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Recent and Relevant Literature in 2020 on Trauma Around Shoulder

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Journal of Clinical Orthopaedics | Vol 6 | Issue 1 |  Jan-Jun 2021 | page: 81-83 | Sandeep R Biraris

Author: Sandeep R Biraris [1]

[1] Head of Orthoapedics, Mumbai Port Trust Hospital, Nadkarni Park, Wadala (E), Mumbai-400037, India

Address of Correspondence
Dr. Sandeep R Biraris,
BHead of Orthoapedics, Mumbai Port Trust Hospital, Nadkarni Park, Wadala (E), Mumbai-400037, India
E-mail: sandeepbiraris@gmail.com

References

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2. Goss TP. Double disruptions of the superior shoulder suspensory complex. J Orthop Trauma 1993;7:99-106.
3. Dombrowsky AR, Boudreau S, Quade J, Brabston EW, Ponce BA, Momaya AM. Clinical outcomes following conservative and surgical management of floating shoulder injuries: Asystematic review. J Shoulder Elbow Surg 2020;29:634-42.
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11. Ishii H, Shintaku T, Yoshizawa S, Sakamoto M, Kaneko T, Musha Y, et al. In vitro evaluation of the tension band suture method for proximal humerus fracture treatment. J Orthop Surg Res 2020;15:345.
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How to Cite this article: Biraris S. Potpourri: Recent and Relevant Literature in 2020 on Trauma Around
Shoulder. Journal of Clinical Orthopaedics Jan-Jun 2021;6(1):81-83.

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“ Shoulder Arthroplasty in Young ”

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Journal of Clinical Orthopaedics | Vol 6 | Issue 1 |  Jan-Jun 2021 | page: 74-80 | Nagraj Shetty

Author: Nagraj Shetty [1]

[1] Consultant Arthroscopy, Shoulder, Knee preservation Surgeon Lilavati hospital Nanavati Superspeciality hospital Hinduja Healthcare Surgical, Mumbai, India.

Address of Correspondence
Dr. Nagraj Shetty,
Orthopaedic Department, Nanavati Superspeciality Hospital, SV Road, Vile Parle west , Mumbai, India.
E-mail: orthodocshetty@gmail.com

Abstract

Background: Prosthetic shoulder replacement provides excellent pain relief and functional improvement for patients with shoulder arthritis. Total shoulder arthroplasty for osteoarthritis and reverse shoulder arthroplasty for cuff tear arthropathy remains the gold standard for the geriatric patient population. Poor long-term survivorship, implant failure (glenoid component loosening, and glenoid arthrosis), and functional deterioration requiring early revision surgery are major concerns of similar management in younger patients. Young patients prove as a major challenge to shoulder surgeons due to expected longer life expectancy, desire to pursue sports, and active lifestyle thereby placing excessive demands on their shoulder arthroplasty components. Alternative strategies for arthroplasty in young have been developed; however, there is presently no clear consensus, recommendations to guide clinicians toward management. This manuscript reviews the current concepts of shoulder arthroplasty in young patients.
Keywords: Shoulder, arthritis, arthroplasty, glenoid, total shoulder arthroplasty

References

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2. Tibbetts RM, Wirth MA. Shoulder arthroplasty for the young, active patient. Instr Course Lect 2011;60:99-104.
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29. Denard PJ, Raiss P, Sowa B, Walch G. Mid to long-term follow-up of total shoulder arthroplasty using a keeled glenoid in young adults with primary glenohumeral arthritis. J Shoulder Elbow Surg 2017;26:1298-306.
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31. Eichinger JK, Miller LR, Hartshorn T, Li X, Warner JJ, Higgins LD. Evaluation of satisfaction and durability after hemiarthroplasty and total shoulder arthroplasty in a cohort of patients aged 50 years or younger: An analysis of discordance of patient satisfaction and implant survival. J Shoulder Elbow Surg 2016;25:72-80.
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38. Clinton J, Franta AK, Lenters TR, Mounce D, Matsen FA 3rd. Nonprosthetic glenoid arthroplasty with humeral hemiarthroplasty and total shoulder arthroplasty yield similar self-assessed outcomes in the management of comparable patients with glenohumeral arthritis. J Shoulder Elbow Surg 2007;16:534-8.

