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Tibial Condyle Fractures: Current Concepts of Internal Fixation

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Journal of Clinical Orthopaedics | Vol 6 | Issue 1 |  Jan-Jun 2021 | page: 32-44 | Vivek Shetty, Sajeev Shekhar, Yash Wagh

Author: Vivek Shetty [1], Sajeev Shekhar [2], Yash Wagh [2]

[1] Consultant Orthopaedic Surgeon, P.D Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India
[2] Department of Orthopaedics, P.D Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India.

Address of Correspondence
Dr. Vivek Shetty,
Consultant Orthopaedic Surgeon, P.D Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India
Sector 7, Nerul, Navi Mumbai – 400706
E-mail: vivshetty7777@gmail.com

Abstract

Intraarticular Proximal Tibial fractures pose a great challenge, due to its wide variety of complex injury patterns and hence have a varied management protocol. There are various classifications and treatment options described in literature which do not give any guidelines on surgical approach and management. This review article is an attempt to provide a surgical protocol of treatment of these complex challenging fractures keeping in mind the mechanism of injury, understanding of the fracture pattern, surgical approach and column specific reconstruction.
Keywords: Tibial, Condyle

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How to Cite this article: Shetty V, Shekhar S, Wagh Y. Tibial Condyle Fractures: Current Concepts Of Internal Fixation. Journal of Clinical Orthopaedics Jan-Jun 2021;6(1):32-44.

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Ten Lessons Learnt From Covid Pandemic

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Journal of Clinical Orthopaedics | Vol 6 | Issue 1 |  Jan-Jun 2021 | page: 4-5 | Dr. Parag Sancheti, Dr. Ashok Shyam

Author: Dr. Parag Sancheti [1], Dr. Ashok Shyam [1]

[1] Sancheti Institute for Orthopaedics and Rehabilitation, Pune, India

[1] Hospital: Sancheti Institute for orthopaedics and rehabilitation, Pune, India

Address of Correspondence
Dr. Ashok Shyam
Sancheti Institute for Orthopaedics and Rehabilitation, Pune, India.
Hospital: Sancheti Institute for orthopaedics and rehabilitation, Pune, India.
E-mail: drashokshyam@gmail.com

 

Ten Lessons Learnt From Covid Pandemic

We are living through unprecedented times of Covid19 Pandemic. The sudden onset and heavy impact of the Pandemic caught most of us unaware and took us on a long roller coaster ride of uncertainty. We are in still the clutches of an unseen enemy that is dismantling us at our very genetic code level. However, we believe ‘Adversities Bring out the Worst & Best in Everything’ At the onset, we would like to pay homage to everyone who has lost near and dear ones during this Pandemic. We were among the more fortunate ones to not face such eventuality, but we all have met our own dark places and have indeed learnt something valuable from this experience. We will be sharing ten lessons and insights that we have learnt at various levels, including professional, community, administrative family, personal and global perspectives.

1. Use of the Internet: Our use of online resources has exponentially increased during the Pandemic. The use of webinars, Zoom meetings, work from home, telemedicine all played a significant role during the last few months of our lives. And we predict these will continue to be part of our lives in future too. However, social media and online resources are also double-edged swords, and we have to learn to Utilize Social Media wisely and optimally

2. Work Expands to The Time Available: We have always cribbed about not having enough time but the pandemic made us realise that having more time was not the solution. With more available time, we realize that we were performing lesser. However, we now understand the importance of time more acutely than ever before, and should learn good time management

3. Administrative Responsibilities: As head of the hospital or organizations, we were in unique positions. We were faced with anxieties and fear of our staff and co-workers. We quickly realized Reassurance & Positive Communication played a vital role. We also recognized the Urgent Need for the Reorganization of our work systems. Challenging times help us differentiate between people who are with you or otherwise. This realization helps us a lot in the long run specially for growth of an organisation

4. Humility, Gratitude: If we have to take one single lesson to take away from this Pandemic, then it will be humility and gratitude. Migrant helpless labourer’s and many others faced very tough times, and this made us realize and learn to understand & live life in a different view. We must stop complaining about minor things, be thankful that we are in a better position. We must show gratitude to the higher power or have faith in whatever we individually perceive as divine. It is one of our greatest sources of strength and courage.

5. Strengthen Family Relationships: In our busy schedules, most of us had lost touch with our families, even with our close ones. Pandemic gave us time to strengthen these ties and reinvent them. We realized the importance of the safety of our family and understand that one of the greatest gifts that we have is that the closest people that we care for, are healthy and happy

6. Opportunity for Great Personal Development: Pandemic also gave us enough time to introspect about ourselves and realign priorities in our lives. We needed to Introspect & Rediscover ourselves and our Value Systems. Many of us realized our long lost passions and started working on them, and hopefully, we would continue working on them

7. Adequate reserves for bad times: Money is essential, and those who had reserves and resources used them to tide over difficult times. We have to educate ourselves in terms of financial knowledge and be wiser about our economic outlooks

8. Everything was on a standstill but still life went on. Things like restaurants, mall, movie theatres, entertainment centres, air travels etc all were closed but we were still very much here. We realized that many things that we thought were important in our lives were quite dispensable and this realization will help us in future too

9. E- education is one of the greatest discovery of this Pandemic. The gain and sharing of knowledge were simplified, and it diversified into massive knowledge sharing platforms. Starting from schools to colleges to universities and national and international societies all focussed on e-education. This increased the outreach of quality education to each and every corner of the world.

