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Financial Literacy Rate of Orthopaedic Resident Doctors: A Cross-sectional Study

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Journal of Clinical Orthopaedics | Vol 8 | Issue 2 |  Jul-Dec 2023 | page: 21-28 | Khushi A Rajani, Kashish A Rajani, Kareena Rajani, Anmol R S Mittal, Dhruv Shivdasani

DOI: https://doi.org/10.13107/jcorth.2023.v08i02.586

Authors: Khushi A Rajani [1], Kashish A Rajani [1], Kareena Rajani [1], Anmol R S Mittal [2], Dhruv Shivdasani [3]

[1] OAKS Clinic, 707 Panchshil Plaza, N S Patkar Marg, opp. Ghanasingh Fine Jewels, next to Dharam Palace, Mumbai, Maharashtra, India.
[2] Department of  Orthopaedics, OAKS Clinic, 707 Panchshil Plaza, N S Patkar Marg, opp. Ghanasingh Fine Jewels, next to Dharam Palace, Mumbai, Maharashtra, India.
[3] Digital Initiatives and Business Intelligence, Mumbai, Maharashtra, India.

Address of Correspondence
Khushi A Rajani,
Investigator and Financial Advisor, OAKS Clinic, 707 Panchshil Plaza, N S Patkar Marg, opp. Ghanasingh Fine Jewels, next to Dharam Palace, Mumbai, Maharashtra, India.
E-mail: khushirajani04@gmail.com

Abstract

Background: Healthy financial practices directly affect the financial well-being of an individual, and subsequently the quality of life. Paucity of financial literature in young Indian professionals has been established before by studies that evaluated this topic subjectively. This study emphasizes on assessing the financial literacy of orthopedic resident doctors in a developing country and ascertaining the factors affecting it to improve the same.
Methods: Total 286 resident doctors were analyzed cross-sectionally in terms of their financial knowledge, factors affecting it, financial attitude, subjective satisfaction, and thought process regarding improving this scenario. An objective, 46-question survey-based model was used from February 2023 to April 2023. All the findings were collated and analyzed.
Results: The mean financial literacy was recorded to be 53.56±17.59%. Age, marital status, children, population of the city, education, and occupation of parent 2 had no bearing on the financial literacy of the residents (P > 0.05). The socioeconomic status, retirement savings, loan/debt, and the presence of an emergency fund significantly influenced the financial literacy (P < 0.05). Only 22.38% were satisfied with the current financial situation and 61.89% wanted an in-person meeting with a financial advisor.
Conclusion: Orthopedic resident doctors show low financial literacy and financial satisfaction. Significant steps need to be taken to improve financial knowledge and understanding of the investment options of these professionals to ensure the economic growth of the community.
Keywords: Financial literacy, financial knowledge, resident doctors, orthopedics, financial well-being, financial attitude.

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How to Cite this article: Rajani KA, Rajani KA, Rajani K, Mittal ARS, Shivdasani D. Financial Literacy Rate of Orthopaedic Resident Doctors: A Cross-sectional Study. Journal of Clinical Orthopaedics 2023;8(2):21-28.

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Current Concepts in Prevention of Sports Injuries

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Journal of Clinical Orthopaedics | Vol 8 | Issue 2 |  Jul-Dec 2023 | page: 29-34 | Clevio Joao Baptista Desouza, Nicholas Antao

DOI: https://doi.org/10.13107/jcorth.2023.v08i02.588

Author: Clevio Joao Baptista Desouza [1, 2], Nicholas Antao [2]

[1] Department of Orthopaedics, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, Maharashtra, India

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

Address of Correspondence

Dr. Clevio Joao Baptista Desouza, Department of Orthopaedics, Holy Spirit Hospital, Andheri, Mumbai, Maharashtra, India.

E-mail: ceviod@gmail.com

Abstract

Introduction: The contemporary surge in sports participation, from recreational to professional levels, has brought forth an undeniable enthusiasm for physical activity. However, this heightened engagement comes with an inherent risk of sports-related injuries, spanning various nature and severity. This article introduces the imperative need for a systematic and practical approach to prevent sports injuries, emphasizing the age-diverse demographic involved and the multifaceted motivations driving sports participation.

