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Study of Functional Outcome of Intra-articular Proximal Third Tibia Fractures Treated with Locking Compression Plate

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Journal of Clinical Orthopaedics | Vol 9 | Issue 2 |  July-December 2024 | page: 88-94 | Adnan Asif, Saurabh Harikant Yadav, P Gokula Kumar, Pawar Bhushan Kumar Bhajandas, Atul Jain, Lalit C Panchal

DOI: https://doi.org/10.13107/jcorth.2024.v09i02.678

Open Access License: CC BY-NC 4.0

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

Submitted Date: 13 Jul 2024, Review Date: 19 Aug 2024, Accepted Date: 16 Sep 2024 & Published Date: 10 Dec 2024

Author: Adnan Asif [1], Saurabh Harikant Yadav [1], P Gokula Kumar [1], Pawar Bhushan Kumar Bhajandas [2], Atul Jain [3], Lalit C Panchal [1]

[1] Department of Orthopaedics, K B Bhabha Municipal General Hospital, Mumbai, Maharashtra, India,
[2] Department of Orthopaedics, Chhatrapati Shivaji Maharaj Hospital and Rajiv Gandhi Medical College, Thane, Maharashtra, India,
[3] Department of Orthopaedics, Swami Dayanand Hospital, New Delhi, India

Address of Correspondence

Adnan Asif,
K B Bhabha Municipal General Hospital, Maharashtra, Mumbai, India.
E-mail: adnan.asif1092@gmail.com

Abstract

Background: The study aimed to provide an estimate of the functional outcome following the use of locking compression plate (LCP) in the management of intra-articular proximal third tibia fractures. Materials and Methods: A prospective cohort study was carried out on 30 intra-articular proximal third tibia fractures which were operated with LCP fixation between August 2020 and July 2021. Primary outcome measurement was carried out using Rasmussen’s functional knee grading criteria. Results: Functional outcome assessed by Rasmussen’s functional knee grading criteria showed Excellent results in 16/30 (53.33%) of patients, good result in 9/30 (30%) of patients (overall 83.33% acceptable results), and fair in 4/30 (13.33%) and poor result in 1/30 (3.33%) of patients. Post-operative complications occurred in eight out of 30 of our patients (26.67%). Open reduction and internal fixation was more commonly used (76.67%) as compared to minimally invasive percutaneous plate osteosynthesis (23.33%). We commonly applied a combined principle of fixation (bridging + compression) across 46.67% of our fracture fixations. Primary surgical approach used was almost equal across our study between medial/posteromedial (53.33%) and anterolateral (46.67%).
Conclusion: We conclude that the LCP system with its various type of fixation act as a good biological fixation including difficult fracture situations. However, this also involves the risk that may occur unless properly planned preoperatively and follow guided principles intraoperatively.
Keywords: Proximal tibia, locking compression plate, Rasmussen functional knee grading criteria.

References

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12. Segal D, Mallik AR, Wetzler MJ, Franchi AV, Whitelaw GP. Early weight bearing of lateral tibial plateau fractures. Clin Orthop 1993;294:232-7.

How to Cite this article: Asif A, Yadav SH, Kumar PG, Bhajandas PBK, Jain A, Panchal LC. Study of Functional Outcome of Intra-articular Proximal Third Tibia Fractures Treated with Locking Compression Plate. Journal of Clinical Orthopaedics 2024:July-December:9(2)88-94.

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Chronic Low Back Pain: A Spine Surgeon’s Graveyard

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Journal of Clinical Orthopaedics | Vol 9 | Issue 2 |  July-December 2024 | page: 29-34 | Pranav Shah, Gautam Zaveri

DOI: https://doi.org/10.13107/jcorth.2024.v09i02.648

Open Access License: CC BY-NC 4.0

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

Submitted Date: 25 Jul 2024, Review Date: 02 Aug 2024, Accepted Date: 12 Sep 2024 & Published Date: 10 Dec 2024

Author: Pranav Shah [1], Gautam Zaveri [2]

[1] Department of orthopedic Spine Surgeon, Namaha Hospital, Mumbai, Maharashtra, India
[2] Department of orthopedic Spine Surgeon, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India

Address of Correspondence

Dr. Gautam Zaveri, Department of orthopedic Spine Surgeon, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India.
E-mail: gautamzaveri1969@gmail.com