10. Pandemics Shape History: Plague – 14th Century had 200 million deaths, Smallpox – 15th Century – 50 million deaths, Cholera – 1817 – 1 million deaths, Spanish flu – 1918 – 50 million deaths and now in Covid-19 Ongoing – more than a million deaths so far and still counting. However, we realize that we are all in this together, and Together, we WILL Survive & Thrive We have to realize that We are Descendent of Cavemen, Who have braved and survived with much fewer resources, and we will survive this too. Although we are practising social distancing, in a way, we are more socially connected than ever

Many of these lessons or insights we already knew; however, Pandemic has forced us to perceive these things intimately. We would underline again that humility, gratitude and understanding that safety of our family and dear ones is most valuable things in our lives have been major learning points for us. We believe many of us have also learned many more and many different lessons from this Pandemic. We hope we all come out of it as a better person, both individually and professionally.

How to Cite this article: Sancheti P, Shyam A. Ten Lessons Learnt From Covid Pandemic. Journal of Clinical Orthopaedics. January-June 2021;6(1):4-5.

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Current Concepts in High Tibial Osteotomy

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Journal of Clinical Orthopaedics | Vol 6 | Issue 1 |  Jan-Jun 2021 | page:24-31 | Vikram Arun Mhaskar, Yogesh Jain, Jitendra Maheshwari

Author: Vikram Arun Mhaskar [1], Yogesh Jain [1], Jitendra Maheshwari [1]

[1] Knee & Shoulder Clinic, New Delhi, Max Superspecilaity Hospital Saket, New Delhi, India

Address of Correspondence
Dr. Vikram Arun Mhaskar,
Knee & Shoulder Clinic, New Delhi, Max Superspecilaity Hospital Saket, New Delhi, India
E-mail: drvikrammhaskar@gmail.com

Abstract

Background: High tibial osteotomy is an effective procedure for the management of medial compartment osteoarthritis. This paper intends to analyze the current indications, contra indications, technique, complications, survival, and recent advances of this procedure.

Method: Literature review was done by searching journals with “High tibial osteotomy,” “Indications of HTO,” “Alignment in HTO,” “Survival and clinical outcomes of HTO,” and “Recent advances in HTO.” A total of 12 articles were found suitable for this study and reviewed.

Outcomes: Indications have largely remained the same except for thrust, which was earlier, a contra indication, Biplanar osteotomy, patient specific instrumentation; 3D printing and computer navigation are the recent technical modifications. The rate of complications is variable in different studies and the 5-year survival is still over 90% in most studies. Rate of serious complications is low but minor complications are high.

Conclusion: HTO is a successful procedure in treating medial compartment OA in isolation or with ligament deficiencies with a good 5 and 10-year survival. Recent advances have focused on improving planning, rehabilitation, and accuracy of alignment.

Keywords: High Tibial Osteotomy, osteotomy, deformity, gene varum, osteoarthritis, knee preservation, deformity correction