Materials and Methods: The “Rule of 10,” presented in this paper, serves as a comprehensive guideline for sports injury prevention. The methodology encompasses a range of proactive measures addressing pre-season preparation, athlete education, and holistic strategies to mitigate injury risks. Each facet of the rule, from pre-season physical check-ups to emphasizing psychological preparedness, contributes to a cohesive and multifaceted injury prevention framework.

Conclusion: We through our review article have focused on the “Rule of 10” which advocates a holistic approach to sports injury prevention, integrating pre-season assessments, diverse training, and technology. It emphasizes resilience, education, and collective responsibility for athlete well-being.

Keywords: Agility, Endurance, Prevention, Sports, Strength.

References

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2. Patel DR, Yamasaki A, Brown K. Epidemiology of sports-related musculoskeletal injuries in young athletes in United States. Transl Pediatr 2017;6:160-6.

3. Drawer S, Fuller CW. Evaluating the level of injury in English professional football using a risk based assessment process. Br J Sports Med 2002;36:446-51.

4. Engebretsen L, Bahr R. Why is injury prevention in sports important? In: Sports Injury Prevention. Hoboken, NJ: Wiley-Blackwell; 2009. p. 1-6.

5. Andersen TE, Árnason A, Engebretsen L, Bahr R. Mechanisms of head injuries in elite football. Br Journal Sports Med 2004;38:690-6.

6. Griffin LY, Albohm MJ, Arendt EA, Bahr R, Beynnon BD, Demaio M, et al. Understanding and preventing noncontact anterior cruciate ligament injuries: A review of the Hunt Valley II meeting, January 2005. Am J Sports Med 2006;34:1512-32.

7. Nakase K, Shitara H, Tajika T. An analysis of pre-season risk factors for low back injury in high-school baseball pitchers: a prospective study. Sci Rep. 2021 Jun 1;11(1):11415.

8. Lauersen J.B., Bertelsen D.M., Andersen L.B. The effectiveness of exercise interventions to prevent sports injuries: A systematic review and meta-analysis of randomised controlled trials. Br. J. Sports Med. 2014;48:871–877.

9. Barengo NC, Meneses-Echávez JF, Ramírez-Vélez R, Cohen DD, Tovar G, Bautista JE. The impact of the FIFA 11+ training program on injury prevention in football players: A systematic review. Int J Environ Res Public Health 2014;11:11986-2000.

10. Árnason A, Andersen TE, Holme I, Engebretsen L, Bahr R. Prevention of hamstring strains in elite soccer: An intervention study. Scand J Med Sci Sports 2008;18:40-8.

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22. Engebretsen L, Bahr R, Cook JL, Derman W, Emery CA, Finch CF, et al. The IOC centres of excellence bring prevention to sports medicine. Br J Sports Med 2014;48:1270-5.

23. Verhagen E, Bolling C. Protecting the health of the @hlete: How online technology may aid our common goal to prevent injury and illness in sport. Br J Sports Med 2015;49:1174-8.  

How to Cite this article: Desouza C, Antao N. Current Concepts in Prevention of Sports Injuries. Journal of Clinical Orthopaedics 2023:8(2);29-34.

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Comparing the Efficiency of the Femoral Neck System and the Cannulated Compression Screw in Treating Femoral Neck Fractures in Patients Who Are Young and Middle-aged Indian Population

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Journal of Clinical Orthopaedics | Vol 8 | Issue 2 |  Jul-Dec 2023 | page: 16-20 | Arvind Vatkar, Sachin Kale, Gaurav Kanade, Ashok Godke, Joydeep K. Dey, Rahul Godke, Nrupam Mehta, Sonali Das

DOI: https://doi.org/10.13107/jcorth.2023.v08i02.584

Authors: Arvind Vatkar [1], Sachin Kale [1], Gaurav Kanade [2], Ashok Godke [3], Joydeep K. Dey [4], Rahul Godke [4], Nrupam Mehta [3], Sonali Das [4]

[1] Department of Orthopaedics, Apollo Hospital, Belapur, Navi Mumbai, Maharashtra, India.
[2] Department of Orthopaedics, MGM Hospital, Kamothe, Navi Mumbai, Maharashtra, India.
[3] Department of Orthopaedics, Dr. D. Y. Patil Hospital, Navi Mumbai, Maharashtra, India.
[4] Department of Orthopaedic, Matoshree Hospital, Panvel, Navi Mumbai, Maharashtra, India.