How to Cite this article: Shetty N. “ Shoulder Arthroplasty in Young ”. Journal of Clinical Orthopaedics Jan-Jun 2021;6(1):74-80.

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Chondral Lesions of the Patella

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Journal of Clinical Orthopaedics | Vol 5 | Issue 1 |  Jan-Jul 2021 | page: 65-73 | Deepak Goyal

Author: Deepak Goyal [1]

[1] Saumya Arthroscopy & Sports Knee Clinic, 201, Viva Atelier, Opp B D Patel House, Naranpura, Ahmedabad, India: 380014
[2] Visiting Professor of Orthopaedics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

Address of Correspondence
Dr. Deepak Goyal,
Saumya Arthroscopy & Sports Knee Clinic, 201, Viva Atelier, Opp B D Patel House, Naranpura, Ahmedabad, India: 380014
E-mail: deepak@knee.in

Abstract

Background: The articular cartilage injuries of the patella are increasingly being reported, being more common in young population and are mostly associated with abnormal biomechanics. The abnormal biomechanics could be an instability, a maltracking or a patellofemoral overload. It is not uncommon to have a mixture of abnormal alignment and abnormal loading, making understanding of the patellofemoral biomechanics more difficult. Abnormal biomechanics put different types of biomechanical forces on the patella leading to the chondral damage. The patellar cartilage lesions usually show different patterns based on these different biomechanics. It is very important to understand the biomechanics of patella before treating the patellar cartilage lesion. A consideration to correct the abnormally aligned or loaded patella is an important step while treating a patellar chondral defect. The purpose of this article is to review the concepts behind occurrence of patellar chondral lesions and the biomechanics behind it, decision making with a brief overview of the treatment strategies.
Keywords: Chondral Lesion, Patella, Maltracking, biomechanics

References

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How to Cite this article: Goyal D. Chondral Lesions of the Patella. Journal of Clinical Orthopaedics Jan-Jun 2021;6(1):65-73.

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First time Anterior Shoulder Dislocation: Rationale for Treatment

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Journal of Clinical Orthopaedics | Vol 6 | Issue 1 |  Jan-Jun 2021 | page: 60-64 | Shirish S Pathak , Gaurav Waghmare

Author: Shirish S Pathak [1], Gaurav Waghmare [1]

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

Address of Correspondence
Dr. Gaurav Waghmare,
Department of Shoulder and Sports Injury, Deenanath Mangeshkar Hospital, Pune, India
E-mail: drgauravwaghmare@gmail.com

Abstract

Anterior traumatic glenohumeral joint dislocation is the most common dislocation in the human body. The definitive management of first-time anterior shoulder dislocation remains controversial. The traditional conservative treatment of closed reduction and immobilisation has shown high recurrence rates in the young athletic male population involved in contact sports. This has led to an increased interest and trend amongst shoulder surgeons to offer early operative stabilisation after first dislocation itself. This article reviews current literature about recurrence rates after conservative versus operative treatment of first time shoulder dislocation. It also highlights key issues of defining the high risk group for recurrence after conservative treatment, compares the outcomes of surgery for first versus recurrent shoulder dislocations and also mentions complications of early surgery. Article also discusses an evidenced based treatment algorithm for the treatment of a first time anterior shoulder dislocation.
Keywords: dislocation, rationale, anterior

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How to Cite this article: Pathak SS, Waghmare G. First time anterior shoulder dislocation: rationale for treatment. Journal of Clinical Orthopaedics Jan-Jun 2021;6(1):60-64.

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Barriers in social integration of post traumatic spinal cord injury patients

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Journal of Clinical Orthopaedics | Vol 6 | Issue 1 |  Jan-Jun 2021 | page: 6-13 | Quamar Azam, Bhaskar Sarkar, Siddharth Dubey, Javed Khan, Siddharth Lamba

Author: Quamar Azam [1], Bhaskar Sarkar [1], Siddharth Dubey [2], Javed Khan [3], Siddharth Lamba [4]

[1] AIIMS, Rishikesh. MS(Ortho), India.
[2] SRMSIMS, Bareilly. MS(Orthopaedics), Barielly, India.
[3] Sharda hoispital. Barielly. MS(Orthopaedics), Bareilly, India.
[4] NIMS Medical college& Hospital, Jaipur. DNB(Orthopaedics), Jaipur ,India.