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  70. Maas S, Diffo Kaze A, Dueck K, Pape D. Static and dynamic differences in fixation stability between a spacer plate and a small stature plate fixator used for high tibial osteotomies: a biomechanical bone composite study. International Scholarly Research Notices. 2013;2013.
  71. Kaze AD, Maas S, Waldmann D, Zilian A, Dueck K, Pape D. Biomechanical properties of five different currently used implants for open-wedge high tibial osteotomy. Journal of experimental orthopaedics. 2015 Dec 1;2(1):14.
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  73. Perren SM. Optimizing the degree of fixation stability based on the strain theory. Der Orthopade. 2010 Feb;39(2):132-8.
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  76. Solomin LN, Shchepkina EA, Korchagin KL, Sabirov FK, Takata M, Tsuchiya H. The new method of long bone multilevel deformities correction using the orthopedic hexapod (preliminary report). Traumatology and Orthopedics of Russia. 2017 Oct 4;23(3):103-9.
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  78. Bode G, Ogon P, Pestka J, Zwingmann J, Feucht M, Südkamp N, Niemeyer P. Clinical outcome and return to work following single-stage combined autologous chondrocyte implantation and high tibial osteotomy. International orthopaedics. 2015 Apr 1;39(4):689-96.
  79. Bode G, Schmal H, Pestka JM, Ogon P, Südkamp NP, Niemeyer P. A non-randomized controlled clinical trial on autologous chondrocyte implantation (ACI) in cartilage defects of the medial femoral condyle with or without high tibial osteotomy in patients with varus deformity of less than 5. Archives of orthopaedic and trauma surgery. 2013 Jan 1;133(1):43-9.
  80. Sterett WI, Steadman JR. Chondral resurfacing and high tibial osteotomy in the varus knee. The American journal of sports medicine. 2004 Jul;32(5):1243-9.
  81. Trinh TQ, Harris JD, Siston RA, Flanigan DC. Improved outcomes with combined autologous chondrocyte implantation and patellofemoral osteotomy versus isolated autologous chondrocyte implantation. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2013 Mar 1;29(3):566-74.
  82. Waller C, Hayes D, Block JE, London NJ. Unload it: the key to the treatment of knee osteoarthritis. Knee Surgery, Sports Traumatology, Arthroscopy. 2011 Nov 1;19(11):1823-9.
  83. Parker DA, Beatty KT, Giuffre B, Scholes CJ, Coolican MR. Articular cartilage changes in patients with osteoarthritis after osteotomy. The American journal of sports medicine. 2011 May;39(5):1039-45.
  84. Verdonk PC, Verstraete KL, Almqvist KF, De Cuyper K, Veys EM, Verbruggen G, Verdonk R. Meniscal allograft transplantation: long-term clinical results with radiological and magnetic resonance imaging correlations. Knee Surgery, Sports Traumatology, Arthroscopy. 2006 Aug 1;14(8):694-706.
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  86. Jenny JY, Tavan A, Jenny G, Kehr P. Long-term survival rate of tibial osteotomies for valgus gonarthrosis. Revue de chirurgie orthopedique et reparatrice de l’appareil moteur. 1998 Jul;84(4):350-7.
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  94. Valkering KP, van den Bekerom MP, Kappelhoff FM, Albers GR. Complications after tomofix medial opening wedge high tibial osteotomy. Journal of Knee Surgery. 2009 Jul 1;22(3):218.
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  96. Hui C, Salmon LJ, Kok A, Williams HA, Hockers N, van der Tempel WM, Chana R, Pinczewski LA. Long-term survival of high tibial osteotomy for medial compartment osteoarthritis of the knee. The American journal of sports medicine. 2011 Jan;39(1):64-70.
  97. Howells NR, Salmon L, Waller A, Scanelli J, Pinczewski LA. The outcome at ten years of lateral closing-wedge high tibial osteotomy: determinants of survival and functional outcome. The bone & joint journal. 2014 Nov;96(11):1491-7.
  98. Niinimäki TT, Eskelinen A, Mann BS, Junnila M, Ohtonen P, Leppilahti J. Survivorship of high tibial osteotomy in the treatment of osteoarthritis of the knee: Finnish registry-based study of 3195 knees. The Journal of bone and joint surgery. British volume. 2012 Nov;94(11):1517-21.
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How to Cite this article: Mhaskar VA, Jain Y, Maheshwari J. Current Concepts in High Tibial Osteotomy. Journal of Clinical Orthopaedics Jan-Jun 2021;6(1):24-31.

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From the Desk of the President…

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Journal of Clinical Orthopaedics | Vol 6 | Issue 1 |  Jan-Jun 2021 | page: 2-3 | Dr. Shubhranshu S. Mohanty

Author: Dr. Shubhranshu S. Mohanty [1]

Bombay Orthopaedic Society, KEM Hospital and Nanavati Hospital – 400050, India.

Address of Correspondence
Prof (Dr). Shubhranshu S. Mohanty
Hon. President, Bombay Orthopaedic Society.
Hospital: KEM Hospital and Nanavati Hospital, India.
E-mail: drssmohanty@hotmail.com

 

From the Desk of the President…

All over the world, people were worried about the pandemic that took a toll on the entire mankind. However, an old adage goes: “Instead of worrying about what you cannot control, shift your energy to what you can create”. But creation is always difficult, time-consuming, and involves utilising your body and mind towards an appropriate direction and cause. Moreover, when the creation is nearing completion, one tries to achieve excellence, thereby making the process longer. But when the creation is complete, the satisfaction you get is unparalleled! It’s like a mother having a baby. Despite all the ordeals, after looking at the baby’s face, a mother forgets them instantly because when the baby is born, he/she creates a Mother as well!

Academic writing’ has been the most difficult task for an Orthopod. Dealing with a difficult patient, diagnose a difficult problem, perform a difficult surgery is one thing — but to pen these experiences has traditionally not been a cup of tea for most of our esteemed members. The Bombay Orthopaedic Society (BOS) stands for academics, and academic writing is the strength of any Association. It is relatively easy to present a case, but becomes difficult to present a series of cases, and it is even more difficult to follow it up and write a manuscript. But when the manuscript is ready and accepted for publication by a peer-reviewed journal, the amount of satisfaction is overwhelming. It leaves a permanent impression about your excellence around the world and you stand alone among the peers. That is why BOS began recognising the publications of its members since 2006, when I was the Secretary of this August society.

In a time of destruction, create something… at least start with a case report. The case which you have handled differently and unconventionally gives a better outcome to not only the patient, but the entire Orthopaedic community. After your case reports are published, you can get a little confidence in going for a case series, then retrospective analysis, followed by prospective studies. Of course, all these creations are possible with good record keeping. You need to maintain a record of each and every patient you handle, from conservative or operative. Electronic gadgets are a useful tool now-a-days. Besides your creation, the record keeping will help you in handling any medicolegal issues as well. Hence it is of dual benefit to every orthopod.

While I am coming close to the end of my tenure, I shall be devoting more time to the editorial board of our journal in a different role. We are striving hard to make our “Journal of Clinical Orthopaedics” to make it indexed in PubMed. This needs more and more original articles or case reports. Hence, contributions from the grass-root level will help to build up our journal to national and international repute and get recognition with our 2,740-strong members contributing to reach a mammoth academic platform!