Address of Correspondence
Dr. Arvind Vatkar,
Consultant Spine Surgeon, Department of Orthopaedics, Apollo Hospital, Belapur, Navi Mumbai, Maharashtra, India.
E-mail: vatkararvind@gmail.com

Abstract

Background: There are no long-term studies regarding the clinical effectiveness of a novel fixation technique (femoral neck system [FNS]) for femoral neck fractures. The primary aim of this study was to compare the effectiveness of two internal fixation techniques (FNS and cannulated compression screw [CCS]) for treating femoral neck fractures in individuals between the ages of 20 and 40 years.
Materials and Methods: Data of patients who underwent internal fixation surgery for femoral neck fractures in our hospital between January 2018 and January 2020 with CCS and between January 2020 and January 2022 with FNS were retrospectively evaluated. The groups of CCS and FNS were separated based on the various internal fixation techniques. Demographics about all patients, including sex, age, body mass index, and fracture type were recorded. Pre-operative and 1-year post-operative follow-up of patients was to assess femoral neck shortenings and the Harris Hip score was used to evaluate joint function. Post-operative complications such as femoral head necrosis, non-union, and femoral neck shortening were noted.
Results: 30 patients each of CCS and FNS system fixation were enrolled in the study. The male-to-female ratio was 21:9 and 18:12 for CCS and FNS, respectively. The average age of both groups was around 30 years. Compared to patients treated with CC screws, patients who had FNS treatment required less time to recuperate and resume normal activities. The HSS score improvement at 2 weeks and 12 weeks was significantly better in the FNS system than CCS fixation. There was improvement in flexion, abduction, and external rotation range of motion in FNS compared to CCS. There was no statistically significant difference between the two groups in the incidence of femoral head necrosis or fracture non-union following surgery.
Conclusion: Patients treated with FNS for femoral neck fractures in the age range of 20–40 years can achieve better hip scores than CCS fixation and also have improved range of motion in flexion, abduction, and external rotation.
Keywords: Femoral neck system, cannulated cancellous screw, femoral neck fractures, harris hip score

References

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2. Thorngren KG, Hommel A, Norrman PO, Thorngren J, Wingstrand H. Epidemiology of femoral neck fractures. Injury 2002;33 Suppl 3:C1-7.
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14. Yan C, Wang X, Xiang C, Jiang K, Li Y, Chen Q, et al. Comparison of effectiveness of femoral neck system and cannulate compression screw in treatment of femoral neck fracture in young and middle-aged patients. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2021;35:1286-92.

How to Cite this article: Vatkar A, Kale S, Kanade G, Godke A, Dey JK, Godke R, Mehta N, Das S. Comparing the Efficiency of the Femoral Neck System and the Cannulated Compression Screw in Treating Femoral Neck Fractures in Patients Who Are Young and Middle-aged Indian Population. Journal of Clinical Orthopaedics 2023;8(2):16-20.

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Comparative Analysis of the Immediate Post-operative Outcomes between Conventional and Fully Automatic Robotic-assisted Total Knee Arthroplasty

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Journal of Clinical Orthopaedics | Vol 8 | Issue 2 |  Jul-Dec 2023 | page: 12-15 | Sanjay Bhalchandra Londhe, Ravi Vinod Shah, Clevio Desouza, Vijay Shetty, Nicholas Antao, Meghana Patwardhan, Suhail Kantawala

DOI: https://doi.org/10.13107/jcorth.2023.v08i02.582

Author: Sanjay Bhalchandra Londhe [1, 2], Ravi Vinod Shah [1], Clevio Desouza [2, 3, 4], Vijay Shetty [1, 3], Nicholas Antao [2], Meghana Patwardhan [5], Suhail Kantawala [2]

[1] Department of Orthopaedics, Criticare Asia Hospital, Andheri, Maharashtra, India,
[2] Department of Orthopaedics, Holy Spirit Hospital, Andheri, Maharashtra, India,
[3] Department of Orthopaedics, SAANVI Orthopaedics, Mumbai, Maharashtra, India,
[4] Department of Orthopaedics, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai,
Maharashtra, India,
[5] Department of Anaesthesia, Criticare Asia Hospital, Andheri, Maharashtra, India.