Abstract

Background: Chronic low back pain (cLBP) is a prevalent and debilitating condition. The World Health Organisation identified it as a major global health concern with the incidence rising by 50% between 1989 and 2019. It is projected that about 843 million people globally will suffer from cLBP by 2050. Despite its prevalence, the pathogenesis of cLBP remains poorly understood and its treatment fragmented. Almost 70% of cases are categorized as non-specific where the pain could likely be arising from dysfunction in ligament, muscles or joints. Degenerative conditions amount to 27% of cases, while non-spinal and sinister causes contribute to a smaller percentage. Psychosocial factors also play a significant role in both the onset and persistence of cLBP.
Discussion: The management of cLBP is multifaceted, focussing on non-surgical interventions such as pharmacological treatment, physical therapy, lifestyle modifications and complementary therapies. While non-steroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants provide symptomatic relief, physical and behavioural therapies are crucial in addressing the chronic nature of the condition. Surgical options are reserved for cases with specific patho-anatomic aetiologies such as spondylolisthesis or spinal stenosis. The management of psychosocial aspects through cognitive behavioural therapy (CBT) is pertinent in enhancing patient outcomes.
Conclusion: This article provides a comprehensive review of cLBP, encompassing its aetiology, natural history, evaluation and management strategies. The role of multi-disciplinary approach, patient education and lifestyle modification is important in treating this complex condition. By integrating evidence-based practices with individualized care, the clinician can improve quality of life of patients affected by cLBP.
Keywords: Chronic low back pain, Non-specific low back pain, Degenerative lumbar spine, Cognitive behavioural therapy, Ergonomics.

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How to Cite this article: Shah P, Zaveri G. Chronic Low Back Pain: A Spine Surgeon’s Graveyard. Journal of Clinical Orthopaedics July-December 2024;9(2):29-34.

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The Efficacy of Platelet-rich Plasma in Arthroscopic Rotator Cuff Repairs: A Narrative Review

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Journal of Clinical Orthopaedics | Vol 9 | Issue 2 |  July-December 2024 | page: 22-25 | Nihar Modi, Prasad Bhagunde, Damini Shah

DOI: https://doi.org/10.13107/jcorth.2024.v09i02.650

Open Access License: CC BY-NC 4.0

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

Submitted Date: 15 Jul 2024, Review Date: 09 Aug 2024, Accepted Date: 19 Sep 2024 & Published Date: 10 Dec 2024

Author: Prasad Bhagunde [1, 2, 3, 4], Nihar Modi [1, 3, 5], Daminir shah [6]

[1] Department of Orthopaedics, Sona Medical Centre, Mumbai, Maharashtra, India.
[2] Department of Orthopaedics, Saifee Hospital, Mumbai, Maharashtra, India.
[3] Department of Orthopaedics, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India.
[4] Department of Orthopaedics, Breach Candy Hospital Trust, Mumbai, Maharashtra, India.
[5] Department of Orthopaedics, Criticare Asia Multispeciality Hospital and Research Centre, Mumbai, Maharashtra, India.
[6] Novo Tissue Bank and Research Centre, Mumbai, Maharashtra, India.

Address of Correspondence

Dr. Nihar Modi,
Consultant Orthopaedic Surgeon, Sona Medical Centre, Jaslok Hospital and Research Centre, Criticare Asia Multispeciality Hospital and Research Centre, Mumbai, Maharashtra, India.
E-mail: modi.nihar95@gmail.com

Abstract

Rotator cuff tears are one of the most prevalent musculoskeletal disorders, with a significant risk of retear following repair. Platelet-rich plasma (PRP) has emerged as a potential adjunct to enhance healing through mechanisms including growth factor release, anti-inflammatory effects, and angiogenesis. This narrative review evaluates the efficacy of PRP augmentation in arthroscopic rotator cuff repairs by examining recent studies and meta-analyses. Findings indicate that PRP, particularly leukocyte-poor PRP, shows promise in improving pain and functional outcomes, and reducing retear rates, though its cost-effectiveness and optimal application protocols remain uncertain. Limitations of current studies and avenues for future research are also discussed.
Keywords: Platelet-rich plasma, Arthroscopic rotator Cuff repairs, orthobiologics, PRP