Let’s do it together!!

Long live BOS !

Prof. (Dr) Shubhranshu S. Mohanty

President BOS

How to Cite this article: Mohanty S. From the Desk of the President. Journal of Clinical Orthopaedics. January-June 2021;6(1):2-3.

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Treatment of unstable intertrochanteric femoral fractures in elderly population – A retrospective comparison between those treated by PFNA versus Primary Hemiarthroplasty of the hip

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Journal of Clinical Orthopaedics | Vol 6 | Issue 1 |  Jan-Jun 2021 | page: 19-23 | Ranade Uday Arun, Anne Sai Laxman

Author: Ranade Uday Arun [1], Anne Sai Laxman [1]

[1] Department of Orthopaedics, KIMS Hospitals, Kondapur, Hyderabad, Telangana – 500084, India

Address of Correspondence
Dr. Ranade Uday Arun,
Department of Orthopaedics, KIMS Hospitals, # 1-112/86, Survey No 55/ EE, Kondapur Village, Serilingampally Mandal, Hyderabad – 500084, India
E-mail: dr.udayranade@gmail.com

Abstract

Introduction: Unstable intertrochanteric femur fractures (IFF) have traditionally been reduced and internally fixed with either a hip screw and a side plate or more recently with the proximal femur nails. To counteract the complications of prolonged recumbency, some surgeons advocated using a primary hemiarthroplasty of the hip to treat such patients.
Aim:  Present study is being done to present the data at our institute in order to further our understanding of treatment of unstable IFFs in the elderly.

Methods and Material: A retrospective comparison study where data of 32 patients with unstable IFF (AO type 31 A2 and A3), who satisfied the inclusion and exclusion criteria and who underwent either a PFNA fixation or a primary hemiarthroplasty of the hip from the period of June 2018 to Jan 2019 was collected. Follow up was for a minimum of 12 months. Baseline data, perioperative data and post-operative data was collected. Statistical analysis was done by a statistician using SPSS software Ver 21.0.
Results: PFNA group showed significantly better Harris hip scores at the end of 12 months than the PHH group. Even the surgical time, intra-operative bleeding, amount of blood transfusions and length of stay was significantly less in PFNA group than PHH group.
Conclusions: Proximal femur fixation with PFNA device with its smaller incision, lower blood loss, faster operating time and shorter hospital stay has definitive advantages over a primary hemiarthroplasty hip.
Keywords: Unstable Intertrochanteric Femur Fractures, PFNA, Primary hemiarthroplasty Hip, Bipolar modular prosthesis, Proximal femur fixation

References

1. . Zhou S, Liu J, Zhen P, Shen W, Chang Y, Zhang H, et al. Proximal femoral nail anti-rotation versus cementless bipolar hemiarthroplasty for unstable femoral intertrochanteric fracture in the elderly: Aretrospective study. BMC Musculoskelet Disord 2019;20:500.
2. Koval KJ. Intramedullary nailing of proximal femur fractures. Am J Orthop (Belle Mead NJ) 2007;36 Suppl 4:4-7.
3. Park MS, Cho HM, Kim JH, Shin WJ. Cementless bipolar hemiarthroplasty using a rectangular cross-section stem for unstable intertrochanteric fractures. Hip Int 2013;23:316-22.
4. Luo X, He S, Zeng D, Lin L, Li Q. Proximal femoral nail antirotation versus hemiarthroplasty in the treatment of senile intertrochanteric fractures: Case report. Int J Surg Case Rep 2017;38:37-42.
5. Bansal K, Dahuja A, Kaur R, Singh J, Shyam R. Proximal femur nail vs cemented bipolar prosthesis in unstable intertrochanteric femur fractures in elderly: A prospective study. Int J Orthop Sci 2019;5:642-5.
6. Sexson SB, Lehner JT. Factors affecting hip fracture mortality. J Orthop Trauma 1987;1:298-305.
7. Kumar GN, Meena S, Kumar NV, Manjunath S, Raj MK. Bipolar hemiarthroplasty in unstable intertrochanteric fractures in elderly: A prospective study. J Clin Diagn Res 2013;7:1669-71.
8. Lee YK, Ha YC, Chang BK, Kim KC, Kim TY, Koo KH. Cementless bipolar hemiarthroplasty using a hydroxyapatite-coated long stem for osteoporotic unstable intertrochanteric fractures. J Arthroplasty 2011;26:626-32.
9. Enocson A, Mattisson L, Ottosson C, Lapidus LJ. Hip arthroplasty after failed fixation of trochanteric and subtrochanteric fractures. Acta Orthop 2012;83:493-8.
10. Tang P, Hu F, Shen J, Zhang L, Zhang L. Proximal femoral nail antirotation versus hemiarthroplasty: A study for the treatment of intertrochanteric fractures. Injury 2012;43:876-81.
11. Kumar P, Rajnish RK, Sharma S, Dhillon MS. Proximal femoral nailing is superior to hemiarthroplasty in AO/OTA A2 and A3 intertrochanteric femur fractures in the elderly: A systematic literature review and meta-analysis. Int Orthop 2020;44:623-33.