Address of Correspondence
Dr. Sanjay Bhalchandra Londhe,
Department of Orthopaedics, Criticare Asia Hospital, Andheri, Maharashtra, India.
E-mail: sanlondhe@yahoo.com

Abstract

Background: Different techniques employed during conventional and robotic assisted Total Knee Arthroplasty may lead to variation in the immediate post-operative outcomes. Primary objective of the study was to evaluate the differences in the post-operative pain, analgesics use and length of stay between the RA-TKA and C-TKA. Secondary objective was to study the patient reported outcome measures at six months post TKA.
Materials & Methods: It is a retrospective review of two cohort of patients (C -TKA and RA-TKA) who were operated between January to April 2022. Patients were given the option between C-TKA and RA- TKA. Sample size was estimated to be 28 patients in each group with α error of 0.05 and power of study being 80%. An independent observer analyzed the post-operative parameters like analgesic use, length of stay, VAS score and Oxford Knee Score at 6 months post TKA.
Results: 30 patients in two cohorts were studied. There was no statistically significant difference between the two cohorts as regards the pre-operative patient characteristics. RA- TKA group had a shorter hospital stay (days) than the C-TKA group (3.24±0.50 and 4.07± 0.52, P <0.0001). Pain score (VAS score) was lower in RA -TKA than C-TKA cohort (POD1 5.23 ± 0.50 and 5.93 ± 0.52 POD2 4.40 ± 0.56 and 5.03 ± 0.49, p value <0.0001). R- TKA patients required significantly lower morphine milligram equivalent and NSAIDS than the C-TKA patients (p =0.0005 and p <0.001 respectively). The OKS at 6 months was lower in C-TKA than RA-TKA (32.5± 2.3 C-TKA vs. 33.8±1.5 RA-TKA, p value 0.0120).
Conclusions: RA,-TKA cohort showed significant early advantages like decreased post-operative analgesia usage, shorter length of stay and lower pain scores on day 1 and 2 than the C TKA group. The OKS at 6 months was slightly better in RA-TKA vs. C-TKA.
Keywords: Robotic-assisted total knee arthroplasty, Conventional total knee arthroplasty, Visual analog scale score, Analgesic.

References

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2. Kahlenberg CA, Nwachukwu BU, McLawhorn AS, Cross MB, Cornell CN, Padgett DE. Patient satisfaction after total knee replacement: Asystematic review. HSS J 2018;14:192-201.
3. Mannan A, Vun J, Lodge C, Eyre-Brook A, Jones S. Increased precision of coronal plane outcomes in robotic-assisted total knee arthroplasty: A systematic review and meta-analysis. Surgeon 2018;16:237-44.
4. Jones CA, Voaklander DC, Suarez-Almazor ME. Determinants of function after total knee arthroplasty. Phys Ther
2003;83:696-706.
5. Lim HA, Song EK, Seon JK, Park KS, Shin YJ, Yang HY. Causes of aseptic persistent pain after total knee arthroplasty. Clin Orthop Surg 2016;9:50-6.
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7. Petursson G, Fenstad AM, Gøthesen O, Dyrhovden GS, Hallan G, Röhrl SM, et al. Computer-assisted compared with conventional total knee replacement. J Bone Joint Surg Am 2018;100:1265-74.
8. Kayani B, Konan S, Tahmassebi J, Pietrzak JR, Haddad FS. Robotic-arm assisted total knee arthroplasty is associated with improved early functional recovery and reduced time to hospital discharge compared with conventional jig-based total knee arthroplasty: A prospective cohort study. Bone Joint J 2018;100-B:930-7.
9. Marchand RC, Sodhi N, Khlopas A, Sultan AA, Harwin SF, Malkani AL, et al. Patient satisfaction outcomes after robotic arm-assisted total knee arthroplasty: Ashort-term evaluation. J Knee Surg 2017;30:849-53.
10. Naziri Q, Burekhovich SA, Mixa PJ, Pivec R, Newman JM, Shah NV, et al. The trends in robotic-assisted knee
arthroplasty: A statewide database study. J Orthop 2019;16:298-301.
11. Khlopas A, Chughtai M, Hampp EL, Scholl LY, Prieto M, Chang TC, et al. Robotic-arm assisted total knee arthroplasty demonstrated soft tissue protection. Surg Technol Int 2017;30:441-6.
12. Hampp EL, Chughtai M, Scholl LY, Sodhi N, Bhowmik-Stoker M, Jacofsky DJ, et al. Robotic-arm assisted total knee arthroplasty demonstrated greater accuracy and precision to plan compared with manual techniques. J Knee Surg 2018;32:239-50.
13. Kayani B, Konan S, Pietrzak JR, Haddad FS. Iatrogenic bone and soft tissue trauma in robotic-arm assisted total knee arthroplasty compared with conventional jig-based total knee arthroplasty: Aprospective cohort study and validation of a new classification system. J Arthroplast 2018;33:2496-501.
14. Nicoll D, Rowley DI. Internal rotational error of the tibial component is a major cause of pain after total knee
replacement. J Bone Joint Surg Br 2010;92:1238-44.
15. Kayani B, Konan S, Pietrzak JR, Huq SS, Tahmassebi J, Haddad FS. The learning curve associated with robotic-arm assisted unicompartmental knee arthroplasty. Bone Joint J 2018;100-B:1033-42.
16. Kayani B, Konan S, Ayuob A, Onochie E, Al-Jabri T, Haddad FS. Robotic technology in total knee arthroplasty: A systematic review. EFORTOpen Rev 2019;4:611-7.
17. Clark G, Steer R, Tippett B, Wood D. Short-term benefits of robotic assisted total knee arthroplasty over computer navigated total knee arthroplasty are not sustained with no difference in postoperative patient-reported outcome measures. Arthroplast Today 2022;14:210-5.e0.