References

1. Snow M, Hussain F, Pagkalos J, Kowalski T, Green M, Massoud S, James S. The Effect of Delayed Injection of Leukocyte-Rich Platelet-Rich Plasma Following Rotator Cuff Repair on Patient Function: A Randomized Double-Blind Controlled Trial. Arthroscopy. 2020 Mar;36(3):648-657.
2. Ahmad Z, Ang S, Rushton N, Harvey A, Akhtar K, Dawson-Bowling S, Noorani A. Platelet-Rich Plasma Augmentation of Arthroscopic Rotator Cuff Repair Lowers Retear Rates and Improves Short-Term Postoperative Functional Outcome Scores: A Systematic Review of Meta-Analyses. Arthrosc Sports Med Rehabil. 2022 Feb 5;4(2):e823-e833.
3. Samuelson EM, Odum SM, Fleischli JE. The Cost-Effectiveness of Using Platelet-Rich Plasma During Rotator Cuff Repair: A Markov Model Analysis. Arthroscopy. 2016 Jul;32(7):1237-44.
4. Routledge JC, Saber AY, Pennington N, Gupta N. Re-Tear Rates Following Rotator Cuff Repair Surgery. Cureus. 2023 Jan 31;15(1):e34426.
5. Liu B, Jeong HJ, Yeo JH, Oh JH. Efficacy of Intraoperative Platelet-Rich Plasma Augmentation and Postoperative Platelet-Rich Plasma Booster Injection for Rotator Cuff Healing: A Randomized Controlled Clinical Trial. Orthop J Sports Med. 2021 Jun 4;9(6):23259671211006100.
6. Syed, A. N., Landrum, K., & Ganley, T. J. (2024). Platelet-rich plasma and other injectables in the young athlete. Journal of the Pediatric Orthopaedic Society of North America, 6, 100008.
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8. Hurley ET, Danilkowicz RM, Klifto CS. Editorial Commentary: Platelet-Rich Plasma Injections Produced a Significant Improvement in Most Patients With Rotator Cuff Tendinopathy. Arthroscopy. 2023 Sep;39(9):2009-2011.
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12. Malavolta EA, Gracitelli ME, Ferreira Neto AA, Assunção JH, Bordalo-Rodrigues M, de Camargo OP. Platelet-rich plasma in rotator cuff repair: a prospective randomized study. Am J Sports Med. 2014 Oct;42(10):2446-54.
13. Flury M, Rickenbacher D, Schwyzer HK, Jung C, Schneider MM, Stahnke K, Goldhahn J, Audigé L. Does Pure Platelet-Rich Plasma Affect Postoperative Clinical Outcomes After Arthroscopic Rotator Cuff Repair? A Randomized Controlled Trial. Am J Sports Med. 2016 Aug;44(8):2136-46.
14. Trantos IA, Vasiliadis ES, Giannoulis FS, Pappa E, Kakridonis F, Pneumaticos SG. The Effect of PRP Augmentation of Arthroscopic Repairs of Shoulder Rotator Cuff Tears on Postoperative Clinical Scores and Retear Rates: A Systematic Review and Meta-Analysis. J Clin Med. 2023 Jan 11;12(2):581.
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How to Cite this article: Prabhu S, Zaveri G. Surgery for Lumbar Disc Prolapse: The Decision is More Important than the Incision. Journal of Clinical Orthopaedics July-December 2024;9(2):17-21.

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Surgery for Lumbar Disc Prolapse: The Decision is More Important than the Incision

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Journal of Clinical Orthopaedics | Vol 9 | Issue 2 |  July-December 2024 | page: 17-21 | Shrinivas Prabhu, Gautam Zaveri

DOI: https://doi.org/10.13107/jcorth.2024.v09i02.648

Open Access License: CC BY-NC 4.0

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

Submitted Date: 13 Sep 2024, Review Date: 22 Sep 2024, Accepted Date: 28 Nov 2024 & Published Date: 10 Dec 2024

Author: Shrinivas Prabhu [1], Gautam Zaveri [2]