How to Cite this article: Arun RU, Laxman AS. Treatment of unstable intertrochanteric femoral fractures in elderly population – A retrospective comparison between those treated by PFNA versus Primary Hemiarthroplasty of the hip. Journal of Clinical Orthopaedics Jan-Jun 2021;6(1):19-23.

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Interview with Dr. Nandkishore Laud conducted by Dr Ashok Shyam and Dr Nicholas Antao

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Journal of Clinical Orthopaedics | Vol 6 | Issue 1 |  Jan-Jun 2021 | page: 92-94 | Nandkishore Laud, Ashok Shyam, Nicholas Antao

Author: Nandkishore Laud [1], Ashok Shyam [1], Nicholas Antao 

[1] Department of Orthopaedics, KIMS Hospitals, Kondapur, Hyderabad, Telangana – 500084, India

Address of Correspondence
Dr. Ranade Uday Arun,
Department of Orthopaedics, KIMS Hospitals, # 1-112/86, Survey No 55/ EE, Kondapur Village, Serilingampally Mandal, Hyderabad – 500084, India
E-mail: dr.udayranade@gmail.com

Abstract

Introduction: Unstable intertrochanteric femur fractures (IFF) have traditionally been reduced and internally fixed with either a hip screw and a side plate or more recently with the proximal femur nails. To counteract the complications of prolonged recumbency, some surgeons advocated using a primary hemiarthroplasty of the hip to treat such patients.
Aim:  Present study is being done to present the data at our institute in order to further our understanding of treatment of unstable IFFs in the elderly.

Methods and Material: A retrospective comparison study where data of 32 patients with unstable IFF (AO type 31 A2 and A3), who satisfied the inclusion and exclusion criteria and who underwent either a PFNA fixation or a primary hemiarthroplasty of the hip from the period of June 2018 to Jan 2019 was collected. Follow up was for a minimum of 12 months. Baseline data, perioperative data and post-operative data was collected. Statistical analysis was done by a statistician using SPSS software Ver 21.0.
Results: PFNA group showed significantly better Harris hip scores at the end of 12 months than the PHH group. Even the surgical time, intra-operative bleeding, amount of blood transfusions and length of stay was significantly less in PFNA group than PHH group.
Conclusions: Proximal femur fixation with PFNA device with its smaller incision, lower blood loss, faster operating time and shorter hospital stay has definitive advantages over a primary hemiarthroplasty hip.
Keywords: Unstable Intertrochanteric Femur Fractures, PFNA, Primary hemiarthroplasty Hip, Bipolar modular prosthesis, Proximal femur fixation

How to Cite this article: Laud N, Shyam AK, Antao N. Orthowalkathon: Interview with Dr. Nandkishore Laud
conducted by Dr Ashok Shyam and Dr. Nicholas Antao. Journal of Clinical Orthopaedics Jan-Jun 2021;6(1):92-94.

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ALPSA Lesion or Bankart does it Really Matter in Shoulder Instability? A Review of Literature with Surgical Technique for ALPSA Repair

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Journal of Clinical Orthopaedics | Vol 6 | Issue 1 |  January-June 2021 | page: 14-18 | Timothy Weiwen Teo, Andy Teck Huat Wee

Author: Timothy Weiwen Teo [1], Andy Teck Huat Wee [1]

[1] Consultant Orthopaedic Surgeon Khoo Teck Puat Hospital

[2] Consultant Orthopaedic Surgeon Pinnacle Orthopaedic Group

Address of Correspondence
Dr. Timothy Weiwen Teo,
Consultant Orthopaedic Surgeon Khoo Teck Puat Hospital
E-mail: timothyteo.ww@gmail.com

Abstract

The anterior labroligamentous periosteal sleeve avulsion (ALPSA) lesion has been described as a distinct pathology from the classic Bankart lesion in anterior glenohumeral instability. ALPSA lesions are associated with younger patients, patients with more chronic symptoms, more episodes of pre-operative instability and associated with increased humeral and glenoid bone loss as compared to Bankart lesions. After surgery, ALPSA lesions also have a higher risk of redislocations and greater loss of range of motion. In this article, we outline some surgical pearls in dealing with ALPSA lesions.

Keywords: Anterior labroligamentous periosteal sleeve avulsion, bankart, traumatic anterior shoulder instability, labrum

References

1. KHovelius L. Incidence of shoulder dislocation in Sweden. Clin Orthop Relat Res 1982;166:127-31.
2. Bankart AS. The pathology and treatment of recurrent dislocation of the shoulder joint. Br J Surg 1939;26:23-9.
3. Yiannakopoulos CK, Mataragas E, Antonogiannakis E. A comparison of the spectrum of intra-articular lesions in acute and chronic anterior shoulder instability. Arthroscopy 2007;23:985-90.
4. Neviaser TJ. The anterior labroligamentous periosteal sleeve avulsion lesion: Acause of anterior instability of the shoulder. Arthroscopy 1993;9:17-21.