How to Cite this article: Londhe SB, Shah RV, Desouza C, Shetty V, Antao N, Patwardhan M, Kantawala S. Comparative Analysis of the Immediate Post-operative Outcomes between Conventional and Fully Automatic Robotic-assisted Total Knee Arthroplasty. Journal of Clinical Orthopaedics 2023;8(2):12-15.

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What is Associated with the Greatest Effect on Lengths of Stay after Total Knee Arthroplasty: The Hospital, the Surgeon, or the Patient

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Journal of Clinical Orthopaedics | Vol 8 | Issue 2 |  Jul-Dec 2023 | page: 07-11 | Max Willinger, Peter Gold, Luke Garbarino, Hiba Anis, Nipun Sodhi, Jonathan R Danoff

DOI: https://doi.org/10.13107/jcorth.2023.v08i02.580

Author: Max Willinger [1], Peter Gold [1], Luke Garbarino [1], Hiba Anis [2], Nipun Sodhi [1], Jonathan R Danoff [3]

[1] Department of Orthopedic Surgery, Long Island Jewish Medical Center, New Hyde Park, New York, USA,
[2] Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, Ohio, USA,
[3] Department of Orthopedic Surgery, North Shore University Hospital, Manhasset, New York, USA.

Address of Correspondence
Dr. Max Willinger,
Department of Orthopedic Surgery, Long Island Jewish Medical Center, New Hyde Park, New York, USA.
E-mail: max.willinger1@gmail.com

Abstract

Introduction: Patient-, hospital-, and surgeon-related factors are each associated with the variable nature of length of stay (LOS) after total knee arthroplasty (TKA). However, there is a paucity of literature regarding these intertwined relationships. This study aimed to determine if the hospital, the surgeon, or the patient has the greatest association with LOS after TKA.
Materials and Methods: A total of 11,402 patients were identified from a multicenter prospectively collected institutional database between January 01, 2017, and April 01, 2019. Surgeons and hospitals were subdivided into three groups: (1) low volume (<10 and <100 cases, respectively), (2) intermediate volume (10–150 and 100–400 cases, respectively), and (3) high volume (>150 and >400 cases, respectively). Patient demographics, comorbidities, hospital academic status, and LOS were identified. Univariate and multivariate analyses were performed to compare hospital-, surgeon-, and patient-related factors.
Results: Neither hospital (P = 0.173) volume nor surgeon (P = 0.413) volume were significantly associated with LOS in multivariate analyses while controlling for patient-, surgeon-, and hospital-related factors. Patient medical factors including diabetes (P < 0.001), congestive heart failure (P < 0.001), peripheral vascular disease (P < 0.001), chronic kidney disease (P < 0.001), chronic obstructive pulmonary disease (P < 0.001), and anemia (P < 0.033), as well as academic teaching hospitals (P < 0.001) were associated with a significant increase in hospital LOS.
Conclusion: Patient’s chronic medical conditions and hospital status as an academic teaching hospital were found to be the most important associated risk factors on post-operative hospital LOS after TKA. This study directs the focus onto pre-operative optimization and patient selection and helps demonstrate where to best allocate resources to successfully decrease LOS.
Keywords: Lengths of stay, Total knee arthroplasty, Pre-operative optimization, Complications, High volume surgeon.