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

Address of Correspondence

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

Abstract

The common techniques of discectomy for a posterolateral lumbar disc herniation include conventional open discectomy, microlumbar discectomy, tubular microdiscectomy, and endoscopic discectomy. All these techniques involve an interlaminar fenestration for accessing the spinal canal, decompressing the neural elements, and performing the discectomy with the goal of relieving radicular leg pain and improving function. The current review aims to briefly outline the evolution of lumbar discectomy over the last century, examine the pros and cons, and compare the short-term and long-term clinical outcomes of the common techniques of lumbar discectomy. While no single approach may be universally superior to the other, surgical selection tailored to patient-specific factors and surgeons’ experience with a technique helps to optimize clinical outcomes.
Keywords: Lumbar disc prolapse, microlumbar discectomy, tubular discectomy, endoscopic discectomy

References

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3. He J, Xiao S, Wu Z, Yuan Z. Microendoscopic discectomy versus open discectomy for lumbar disc herniation: A meta-analysis. Eur Spine J 2016;25:1373-81.
4. Brock M, Kunkel P, Papavero L. Lumbar microdiscectomy: Subperiosteal versus transmuscular approach and influence on the early postoperative analgesic consumption. Eur Spine J 2008;17:518-22.
5. Teles P, Pereira P, Silva C, Vaz R, Santos Silva P. Minimally invasive treatment for lumbar disc herniation: A matched comparison between tubular microdiscectomy and percutaneous endoscopic lumbar discectomy. Cureus 2024;16:e57589.
6. Liu X, Yuan S, Tian Y, Wang L, Gong L, Zheng Y, et al. Comparison of percutaneous endoscopic transforaminal discectomy, microendoscopic discectomy, and microdiscectomy for symptomatic lumbar disc herniation: Minimum 2-year follow-up results. J Neurosurg Spine 2018;28:317-25.
7. Giardi FP, Cammisa FP Jr., Huang RC, Parvataneni HK, Tsairis P. Improvement of preoperative foot drop after lumbar surgery. J Spinal Disord Tech 2002;15:490-4.
8. Postacchini F, Giannicola G, Cinnoti G. Recovery of motor deficits after microdiscectomy for lumbar disc herniation. J Bone Joint Surg Br 2002;84:1040-5.
9. Aono H, Iwasaki M, Ohwada T, Okuda S, Hosono N, Fuji T, et al. Surgical outcome of drop foot caused by degenerative lumbar diseases. Spine (Phila Pa 1976) 2007;32:E262-6.
10. Liu K, Zhu W, Shi J, Jia L, Shi G, Wang Y, et al. Foot drop caused by lumbar degenerative disease: Clinical features, prognostic factors of surgical outcome and clinical stage. PLoS One 2013;8:e80375.
11. Moranjkic M, Ercegovic Z, Hodzic M, Brkic H. Outcome prediction in lumbar disc herniation surgery. Acta Med Sal 2010;39:75-8.
12. Stromqvist F, Ahmad M, Hildingsson C, Jönsson B, Strömqvist B. Gender differences in lumbar disc herniation surgery. Acta Orthop 2008;79:643-9.

 

How to Cite this article: Prabhu S, Zaveri G. Surgery for Lumbar Disc Prolapse: The Decision is More Important than the Incision. Journal of Clinical Orthopaedics July-December 2024;9(2):17-21.

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Grapefruit Method: Metaphyseal Bone Grafting to Improve Press-fit of Cementless Humeral Stems in Reverse Shoulder Arthroplasty

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Journal of Clinical Orthopaedics | Vol 9 | Issue 2 |  July-December 2024 | page: 26-28 | Manit Arora

DOI: https://doi.org/10.13107/jcorth.2024.v09i02.652

Open Access License: CC BY-NC 4.0

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

Submitted Date: 19 July 2024, Review Date: 25 Aug 2024, Accepted Date: 12 Sep 2024 & Published Date: 10 Dec 2024

Author: Manit Arora [1]

[1] Department of Orthopaedics and Sports Medicine, Fortis Hospital, Mohali, Punjab, India.

