osteonecrosis of the femoral head with core decompression and bone grafting. Hip Int 2011;21:206-10.
5. Meyers MH. The surgical treatment of osteonecrosis of the femoral head with an osteochondral allograft. Acta Orthop Belg 1999;65:66-7.
6. Ligh CA, Nelson JA, Fischer JP, Kovach SJ, Levin LS. The effectiveness of free vascularized fibular flaps in osteonecrosis of the femoral head and neck: A systematic review. J Reconstr Microsurg 2017;33:163-72.
7. Aldridge JM 3rd, Urbaniak JR. Vascularized fibular grafting for osteonecrosis of the femoral head with unusual indications. Clin Orthop Relat Res 2008;466:1117-24.
8. Dean GS, Kime RC, Fitch RD, Gunneson E, Urbaniak JR. Treatment of osteonecrosis in the hip of pediatric patients by free vascularized fibular graft. Clin Orthop Relat Res 2001;386:106-13.
9. Ding H, Gao YS, Chen SB, Jin DX, Zhang CQ. Free vascularized fibular grafting benefits severely collapsed femoral head in concomitant with osteoarthritis in very young adults: A prospective study. J Reconstr Microsurg 2013;29:387-92.
10. Gangji V, Toungouz M, Hauzeur JP. Stem cell therapy for osteonecrosis of the femoral head. Expert Opin Biol Ther 2005;5:437-42.
11. Baksi DP, Pal AK, Baksi DD. Long-term results of decompression and muscle-pedicle bone grafting for  steonecrosis of the femoral head. Int Orthop 2009;33:41-7.
12. Alves EM, Angrisani AT, Santiago MB. The use of extracorporeal shock waves in the treatment of osteonecrosis of the femoral head: A systematic review. Clin Rheumatol 2009;28:1247-51.
13. Aaron RK, Lennox D, Bunce GE, Ebert T. The conservative treatment of osteonecrosis of the femoral head. A comparison of core decompression and pulsing electromagnetic fields. Clin Orthop Relat Res 1989;249:209-18.
14. Camporesi EM, Vezzani G, Bosco G, Mangar D, Bernasek TL. Hyperbaric oxygen therapy in femoral head necrosis. J Arthroplasty 2010;25 Suppl 6:118-23.
15. Morita D, Hasegawa Y, Okura T, Osawa Y, Ishiguro N. Long-term outcomes of transtrochanteric rotational osteotomy for non-traumatic osteonecrosis of the femoral head. Bone Joint J 2017;99-B:175-83.
16. Berend KR, Gunneson E, Urbaniak JR, Vail TP. Hip Arthroplasty after failed free vascularized fibular grafting for osteonecrosis in young patients. J Arthroplasty 2003;18:411-9..
17. Eward WC, Rineer CA, Urbainak R, Richard MJ, Ruch DS. The vascularized fibular graft in precollapse osteonecrosis: Is long term hip preservation possible? Clin orthop Relat Res 2012;470:2819-26.
18. Walter TS, Brawne JA, Ortemdo LA, Wellmam SS, Urbaniak JR, Bolognest MP. Cost-effectiveness analysis of free vascularized fibular grafting for osteonecrosis of the femoral head. J Surg Orthop Adv 2011;20:158-67.
19. Ryan SP, Woostar B, Jiranek W, Wellman S, Bolognesi M, Seyler T. Outcomes of conversion total hip arthroplasty from free vascularized fibular grafting. J Arthroplasty 2019;34:88-2.
20. Davis ET, Mckee MD, Wadell JP, Hupel T, Schemitsch EH. Total Hip arthroplasty following failure of free vascularized fibular graft. J Bone Joint Surg Am 2006;88:110-5.

How to Cite this article: Shah VI, Pachore JA, Shetty GM, Kshatriya A, Sheth A, Shah K. En bloc Extraction Technique in Total Hip Arthroplasty for Avascular Necrosis Treated with Non-vascular Fibular Autografts. Journal of Clinical Orthopaedics Jul-Dec 2021;6(2):32-34.