References

1. Hoffmann JD, Kusnezov NA, Dunn JC, Zarkadis NJ, Goodman GP, Berger RA. The shift to same-day outpatient joint arthroplasty: A systematic review. J Arthroplasty 2018;33:1265-74.
2. Burn E, Edwards CJ, Murray DW, Silman A, Cooper C, Arden NK, et al. Trends and determinants of length of stay and hospital reimbursement following knee and hip replacement: Evidence from linked primary care and NHS hospital records from 1997 to 2014. BMJ Open 2018;8:e019146.
3. Kreder HJ, Grosso P, Williams JI, Jaglal S, Axcell T, Wal EK, et al. Provider volume and other predictors of outcome after total knee arthroplasty: A population study in Ontario. Can J Surg 2003;46:15-22.
4. Styron JF, Koroukian SM, Klika AK, Barsoum WK. Patient vs provider characteristics impacting hospital lengths of stay after total knee or hip arthroplasty. J Arthroplasty 2011;26:1418- 26.e1.
5. Yasunaga H, Tsuchiya K, Matsuyama Y, Ohe K. Analysis of factors affecting operating time, postoperative complications, and length of stay for total knee arthroplasty: Nationwide web-based survey. J Orthop Sci 2009;14:10-6.
6. Piuzzi NS, Strnad GJ, Sakr Esa WA, Barsoum WK, Bloomfield MR, Brooks PJ, et al. The main predictors of length of stay after total knee arthroplasty: Patient-related or procedure-related risk factors. J Bone Joint Surg Am 2019;101:1093.
7. Bozic KJ, Maselli J, Pekow PS, Lindenauer PK, Vail TP, Auerbach AD. The influence of procedure volumes and standardization of care on quality and efficiency in total joint replacement surgery. J Bone Joint Surg Am 2010;92:2643-52.
8. Prohaska MG, Keeney BJ, Beg HA, Swarup I, Moschetti WE, Kantor SR, et al. Preoperative body mass index and physical function are associated with length of stay and facility discharge after total knee arthroplasty. Knee 2017;24:634-40.
9. Winemaker M, Petruccelli D, Kabali C, de Beer J. Not all total joint replacement patients are created equal: Preoperative factors and length of stay in hospital. Can J Surg 2015;58:160-6.
10. Martino J, Peterson B, Thompson S, Cook JL, Aggarwal A. Day of week and surgery location effects on stay length and cost for total joint arthroplasty: Academic versus orthopaedic-specific hospital. J Knee Surg 2018;31:815-21.
11. Pamilo KJ, Peltola M, Paloneva J, Makela K, Hakkinen U, Remes V. Hospital volume affects outcome after total knee arthroplasty. Acta Orthop 2015;86:41-7.
12. Lavernia CJ, Guzman JF. Relationship of surgical volume to short-term mortality, morbidity, and hospital charges in arthroplasty. J Arthroplasty 1995;10:133-40.
13. Hervey SL, Purves HR, Guller U, Toth AP, Vail TP, Pietrobon R. Provider volume of total knee arthroplasties and patient outcomes in the HCUP-nationwide inpatient sample. J Bone Joint Surg Am 2003;85:1775-83.

How to Cite this article: Willinger M, Gold P, Garbarino L, Anis H, Sodhi N, Danoff JR. What is associated with the Greatest Effect on Lengths of Stay after Total Knee Arthroplasty: The Hospital, the Surgeon, or the patient. Journal of Clinical Orthopaedics 2023:8(2);07-11.

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ORTHO AI: The Dawn of a New Era: Artificial Intelligence in Orthopaedics

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Journal of Clinical Orthopaedics | Vol 8 | Issue 2 |  Jul-Dec 2023 | page: 05-06 | Parag Sancheti, Neeraj Bijlani, Ashok Shyam, Amit Yerudkar, Rohan Lunawat

DOI: https://doi.org/10.13107/jcorth.2023.v08i02.578

Authors: Parag Sancheti [1], Neeraj Bijlani [2], Ashok Shyam [1, 3], Amit Yerudkar [4], Rohan Lunawat [4]

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

[2] Orthotech Clinic, Chembur, Mumbai, India.

[3] ndian Orthopaedic Research group, Thane, India.

[4] Scriptlanes Pvt Ltd, Pune, India.