Address of Correspondence

Manit Arora,
Department of Orthopaedics and Sports Medicine, Fortis Hospital, Mohali, Punjab, India.
E-mail: manit_arora@hotmail.com

Abstract

Reverse shoulder arthroplasty is one of the fastest-growing orthopedic surgeries globally. There exist two options for stemmed humeral components: Cemented and cementless or press-fit designs. In cases of osteoporosis or poor metaphyseal bone stock, generally, the choice is made to opt for the former. We describe a method for metaphyseal bone grafting using the resected humeral head as an autograft to improve metaphyseal bone stock and allow for press-fit humeral component in such cases.
Keywords: Shoulder replacement, Shoulder surgery, Reverse shoulder replacement, Bone grafting

References

1. Levy O, Narvani A, Hous N, Abraham R, Relwani J, Pradhan R, et al. Reverse shoulder arthroplasty with a cementless short metaphyseal humeral implant without a stem: Clinical and radiologic outcomes in prospective 2- to 7-year follow-up study. J Shoulder Elbow Surg 2016;25:1362-70.
2. Plachel F, Scheibel M. Humeral bone grafting in stemless shoulder arthroplasty. Obere Extrem 2017;12:183-5.
3. Micheloni GM, Salmaso G, Berti M, Bortolato S, Zecchinato G, Momoli A, et al. Cementless metaphyseal reverse shoulder arthroplasty: Our preliminary experience. Acta Bio Med Atenei Parm 2019;90 Suppl 1:47-53.

How to Cite this article: Arora M. Grapefruit Method: Metaphyseal Bone Grafting to Improve Press-fit of Cementless Humeral Stems in Reverse Shoulder Arthroplasty. Journal of Clinical Orthopaedics 2024:July-December:9(2)26-28.

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Open Reduction with Collateral Ligaments Reconstruction in Neglected Elbow Dislocation – A Case Report

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Journal of Clinical Orthopaedics | Vol 9 | Issue 1 |  January-June 2024 | page: 57-60 | Made Winatra Satya Putra, Anak Agung Gde Yuda Asmara

Open Access License: CC BY-NC 4.0

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

DOI: https://doi.org/10.13107/jcorth.2024.v09i01.636

Author: Made Winatra Satya Putra [1], Anak Agung Gde Yuda Asmara [1]

[1] Department of Orthopaedics and Traumatology, General Hospital Prof. IGNG Ngoerah, Faculty of Medicine Udayana University, Bali, Indonesia

Address of Correspondence

Dr. Made Winatra Satya Putra,
JL. Diponegoro, Dauh Puri Klod, Bali, Indonesia.
E-mail: borthopaedi@gmail.com

Abstract

Neglected elbow dislocations pose a challenge to orthopedic surgeons, leading to contracture and functional limitations. This case involves a 51-year-old female patient experiencing pain and stiffness in her left elbow for the past 5 months due to neglected dislocation. Previous traditional treatment showed no improvement. Disuse atrophy was suspected, prompting open reduction, ligament reconstruction, and a 3-week temporary pinning. The intervention aimed to address the late-presenting unreduced elbow, utilizing autograft for ligament reconstruction. The subsequent supervised physiotherapy played a crucial role in restoring functional, stable, and painless elbow movement. This case underscores the importance of timely intervention in neglected elbow dislocations to prevent disability and enhance the quality of life for affected individuals.
Keywords: Neglected elbow dislocation, ligament reconstruction, autograft.

References

1. Kone SG, Bana A, Dogba EG. Neglected elbow dislocation with conservation of elbow function, concerning a case in Abidjan (Ivory Coast). Open J Orthop 2018;8:127-31.
2. Mahaisavariya B, Laupattarakasem W. Neglected dislocation of the elbow. Clin Orthop Relat Res 2005;431:21-5.
3. Agarwal S, Patel RK. A prospective study of 9 cases of neglected posterior dislocation of elbow treated by open reduction and V-Y tricepsplasty of speed. J Bone Jt Dis 2016;31:26-9.
4. Mehta S, Sud A, Tiwari A, Kapoor SK. Open reduction for late-presenting posterior dislocation of the elbow. J Orthop Surg (Hong Kong) 2007;15:15-21.
5. Coulibaly NF, Tiemdjo H, Sane AD, Sarr YF, Ndiaye A, Seye S. Posterior approach for surgical treatment of neglected elbow dislocation. Orthop Traumatol Surg Res 2012;98:552-8.

How to Cite this article: Putra MWS, Asmara AAGY. Open Reduction with Collateral Ligaments Reconstruction in Neglected Elbow Dislocation – A Case Report. Journal of Clinical Orthopaedics 2024;January-June:9(1)57-60.