Address of Correspondence
Dr. Siddharth Lamba,
Assistant professor (Orthopaedic Department). NIMS Medical college & Hospital. Jaipur, India.
E-mail: drsiddharthorth@gmail.com

Abstract

Study design: This was a cross-sectional follow-up study.
Objective: The objective of the study was to study barriers in social integration and community participation of post-traumatic spinal injury patients. Secondary objective is to suggest measures to enhance gainful community integration of these victims to lead better quality of life and productive to the society.
Background: Spinal cord injury (SCI) is a devastating event in one’s life and management of these patients is a challenge not only to treating physicians but also family and society related to patients. Absence of step-down facilities, non-existent insurance policy, lack/unavailability of qualitative assistive devices, and medical and rehabilitation services coupled with almost negligible financial support (disability allowance) from government are serious impediments in continuity of standard care.
Materials and Methods: A total of 141 patients who satisfied the inclusion criteria and survived beyond 1 year were included in our study and were assessed on parameters of economic independence, domestic life, physical independence, psychosocial, and spiritual support. A modified form of CHART score was also implemented to assess parameters.
Results: On comparison with Craig Handicap Assessment and Reporting Technique-SF parameters, each parameter showed a strong correlation with each other when Pearson correlation coefficient analysis was done. Age, level of education, employment status, and ASIA Impairment Scale showed a significant (P <0.01) when analyzed with parameters for rehabilitation assessment in our study.
Conclusion: Significant number of SCI patients remains neglected, largely deserted and non-productive to the society. Certain inexpensive and easy to implement recommendations can remove the impediments and offer them a quality of life they deserve.
Key words: Spinal cord injury, social integration, barrier, developing nation.

References

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23. Sharma SC, Singh R, Dogra R, Gupta SS. Assessment of sexual functions after spinal cord injury in Indian patients. Int J Rehabil Res 2006;29:17-25..

How to Cite this article: Azam Q, Sarkar B, Dubey S, Khan J, Lamba S. Barriers in social integration of post traumatic spinal cord injury patients. Journal of Clinical Orthopaedics Jan-Jun 2021;6(1):6-13.

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Current trends in ACL repair: Primary repair, mechanical augmentation and biological supplementation

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Journal of Clinical Orthopaedics | Vol 5 | Issue 2 |  July-Dec 2020 | page:36-40 | Rajeev Raman, Bibhuti Nath Mishra

Author: Rajeev Raman [1], Bibhuti Nath Mishra [2]

[1] Consultant Orthopaedic Surgeon, Joint & Bone Care Hospital, Salt Lake City, Kolkata, India
[2] Consultatnt Orthopaedic Surgeon, Birat Medical College Teaching Hospital, Biratnagar, Nepal.

Address of Correspondence
Dr. Bibhuti Nath Mishra,
Birat Medical College Teaching Hospital, Biratnagar, Nepal
E-mail: drbibhuti5@gmail.com

Abstract

Anterior Cruciate Ligament (ACL) tear is one amongst frequent knee injuries. This injury is troublesome as it causes instability of knee while walking/running and also predisposes to the risk of early osteoarthritis in long run. So, its proper management is important, but has always remained debatable and controversial as well. Advancements in tissue engineering and regenerative medicine has changed the understanding of ACL’s anatomy and it’s healing potential and thus a renewed interest has emerged towards ACL repair again over the established gold standard “ACL reconstruction”. Novel techniques like bridging with fiber tapes, Internal Brace Ligament Augmentation (IBLA), and Dynamic Intraligamentary Stabilization (DIS) have emerged focusing on mechanical strength. Also, supplements like bio-scaffolds, platelets & platelet rich plasma (PRP) are in the offing to aid biological ligamentous healing. We will present review of past practice, current trend and future prospects of ACL repair.
Keywords: Anterior Cruciate Ligament, Repair, Reconstruction, Augmentation, Supplementation

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How to Cite this article: Raman R, Mishra BN. Current trends in ACL repair: Primary repair, mechanical augmentation and biological supplementation. Journal of Clinical Orthopaedics July-Dec 2020;5(2):36-40.