Address of Correspondence
Dr. Ashok Shyam, Indian Orthopaedic Research group, Thane, India.

E-mail: drashokshyam@gmail.com

Editorial

OrthoAI is the new buzz word in Orthopaedics. It was launched on 11th Dec 2023 at the hands of Dr Raghunath Mashelkar. It was an amazing event structured around the World’s First AI Focussed on Orthopaedics. Artificial Intelligence revolution began in Nov 2022 with advent of Chat GPT 3.5 on the AI landscape. Since then the advancements in Artificial Intelligence (AI) have started to change the landscape of various industries, and orthopaedics is no exception. Based on our observations and research, we firmly believe AI will redefine the landscape of orthopaedics in the near future specially in fields mentioned below but not restricted to it. With OrthoAI as first step we have created the foundation on which we can build on. We would be working in this field and follow it as it unfolds and present our insights from time to time.

OrthoAI: A Generative AI Revolution in Orthopaedics
As said OrthoAI is the foundation of the AI Revolution in Orthopaedics, and we would like to share some more insights about it. OrthoAI primary is a Generative AI like chat GPT. You can even call it OrthoGPT (Ortho Generative Pre-trained Transformer), a type of artificial intelligence model designed for understanding and generating human-like text. OrthoAI, akin to a specialized version of Chat GPT, or ‘OrthoGPT’, stands on three foundational pillars:
1. The OrthoAI Database: The essence of OrthoAI lies in its meticulously curated vector database, developed over nine months by a team of expert orthopaedic surgeons. This database is the cornerstone of OrthoAI’s reliability and validation.
2. PubMed Access: OrthoAI’s integration with PubMed enriches its evidence base, ensuring that its responses are grounded in the latest orthopaedic literature.
3. OrthoTV Access: With over eleven thousand orthopaedic videos, OrthoTV provides a wealth of expert knowledge and experiences. OrthoAI’s access to this repository allows it to offer comprehensive answers, supplemented with relevant article links and video content
Before we explore the far-reaching applications of OrthoAI, it’s crucial to gain an understanding of what AI is and its main types. At its core, AI involves creating computer systems that mimic human intelligence, enabling them to perform tasks that usually require human intellect.
Before delving into OrthoAI’s applications, it’s vital to understand AI’s core components:

• Machine Learning (ML) is a subset of AI that allows computers to learn and improve from experience without being explicitly programmed. In simpler terms, it’s like teaching a child to identify objects. Over time, the child learns to recognize and distinguish objects on their own, much like ML algorithms learn from data and improve over time. OrthoAI is primed with Machine Learning
• Deep Learning (DL) is a more complex subset of ML that mimics the neural networks of our brain. DL involves feeding a computer system a vast amount of data, which it uses to make decisions. For example, DL can help computers identify diseases by analyzing thousands of radiographs or MRI Scans. This ability to process and analyse a significant amount of data makes DL particularly valuable for OrthoAI.
• Natural Language Processing (NLP) is another critical aspect of AI that focuses on the interaction between computers and humans using natural language. NLP can read and understand human language, enabling it to extract essential information from clinical notes or respond to patient queries in real-time. OrthoAI has NLP built in and will continue to learn from all its interactions.
The rise of NLP and Large language models in last few months has infused new life in the AI arena and has piked the interest in these models.

We believe AI will primarily impact in following Five areas of Orthopaedics
OrthoAI & Clinical Decision Making

OrthoAI as discussed above is built on a validated database, along with PubMed and OrthoTV access. This makes the answers most relevant and trustworthy. With a synthesised answer from all sources, it will be source of having a huge thinking knowledge bank at your fingertips. It will act as CO-PILOT or as EBM Assistant to Orthopaedic Surgeons, helping them in tricky situations. The queries can vary from clinical, academic, case based, surgical steps, drug interactions, rehabilitation, complications, and surgical planning too. This is the version 1, and more things would be added in coming versions

AI and Orthopaedic Imaging
One of the most promising applications of AI in orthopaedics is in imaging. We rely heavily on imaging for diagnosis and treatment planning. AI can help streamline this process. ML algorithms, with their ability to identify patterns, can analyse and interpret imaging data from radiographs, MRIs, CT scans, etc. These algorithms can diagnose conditions like fractures, disc herniations and osteoarthritis with a level of accuracy comparable to experienced radiologists, saving significant diagnostic time. We believe radiologist are already using such algorithms and DL models, but it will soon extrapolate into a more common use by orthopaedic surgeons too