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Surgical Duration Increases the Risk of Infection Following Total Knee Arthroplasty

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Journal of Clinical Orthopaedics | Vol 9 | Issue 1 |  January-June 2024 | page: 22-27 | Jamie C Heimroth, Max L Willinger, Nipun Sodhi, B A Ariel Henig, Alain E Sherman, Jonathan R Danoff

Open Access License: CC BY-NC 4.0

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

DOI: https://doi.org/10.13107/jcorth.2024.v09i01.626

Author: Jamie C Heimroth [1], Max L Willinger [1], Nipun Sodhi1, B A Ariel Henig [2], Alain E Sherman [3], Jonathan R Danoff [1]

[1] Department of Orthopedic Surgery, Long Island Jewish Medical Center, New York, USA,
[2] Department of Orthopedic Surgery, Donald and Barbara Zucker School of Medicine at Hofstra, New York, USA,
[3] Department of Orthopedic Surgery, Lenox Hill Hospital, New York, USA.

Address of Correspondence

Dr. Jonathan Danoff,
Department of Orthopedic Surgery, Long Island Jewish Medical Center, New York, USA.
Email: jdanoff@northwell.edu

Abstract

Introduction: Risk stratification is used in total joint arthroplasty (TKA) to optimize outcomes and minimize complications. Modifiable risk factors such as surgical duration can be influenced by surgeons; however, under certain circumstances, prolonged surgery cannot be avoided. While previous studies have investigated the impact of surgical duration on post-operative complications, we felt that research was lacking in comparing both surgical duration and tourniquet time and the rate of infection following a TKA. Our learning objective was to investigate the risk of surgical site infections (SSIs) and periprosthetic joint infections (PJIs) from prolonged (1) surgical duration or (2) tourniquet time during primary TKAs.
Materials and Methods: A multicenter health-care system database consisting of 15 hospitals was queried for all patients undergoing TKA between March 2020 and December 2020. Patient demographics, comorbidities, and infection data were collected. The surgical duration and tourniquet time were calculated for each patient undergoing a TKA and compared against the rate of PJI or SSI rate. PJI was defined based on the 2018 musculoskeletal infection society (MSIS) criteria, and superficial SSI was defined as any infection that did not meet MSIS criteria.
Results: Of the 2511 patients who underwent primary TKA, 19 were found to have an infection. Average surgical duration of 126.17 min for patients with an infection compared to 103.44 min without infection (P = 0.02). There was a significantly increased infection rate with increased surgical duration after univariate analysis. Patients who developed any infection had an average tourniquet time of 78.5 min, whereas those without infections had an average of 62.14 min (P = 0.004). Infection rate began to increase once the surgical duration reached 70 min; however, the infection rate increase per 10-min increments was not statistically significant (P = 0.09). The infection rate began to increase at 50 min of tourniquet time and significantly increased as tourniquet time increased (P = 0.004).
Conclusion: Surgical duration is associated with an increased risk of infection following TKA. Our study demonstrated tourniquet time had a greater impact on infection. There are many circumstances that lead to increased surgical and tourniquet duration, including increased body mass index, and severe deformity. Surgeons should consider deflating the tourniquet as soon as the critical parts of the surgery are complete to decrease the risk of post-operative infections.
Keywords: Total knee replacement, infection, knee joint, tourniquets.

References

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How to Cite this article: Heimroth JC, Willinger ML, Sodhi N, Henig BAA, Sherman AE, Danoff JR. Surgical Duration Increases the Risk of Infection Following Total Knee Arthroplasty. Journal of Clinical Orthopaedics 2024;January-June:9(1):22-27.

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Bacterial Spectrum Analysis of Pediatric Septic Arthritis in Sanglah General Hospital (2019-2021): A Case Series

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Journal of Clinical Orthopaedics | Vol 9 | Issue 1 |  January-June 2024 | page: 61-69 | Ida Bagus Anom Krishna Caitanya, Made Agus Maharjana, Nyoman Gede Grenata Nanda Ustriyana

Open Access License: CC BY-NC 4.0

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

DOI: https://doi.org/10.13107/jcorth.2024.v09i01.638

Author: Ida Bagus Anom Krishna Caitanya [1], Made Agus Maharjana [1], Nyoman Gede Grenata Nanda Ustriyana [1]

[1] Department of Orthopaedics and Traumatology, Faculty of Medicine Udayana University, Prof Ngoerah General Hospital, Denpasar, Indonesia