5. Ozbaydar M, Elhassan B, Diller D, Massimini D, Higgins LD, Warner JJ. Results of arthroscopic capsulolabral repair: Bankart lesion versus anterior labroligamentous periosteal sleeve avulsion lesion. Arthroscopy 2008;24:1277-83.
6. Lee BG, Cho NS, Rhee YG. Anterior labroligamentous periosteal sleeve avulsion lesion in arthroscopic capsulolabral repair for anterior shoulder instability. Knee Surg Sports Traumatol Arthrosc 2011;19:1563-9.
7. Bernhardson AS, Bailey JR, Solomon DJ, Stanley M, Provencher MT. Glenoid bone loss in the setting of an anterior labroligamentous periosteal sleeve avulsion tear. Am J Sports Med 2014;42:2136-40.
8. Ahmad CS, Galano GJ, Vorys GC, Covey AS, Gardner TR, Levine WN. Evaluation of glenoid capsulolabral complex insertional anatomy and restoration with single-and double-row capsulolabral repairs. J Shoulder Elbow Surg 2009;18:948-54.
9. Burkhart SS, de Beer JF. Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: Significance of the inverted-pear glenoid and the humeral engaging HillSachs lesion. Arthroscopy 2000;16:677-94.
10. Farber JM, Buckwalter KA. Sports related injuries of the shoulder: Instability. Radiol Clin North Am 2002;40:235-49.
11. Elentuck D, Palmer WE. Direct magnetic resonance arthrography. Eur Radiol 2004;14:1956-67.
12. Shankman S, Bencardino J, Beltran J. Glenohumeral instability: Evaluation using MR arthrography of the shoulder. Skeletal Radiol 1999;28:365-82.
13. Magee T. 3-T MRI of the shoulder: Is MR arthrography necessary? AJR Am J Roentgenol 2009;192:86-92.
14. Lippitt S, Matsen F. Mechanisms of glenohumeral joint stability. Clin Orthop Relat Res 1993;291:20-8.
15. Owens BD, Nelson BJ, Duffey ML, Mountcastle SB, Taylor DC, Cameron KL, et al. Pathoanatomy of first-time, traumatic, anterior glenohumeral subluxation events. J Bone Joint Surg Am 2010;92:1605-11.
16. Kim SH, Ha KI, Jung MW, Lim MS, Kim YM, Park JH. Accelerated rehabilitation after arthroscopic Bankart repair for selected cases: A prospective randomized clinical study. Arthroscopy 2003;19:722-31.
17. Magee T, Williams D, Mani N. Shoulder MR arthrography: Which patient group benefits most? AJR Am J Roentgenol 2004;183:969-74
18. Gaunt BW, Shaffer MA, Sauers EL, Michener LA, McCluskey GM, Thigpen C. The American society of shoulder and elbow therapists’ consensus rehabilitation guideline for arthroscopic anterior capsulolabral repair of the shoulder. J Orthop Sports Phys Ther 2010;40:155-68.
19. Nolte PC, Arner JW, Cooper JD, Elrick BP, Millett PJ. Arthroscopic fixation of an anterior labroligamentous periosteal sleeve avulsion (ALPSA) of the shoulder. Arthrosc Tech 2020;9:e553-8.

20. Spatschil A, Landsiedl F, Anderl W, Imhoff A, Seiler H, Vassilev I, et al. Posttraumatic anteriorinferior instability of the shoulder: Arthroscopic findings and clinical correlations. Arch Orthop Trauma Surg 2006;126:217-22.
21. Zhu W, Lu W, Zhang L, Han Y, Ou Y, Peng L, et al. Arthroscopic findings in the recurrent anterior instability of the shoulder. Eur J Orthop Surg Traumatol 2014;24:699-705.

How to Cite this article: Teo TW,  Wee ATH. ALPSA Lesion or Bankart does it Really Matter in Shoulder Instability? A Review of Literature with Surgical Technique for ALPSA Repair. Journal of Clinical Orthopaedics Jan-Jun 2020;6(1): 14-18.

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Whats new in Paediatric Orthopaedics in 2020?

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Journal of Clinical Orthopaedics | Vol 6 | Issue 1 |  Jan-Jun 2021 | page: 89-91 | Arkesh M, Sandeep Patwardhan, Ashok Shyam

Author: Arkesh M [1], Sandeep Patwardhan [1], Ashok Shyam [1]

[1] Sancheti Institute for Orthopaedics and Rehabilitation, Shivajinagar, Pune, Maharashtra India.

Address of Correspondence
Dr. Arkesh M,
Paediatric Orthopaedic Fellow, Sancheti Institute for Orthopaedics and Rehabilitation, Shivajinagar, Pune, Maharashtra India
E-mail: dr.arkesh@gmail.com