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Development of Sports Medicine in India and Recent Advances

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Journal of Clinical Orthopaedics | Vol 6 | Issue 2 |  Jul-Dec 2021 | page: 35-41 | Arumugam Sivaraman, Suresh Perumal, Prakash Ayyathurai, Thiagarajan Alwar

Author: Arumugam Sivaraman [1], Suresh Perumal [1], Prakash Ayyathurai [1], Thiagarajan Alwar [1]

[1] Department of Arthroscopy and Sports Medicine, Sri Ramachandra Institute of Higher Education and Research
(Deemed University), Chennai, Tamil Nadu, India

Address of Correspondence
Dr. Thiagarajan Alwar,
Department of Arthroscopy and Sports Medicine, Sri Ramachandra Institute of Higher Education and Research
(Deemed University), Porur, Chennai – 600 116, Tamil Nadu, India.
E-mail: drkatn@csstrucoach.in

Abstract

Sports are beneficial for us both at individual and social levels. Sports Medicine is an ancient subject. Sports medicine in India is steadily growing. Sports activities have witnessed a remarkable upswing in the recent times, and we require a huge number of sports support staff. There is an urgent need to look at capacity building of institutions in our country. Government of India has launched several measures for sports development including the Khelo India Scheme. Sports Medicine is a multidisciplinary field with a broad objective, focusing on holistic athlete care and not only injuries. Injury prevention, peak performance, high competition levels, and surge in number of sports events has resulted in the development of Sports Medicine. It uses a multi-modal approach including new strategies and technologies. Technology is helping to analyze and create new strategies for boosting performance. Genetic technology can improve performance, health, and safety. Latest advances in sensory garments, helmets, mouth guards, monitors, and wearables have made sports medicine indispensable. Recent advances like High Altitude Simulation Training, Anti-gravity treadmill, exoskeletons, bio-harnesses, smart fabrics, Virtual and Augmented Reality are revolutionizing sports. Centre for Sports Science at Sri Ramachandra Institute of Higher Education and Research (deemed to be university) in Chennai is a center of excellence for Asian Football Confederation and International Cricket Council in India. It serves as a hub for Sports Science Training, Education and Research in India applying the latest scientific advances in sports medicine and sports science. Sports have grown from being just a source of entertainment to a social culture and also as a gratifying career option for many. This trend is expected to evolve further with a bright scope for everyone connected with the sports ecosystem.

Keywords: Sports Medicine, sports science, injury prevention, performance enhancement, sports rehabilitation, wearables, athlete monitoring, GPS tracking system, anti-gravity treadmill, virtual reality, augmented reality, sports genetics

References

1. American College of Sports Medicine-ACSM. Available from: https://www.acsm.org Last accessed on 15.10.2021.
2. Australasian College of Sport and Exercise Physicians-ACSEP. Available from: https://www.acsep.org.au Last accessed on 15.10.2021.
3. International Olympic Committee-medical and Scientific Commission. Available form: https://www.olympics.com/ioc/medical-and-scientific-commission Last accessed on 15.10.2021.
4. FIFA Medical Commission. Available form: https://www.fifa.com/about-fifa/medical Last accessed on 15.10.2021.
5. FICCI. Tanjun Associates Study on Sports as a Full Time Career. New Delhi: FICCI; 2011.
6. Khandare RB. Astudy of physical tutoring and sporting in India. J Sports Phys Educ 2016;3:1-3.
7. Banerjee A. Governmental Initiatives to Promote Sports in India. Available form: https://www.sportskeeda.com/athletics/governmental-initiatives-to-promote-sports-in-india [Last accessed on 2019 Feb 21].
8. Chellathurai P. Sport in modern India: Policies, practices and problems. Int J Hist Sport 2002;19:366-83.
9. Vaishya R, Dhammi IK. Upsurge of sports injuries and their treatment. Indian J Orthop 2017;51:485-6.
10. Dhillon H, Dhillon S, Dhillon MS. Current concepts in sports injury rehabilitation. Indian J Orthop 2017;51:529-36.
11. Centre for Sports Science, SRIHER (DU). Available form: https://www.csstrucoach.in [Last accessed on 15.10.2021].

How to Cite this article: Sivaraman A, Perumal S, Ayyathurai P, Alwar T. Development of Sports Medicine in India and Recent Advances. Journal of Clinical Orthopaedics Jul-Dec 2021;6(2):35-41.

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