Address of Correspondence

Dr. Ida Bagus Anom Krishna Caitanya,
Department of Orthopaedics and Traumatology, Faculty of Medicine Udayana University, Prof Ngoerah General Hospital, Denpasar, Indonesia.
E-mail: borthopaedi@gmail.com

Abstract

This case series presents five pediatric patients diagnosed with septic arthritis in Sanglah General Hospital from 2019 to 2021. The most common infecting organism was Staphylococcus aureus, comprising 66.7% of all infections. Other organisms described in literatures are Salmonella, Staphylococcus epidermidis, Enterobacter cloacae, and Mycobacterium tuberculosis. Antibiotic treatment should be started as soon as the diagnosis is suspected and modified once the organism isolated from the synovial fluid (SF) has been characterized. Unfortunately, in many cases, despite a high clinical suspicion of SA, the diagnosis cannot be confirmed because the SF is sterile on bacterial culture. This may lead to difficulties in patient management. The case series also analyzed the possible causes of negative culture results. The data showed three cases with no pathogen organism detected, which can be turned to false negative that ruled out the infection cause of the arthritis. The study suggests that in the future, other techniques might prove useful in increasing the sensitivity of the detection of bacterial infection, such as Polymerase chain reaction and detection of antibodies against the teichoic acid staphylococcal cell wall component. The detection and identification of Kingela kingae in synovial fluid have improved significantly since the development of PCR. The specificity of these assays relies on the ability of the PCR to generate only the expected amplification product. The duration of the laboratory to process is also a factor that affects the result. The study concludes that early diagnosis and prompt treatment are crucial in achieving good functional outcomes in pediatric septic arthritis.
Keywords: septic arthritis, pediatric patients, bacterial spectrum, diagnosis, culture methods

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How to Cite this article: Caitanya IBAK, Maharjana MA, Ustriyana NGGN. Bacterial Spectrum Analysis of Pediatric Septic Arthritis in Sanglah General Hospital (2019-2021): A Case Series. Journal of Clinical Orthopaedics 2024;January-June:9(1):61-69.

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Current Concept Update on Robotic Technology in Arthroplasty- A Narrative review

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Journal of Clinical Orthopaedics | Vol 9 | Issue 1 |  January-June 2024 | page: 35-41 | Shobit Deshmukh, Vaibhav Bagaria

Open Access License: CC BY-NC 4.0

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

DOI: https://doi.org/10.13107/jcorth.2024.v09i01.630

Author: Shobit Deshmukh [1], Vaibhav Bagaria [1]

[1] Department of Orthopedics, Sir HN Reliance Foundation Hospital, Mumbai, Maharashtra, India.

Address of Correspondence
Dr. Vaibhav Bagaria,
Department of Orthopedics, Sir HN Reliance Foundation Hospital, Mumbai, Maharashtra, India.
E-mail: drbagaria@gmail.com

Abstract

Ensuring precise prosthesis positioning is one of the key elements for improving long-term survival rates in knee arthroplasty. The evolution of Total knee arthroplasty surgeries from Computer assisted navigation to robotic assisted techniques has improved the precision of bone preparation, component positioning and has reduced alignment outliers and surgeon-related errors. The present article gives an overview of the existing robotic arthroplasty systems available.
The present review describes the types of robots, their classification system, comparisons between various robotic assisted devices available in the market. This review highlights the key steps involved in using various systems, current concepts and the future scope of development in this field. This review also proposes the concept of intelligent alignment philosophy which is more patient specific combining different philosophies.
Keywords– Robotic Assisted techniques, current updates, intelligent alignment, total knee arthroplasty

References

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How to Cite this article: Deshmukh S, Bagaria V. Current Concept Update on Robotic Technology in Arthroplasty. Journal of Clinical Orthopaedics 2024 January-June;9(1):35-41

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Expert Consensus on the Significance of Intravenous Iron using Ferric Carboxymaltose Perioperatively and in Elective Major Orthopedic Surgeries

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Journal of Clinical Orthopaedics | Vol 9 | Issue 1 |  January-June 2024 | page: 42-51 | Mohan Desai, Punit Jain, Surendar Singh Bava, Swarnendu Samanta, K R Prathap Kumar, Anand Galagali, Santhosh Shetty, Atul Panghate, Ashish Arbat, Satish Sonar, Attique Vasdev, Prashant Tonape, Miten Sheth, Ashraf Shaikh, Sachin Suryawanshi, Ketan Kulkarni