References

1. Li J, Yue C, Wang HQ, Guo X, Chen K, Ma J, Wang J, Tang X. External fixation and Kirschner wires in the treatment of paediatric displaced supracondylar femur fractures. J Child Orthop. 2020 Aug 1;14(4):293-298.
2. Teo TL, Schaeffer EK, Habib E, El-Hawary R, Larouche P, Shore B, Aarvold A, Carsen S, Reilly C, Mulpuri K. Is the modified Gartland classification system important in deciding the need for operative management of supracondylar humerus fractures? J Child Orthop 2020;14: 502-507.
3. Kuzma AL, Talwalkar VR, Muchow RD, Iwinski HJ, Milbrandt TA, Jacobs CA, Walker JL. Brace Yourselves: Outcomes of Ponseti Casting and Foot Abduction Orthosis Bracing in Idiopathic Congenital Talipes Equinovarus. J Pediatr Orthop. 2020 Jan;40(1):e25-e29.
4. Lin JS, Samora JB. Pediatric acute compartment syndrome: a systematic review and meta-analysis. J Pediatr Orthop B. 2020 Jan;29(1):90-96.
5. Mellor X, Buczek MJ, Adams AJ, Lawrence JTR, Ganley TJ, Shah AS. Collection of Common Knee Patient-reported Outcome Instruments by Automated Mobile Phone Text Messaging in Pediatric Sports Medicine. J Pediatr Orthop. 2020 Feb;40(2):e91-e95.
6. Miller DJ, Flynn JJM, Pasha S, Yaszay B, Parent S, Asghar J, Abel MF, Pahys JM, Samdani A, Hwang SW, Narayanan UG, Sponseller PD, Cahill PJ; Harms Study Group. Improving Health-related Quality of Life for Patients With Nonambulatory Cerebral Palsy: Who Stands to Gain From Scoliosis Surgery? J Pediatr Orthop. 2020 Mar;40(3):e186- e192.
7. Dinçer R, Köse A, Topal M, Öztürk İA, Engin MÇ. Surgical treatment of pediatric forearm fractures with intramedullary nails: is it a disadvantage to leave the tip exposed? J Pediatr Orthop B. 2020 Mar;29(2):158-163.
8. Ernat JJ, Wimberly RL, Ho CA, Riccio AI. Vascular examination predicts functional outcomes in supracondylar humerus fractures: a prospective study. J Child Orthop 2020;14: 495-501.
9. Wang C, Su Y. An Alternative to the Traditional Radiocapitellar Line for Pediatric Forearm Radiograph Assessment in Monteggia Fracture. J Pediatr Orthop. 2020 Mar;40(3):e216-e221.
10. Adams AJ, Mahmoud MAH, Wells L, Flynn JM, Arkader A. Physeal fractures of the distal femur: does a lower threshold for surgery lead to better outcomes? J Pediatr Orthop B. 2020 Jan;29(1):40-46.

How to Cite this article: Arkesh M, Patwardhan S, Shyam A. Whats new in Paediatric Orthopaedics in 2020. Journal of Clinical Orthopaedics Jan-Jun 2021;6(1):89-91.

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Arthroplasty – What was interesting in 2020?

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Journal of Clinical Orthopaedics | Vol 6 | Issue 1 |  Jan-Jun 2021 | page: 87-88 | Harish Bhende, Prakash K George

Author: Harish Bhende[1], Prakash K George [2]

[1] Consultant Ortho & Joint Replacement Surgeon

[2] Fellow in Arthroplasty, Dr. Laud Clinic Dadar, Mumbai

Address of Correspondence
Dr. Harish Bhende,
Consultant Ortho & Joint Replacement Surgeon
E-mail: harishbhende@gmail.com

References

1. Kim YH, Park JW. Eighteen-Year Follow-Up Study of 2 Alternative Bearing Surfaces Used in Total Hip Arthroplasty in the Same Young Patients. J Arthroplasty. 2020 Mar;35(3):824-830.
2. Lee S, Yoo JJ, Kim HJ. Impingement Between the Metal Stem and the Ceramic Liner in Total Hip Arthroplasty: The Neck Is Not the Only Place Where Impingement Occurs. J Bone Joint Surg Am. 2021 Jan 20;103(2):139-145.
3. McEwen PJ, Dlaska CE, Jovanovic IA, Doma K, Brandon BJ. Computer-Assisted Kinematic and Mechanical Axis Total Knee Arthroplasty: A Prospective Randomized Controlled Trial of Bilateral Simultaneous Surgery. J Arthroplasty. 2020 Feb;35(2):443-450.
4. Ishida, Kazunari & Shibanuma, Nao & Takayama, Koji & Kurosaka, Masahiro & Kuroda, Ryosuke & Matsumoto, Tomoyuki. (2018). Posterior Reference Position Affects Intraoperative Kinematic and Soft Tissue Balance in Navigated Posterior Stabilized Total Knee Arthroplasty. The Journal of Arthroplasty. 33.
5. Tammachote N, Kanitnate S. Intravenous Dexamethasone Injection Reduces Pain From 12 to 21 Hours After Total Knee Arthroplasty: A Double-Blind, Randomized, Placebo-Controlled Trial. J Arthroplasty. 2020 Feb;35(2):394-400.
6. Azboy I, Groff H, Goswami K, Vahedian M, Parvizi J. Low-Dose Aspirin Is Adequate for Venous Thromboembolism Prevention Following Total Joint Arthroplasty: A Systematic Review. J Arthroplasty. 2020 Mar;35(3):886-892.
7. Yazdi H, Klement MR, Hammad M, Inoue D, Xu C, Goswami K, Parvizi J. Tranexamic Acid Is Associated With Reduced Periprosthetic Joint Infection After Primary Total Joint Arthroplasty. J Arthroplasty. 2020 Mar;35(3):840-844.
8. Bayram S, Akgül T, Özmen E, Kendirci AŞ, Demirel M, Kılıçoğlu Öİ. Critical Limit of Lower-Extremity Lengthening in Total Hip Arthroplasty: An Intraoperative Neuromonitorization Study. J Bone Joint Surg Am. 2020 Apr 15;102(8):664-673.
9. Grace TR, Tsay EL, Roberts HJ, Vail TP, Ward DT. Staged Bilateral Total Knee Arthroplasty: Increased Risk of Recurring Complications. J Bone Joint Surg Am. 2020 Feb 19;102(4):292-297.
10. Kishawi D, Schwarzman G, Mejia A, Hussain AK, Gonzalez MH. Low Preoperative Albumin Levels Predict Adverse Outcomes After Total Joint Arthroplasty. J Bone Joint Surg Am. 2020 May 20;102(10):889-895.
11. Blom AW, Hunt LP, Matharu GS, Reed MR, Whitehouse MR. The effect of surgical approach in total hip replacement on outcomes: an analysis of 723,904 elective operations from the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man. BMC Med. 2020 Aug 6;18(1):242.