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Orthopaedic and trauma management in covid-19 era: common problems and their probable solution in literature, a narrative review

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Journal of Clinical Orthopaedics | Vol 5 | Issue 2 |  July-Dec 2020 | page:13-19 | Siddharth Dubey, Sidharath Mohindru, Md. Quamar Azam, Bhaskar Sarkar

Author: Siddharth Dubey [1], Sidharath Mohindru [1], Md. Quamar Azam [1], Bhaskar Sarkar [1]

[1] Department of Trauma Surgery AIIMS Rishikesh

Address of Correspondence
Dr. Sidharath Mohindru,
Department of Trauma Surgery AIIMS Rishikesh
E-mail: sidharathmohindru10@gmail.com

Abstract

Purpose: COVID-19 has affected more than 200 countries and has warranted change in the hospital policies and patient management worldwide. It has brought forward many challenges which were and still are being faced by the health care setup in various nations. There still are many unanswered questions and doubts arising in the minds of orthopaedic trauma surgeons all over regarding this pandemic. This article is an attempt to summarise the current knowledge about COVID-19 in relation to orthopaedic trauma.
Methods: This is a review article presenting concise, collected ideas from exhaustive literature taken from PubMed, Google Scholar and Cochrane reviews. Key words such as “COVID-19”, “Management”, “Orthopaedics” and “Trauma” were used and information from various articles has been presented in a concise manner, including the authors’ own personal experience.
Results: There has been a reduction in major trauma cases presenting to the emergency and a dramatic reduction in trauma admissions during the COVID-19 pandemic. Orthopaedic surgeons need to work alongside other frontline health care workers to tackle this calamity. Hospital resources need to be appropriately used in order to provide optimal patient care alongside minimising the risk of spread of infection to other patients and hospital personnel. The decision to operate needs to be a fine balance between suspected orthopaedics and trauma related complications and worsening of respiratory function in patients who are COVID-19 positive.
Conclusion: As orthopaedic surgeons, it is our moral responsibility to try to reduce the impact of the pandemic in which ever manner possible. There is still a lot to discover and guidelines are constantly changing, so it is also important that surgeons stay up to date on the latest protocols.
Key words: COVID-19. Management. Orthopaedic. Trauma.

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How to Cite this article: Dubey S, Mohindru S, Azam Md. Q, Sarkar B. Orthopaedic and trauma management in covid-19 era: common problems and their probable solution in literature, a narrative review. Journal of Clinical Orthopaedics July-Dec 2020;5(2):13-19.

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Potential Combination of Hesperetin and Vitamin C based on PLGA (Poly Lactic-co-Glycolic Acid) on Healing Fragility Fracture in Osteoporosis Patients

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Journal of Clinical Orthopaedics | Vol 5 | Issue 2 |  July-Dec 2020 | page: 25-29 | Kadek Mercu Narapati Pamungkas, Putu Itta Sandi Lesmana Dewi, Made Agus Maharjana

Author: Kadek Mercu Narapati Pamungkas [1], Putu Itta Sandi Lesmana Dewi [1], Made Agus Maharjana [2]

[1] Bachelor of Medicine and Medical Doctor Profession Study Program of Udayana University, Indonesia
[2] Department of Orthopedics and Traumatology, Faculty of Medicine, Udayana University- Sanglah General Hospital, Indonesia

Address of Correspondence
Dr. Kadek Mercu Narapati Pamungkas,
Bachelor of Medicine and Medical Doctor Profession Study Program of Udayana University, Indonesia
E-mail: narapatipamungkas@student.unud.ac.id

Abstract

Background: Osteoporosis is a degenerative bone disease that occurs around 15.3% in Southeast Asia. Osteoporosis patients are very vulnerable and often experience fragility fractures. Until now, the treatment of fragility fractures, namely pharmacological and operative therapy, has not been optimal in restoring bone density and allowing recurrence.
Purpose: The aim of this research is to find the modality of therapy fragility fracture that can prevent and improve the condition. Methods: This literature was prepared using literature review methods being sourced from valid medical journals such as published in PubMed, Research Gate, and Google Scholar.
Results: Hesperetin in citrus fruit can inhibit RANKL-induced osteoclastogenesis, reduce the amount and size of F-actin, and accelerate fracture healing in vivo. Vitamin C, which is also present in citrus fruit, has an important role in the synthesis of the triple helix collagen and shows better fracture healing at week 4. PLGA has a role in more specific drug delivery, preventing rapid clearance, biodegradable, increasing calcium deposition, and extending drug release time.
Conclusion: Combination of Hesperetin and PLGA-based vitamin C can be promising therapies in the healing and prevention of fragility fractures. Suggestion: The author suggests conducting further research to determine side effects, proper dosage, and drug administration.
Keywords: Fragility Fracture, Hesperetin, PLGA, Vitamin C