Open Access License: CC BY-NC 4.0

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

DOI: https://doi.org/10.13107/jcorth.2024.v09i01.000

Author: Mohan Desai [1], Punit Jain [2,3], Surendar Singh Bava [1], Swarnendu Samanta [4], K R Prathap Kumar [5], Anand Galagali [6], Santhosh Shetty [7], Atul Panghate [1], Ashish Arbat [8,9], Satish Sonar [10], Attique Vasdev [11], Prashant Tonape [12], Miten Sheth [13], Ashraf Shaikh [1], Sachin Suryawanshi [14], Ketan Kulkarni [15]

[1] Department of Orthopedics, Seth G.S Medical College and KEM Hospital, Mumbai, Maharashtra, India,
[2] Department of Hematology Oncology and Stem Cell Transplant, Apollo Hospitals, Navi Mumbai, Maharashtra, India,
[3] HematCare-Speciality Hematology Clinic, Powai, Mumbai, India,
[4] Department of Orthopedics, Peerless Hospital, Kolkata, West Bengal, India,
[5] Department of Orthopedics, Sunrise Group of Hospitals, Kochi, Kerala, India,
[6] Department of Orthopedics Surgery Manipal Hospital, Bengaluru, Karnataka, India,
[7] Department of Arthroplasty and Joint Replacement, Surana Group of Hospitals, Malad, Mumbai, Maharashtra, India,
[8] Department of Joint Replacement Surgery, Jehangir Hospital, Pune, Maharashtra, India,
[9] Department of Orthopedics, Oyster and Pearl Hospital, Pune, Maharashtra, India,
[10] SportsMed Arthroscopy and Shoulder Surgery Centre, Nagpur, Maharashtra, India,
[11] Department of Orthopaedics, Institute of Musculoskeletal Disorders and Orthopaedics, Medanta – The Medicity, Gurugram, Haryana, India,
[12] Department ofArthroscopy and Joint Replacement Surgery, Sterling Multispeciality Hospital, Nigadi, Pradhikaran, Pune, Maharashtra, India,
[13] The Knee Clinic, Mumbai, Maharashtra, India,
[14] Medical Services, Emcure Pharmaceuticals Ltd, Mumbai, Maharashtra, India,
[15] Medical Services, Emcure Pharmaceuticals Ltd, Pune, Maharashtra, India.

Address of Correspondence
Dr. Ketan Kulkarni,
Medical Services, Emcure Pharmaceuticals Ltd, Pune, Maharashtra, India.
E-mail: Ketan.Kulkarni@emcure.com

Abstract

Anemia has emerged as a significant healthcare crisis in India and often remains undiagnosed, with broad implications across all age groups. Iron deficiency remains the most important and correctable cause of anemia in our country. It often leads to significant morbidity during major operative procedures such as hip and knee arthroplasties, due to the substantial intraoperative bleeding associated with these procedures. To address this challenge and mitigate complications related to blood transfusions, peri-operative iron therapy, notably parenteral iron therapy, has become common practice. Nevertheless, there is a lack of consensus on managing peri-operative anemia and the role of ferric carboxymaltose (FCM) in pre-operative and post-operative orthopedic surgeries in India. A group of 14 experts, primarily orthopedic surgeons and an hematologist in India, convened an in-person expert group meeting. Their primary focus was on the approach of FCM in managing anemia in elective orthopedic surgeries within the diverse landscape of the Indian healthcare system. The consensus strongly advocated using FCM as a rapid and adequate source of iron replacement, especially in cases of significant pre-operative and post-operative anemia in patients undergoing elective orthopedic surgery.
Keywords: Pre-operative, post-operative, orthopedic surgery, anemia, ferric carboxymaltose.

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How to Cite this article: Desai M, Jain P, Bava S, Samanta S, Kumar KRP, Galagali A, Shetty S, Panghate A, Arbat A, Sonar S, Vasdev A, Tonape P, Sheth M, Shaikh A, Suryawanshi S, Kulkarni K. Expert Consensus on the Significance of Intravenous Iron using Ferric Carboxymaltose Perioperatively and in Elective Major Orthopedic Surgeries. Journal of Clinical Orthopaedics 2024 January-June;9(1):42-51.

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