How to Cite this article: Bhende H, George P. Arthroplasty – What was interesting in 2020?. Journal of Clinical Orthopaedics Jan-Jun 2021;6(1):87-88.

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What has evolved in the Management of Anterior Cruciate Ligament Injuries First Half of 2020 When World was facing the Pandemic and the So-Called “New Normal”

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Journal of Clinical Orthopaedics | Vol 6 | Issue 1 |  Jan-Jun 2021 | page: 84-86 | Abhishek Arun Nerurkar

Author: Abhishek Arun Nerurkar [1]

[1] DM.S. Orthopaedics., D.N.B. Orthopaedics., F. Sports Medicine and Arthroscopy, Germany, F. Advanced Hip and Knee Joint Reconstruction (SICOT)

Address of Correspondence
Dr. Abhishek Arun Nerurkar,
M.S. Orthopaedics., D.N.B. Orthopaedics., F. Sports Medicine and Arthroscopy, Germany, F. Advanced Hip and Knee Joint Reconstruction (SICOT)
E-mail: abhishek.nerurkar@gmail.com

References

  1. Reider B. Sports Medicine in a Time of Pandemic. Am J Sports Med 2020;48:1303-4.
  2. Jog AV, Smith TJ, Pipitone PS, Toorkey BC, Morgan CD, Bartolozzi AR. Is a partial anterior cruciate ligament tear truly partial? A clinical, arthroscopic, and histologic investigation. Arthroscopy 2020;36:1706-13.
  3. Bumberger A, Koller U, Hofbauer M, Tiefenboeck TM, Hajdu S, Windhager R, et al. Ramp lesions are frequently missed in ACLdeficient knees and should be repaired in case of instability. Knee Surg Sports Traumatol Arthrosc 2020;28:840-54.
  4. Mouton C, Magosch A, Pape D, Hoffmann A, Nührenbörger C, Seil R. Ramp lesions of the medial meniscus are associated with a higher grade of dynamic rotatory laxity in ACL-injured patients in comparison to patients with an isolated injury. Knee Surg Sports Traumatol Arthrosc 2020;28:1023-8.
  5. Kim SH, Seo HJ, Seo DW, Kim KI, Lee SH. Analysis of risk factors for ramp lesions associated with anterior cruciate ligament injury. Am J Sports Med 2020;48:1673-81.
  6. Nyland J, Collis P, Huffstutler A, Sachdeva S, Spears JR, Greene J, et al. Quadriceps tendon autograft ACL reconstruction has less pivot shift laxity and lower failure rates than hamstring tendon autografts. Knee Surg Sports Traumatol Arthrosc 2020;28:509-18.
  7. Gagliardi AG, Carry PM, Parikh HB, Albright JC. Outcomes of quadriceps tendon with patellar bone block anterior cruciate ligament reconstruction in adolescent patients with a minimum 2-year follow-up. Am J Sports Med 2020;48:93-8.
  8. Naendrup JH, Marche B, de Sa D, Koenen P, Otchwemah R, Wafaisade A, et al. Vancomycin-soaking of the graft reduces the incidence of septic arthritis following ACL reconstruction: Results of a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc 2020;28:1005-13.
  9. Sundaraj K, Salmon LJ, Heath EL, Winalski CS, Colak C, Vasanji A, et al. Bioabsorbable versus titanium screws in anterior cruciate ligament reconstruction using hamstring autograft: A prospective, randomized controlled trial with 13-year follow-up. Am J Sports Med 2020;48:1316-26.
  10. Mayr R, Smekal V, Koidl C, Coppola C, Eichinger M, Rudisch A, et al. ACL reconstruction with adjustable-length loop cortical button fixation results in less tibial tunnel widening compared with interference screw fixation. Knee Surg Sports Traumatol Arthrosc 2020;28:1036-44.
How to Cite this article: Nerurkar A. What has evolved in the Management of Anterior Cruciate Ligament Injuries First Half of 2020 When World was facing the Pandemic and the So-Called “New Normal”. Journal of Clinical Orthopaedics Jan-Jun 2021;6(1): 84-86.

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