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How to Cite this article: Pamungkas KMN, Dewi PISL, Maharjana MA. Potential Combination of Hesperetin and Vitamin C based on PLGA (Poly Lactic-co-Glycolic Acid) on Healing Fragility Fracture in Osteoporosis Patients. Journal of Clinical Orthopaedics July-Dec 2020;5(2):25-29.

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Challenges and Difficulties faced by Orthopedic Surgeons during the COVID-19 Pandemic: A Review of Modified Surgical Protocols

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Journal of Clinical Orthopaedics | Vol 5 | Issue 2 |  July-Dec 2020 | page: 20-24 | Sajeev Shekhar, Vivek Shetty, Yash Wagh

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

[1] Department of Orthopedics, P.D. Hinduja National Hospital & MRC, Veer Savarkar Marg, Mahim West, Mumbai – 400016

Address of Correspondence
Dr. Vivek Shetty,
Department of Orthopedics, P.D. Hinduja National Hospital & MRC, Veer Savarkar Marg, Mahim West, Mumbai – 400016
E-mail: vivshetty7777@gmail.com

Abstract

Introduction: Since the major outbreak of COVID-19 in March 2020, all hospitals and surgeons opted to postpone elective scheduled surgeries for personal and patient safety
Aim of this study: In this study of 45 consecutive patients, we changed the surgical protocols during this pandemic, our study highlights difficulties faced and how they were tackled.
Materials and Methods: 45 patients were included in this study operated by a single Senior Surgeon at a tertiary centre and their results were compared to similar surgeries performed in the pre-Covid era, in terms of length of hospital stay, duration of surgery, complications/mortality post operatively and overall risk of infection to the patients and hospital staff.
Results: It was found that the, mortality and morbidity in both times were same in Covid-19 negative patients, overall time taken for the surgery was increased, the hospital stay was increased, usage of resources was increased, difficulties faced were not only by the patients but also the health workers.
Keywords: COVID-19, protocols, donning in, doffing off, operation time, aerosol,.

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How to Cite this article: Shekhar S, Shetty V, Wagh Y. Challenges and Difficulties faced by Orthopedic Surgeons during the COVID-19 Pandemic: A Review of Modified Surgical Protocols. Journal of Clinical Orthopaedics July-Dec 2020;5(2):20-24.

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Meniscus Root Injury: A review

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Journal of Clinical Orthopaedics | Vol 5 | Issue 2 |  July-Dec 2020 | page:41-44 | Rajkumar S Amaravathi

Author: Rajkumar S Amaravathi [1]

[1] Department of Arthroscopy and Sports Injury,St John’s Medical College, Bangalore 560034, Karnataka

Address of Correspondence
Dr. Rajkumar S Amaravathi,
Professor Orthopedics,
Head Division of Arthroscopy and Sports Injury,St John’s Medical College, Bangalore 560034, Karnataka
E-mail: rajamarvathi@gmail.com

Abstract

The meniscus provides shock absorption and stability by generating circumferential stresses as load bearing occurs. This is because of the root attachments of the meniscus to the tibia, preventing meniscus extrusion and a subsequent alteration of the transmitted hoop .Meniscus root tears lead to an increase of peak tibiofemoral contact pressure and tibiofemoral contact area which has been shown to lead to altered biomechanics and an acceleration of degenerative changes of the knee. The treatment method for meniscus injuries now primarily is preservation and anatomic restoration, because non-operative and meniscectomy treatments are associated with poor clinical outcomes and progression to degenerative changes in the joint.
Keywords: Meniscus Root Injury.

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How to Cite this article: Amaravathi RS. Review of Meniscus Root Injury. Journal of Clinical Orthopaedics July-December 2020;5(2):41-44.

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