AI in Surgical Planning and Execution
The influence of AI will also transform surgical planning and execution. Patient specific planning and preoperative templating can be easily done by AI. AI’s influence isn’t confined to diagnostics—it’s also transforming surgical planning and execution. Additionally, AI can help surgeons place implants accurately during orthopaedic procedures, thus reducing complications and improving patient outcomes. With large data available from the rise of robotic surgeries in last decade, will help in training these models and soon a combination of robotic AI will be available to help us. OrthoAI is currently being worked as a platform for surgical planning too

AI in Prosthetics and Rehabilitation
Customised prosthetic development and suggesting innovative strategies in prosthetics that mimic natural movements will be achieve through advanced machine learning algorithms. Furthermore, AI-based rehabilitation programs will offer personalized therapy plans and monitor patient progress in real-time, ensuring a more efficient recovery process. Customisation & utilisation of smart devices in this area will increase.

AI in Predictive Analytics
Predictive analytics is another area where AI is showing tremendous potential. AI algorithms can analyse vast amounts of patient data to identify risk factors and predict disease progression. This information allows orthopaedic professionals to intervene early, potentially preventing the development of severe conditions and improving patient care. The algorithmic nature of these analysis make it most suitable to be plugged in into OrthoAI. A separate team in working on adding this unique feature to OrthoAI and we are sure that this will come as an update soon.

Ethical Considerations and Challenges
Like any technology even AI has its limitations. The issues of hallucinations of AI and providing wrong information are not uncommonly reported. This is the reason why we started with creating a validated database for OrthoAI and also limit its access to all unnecessary information. The integration of AI into orthopaedics will not be without challenges but we have created a foundation for it. AI will also raise critical ethical considerations concerning data privacy, informed consent, and accountability in the event of AI errors. Additionally, we need to develop a standardized set of regulations for using AI in healthcare to ensure its ethical and safe application.

Conclusion
OrthoAI is launched at the threshold of a new era in orthopaedics, bringing significant improvements in diagnosis, treatment planning, surgical execution, prosthetics, rehabilitation, and predictive analytics. As we start to incorporate AI more comprehensively into our practice, we need to conscientiously navigate the ethical and legal challenges it presents. Our enthusiasm as technologically inclined orthopaedic surgeons drives us to harness OrthoAI’s full potential, ushering in an era of precision, efficiency, and patient-centric care in orthopaedics.

 

How to Cite this article: Sancheti P, Bijlani N, Shyam A, Yerudkar A, Lunawat R. ORTHO AI: The Dawn of a New Era: Artificial Intelligence in Orthopaedics. Journal of Clinical Orthopaedics 2023;8(2):05-06.

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10 Important Financial Investments for Orthopods in India

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Journal of Clinical Orthopaedics | Vol 8 | Issue 2 |  Jul-Dec 2023 | page: 03-04 |  Sachin Kale, Arvind Janardhan Vatkar

DOI: https://doi.org/10.13107/jcorth.2023.v08i02.576

Authors: Sachin Kale [1], Arvind Janardhan Vatkar [2]

[1]  Head of Unit, Department of Orthopedics, D Y Patil Hospital and Medical College, Navi Mumbai, Maharashtra, India,
[2]  Consultant Orthopedics Spine Surgeon, Fortis Hiranandani Hospital, Navi Mumbai, Maharashtra, India.

 

Address of Correspondence
Dr. Vatkar Arvind Janardhan,
Consultant Spine Surgeon, Department of Orthopaedics, Fortis Hiranandani Hospital, Juhu Nagar, Sector 10A, Vashi, Navi Mumbai – 400703, Maharashtra, India.
E-mail: vatkararvind@gmail.com

Editorial

Orthopedic surgeons are usually well-versed in the medical parts of their career, but they may be less so in the financial aspects. The purpose of this article is to present orthopedic surgeons with a list of ten critical financial investments that will help them ensure their financial future and improve their practice. Orthopedic doctors may make educated decisions and develop a sound financial foundation for their careers and retirement by considering these investing alternatives. The article will discuss a variety of investment possibilities, including stocks, bonds, real estate, and alternative investments, as well as how to manage funds wisely to maximize profits and minimize risks.

Life Insurance Plan
Term life insurance is recommended for doctors due to its affordability and flexibility, but should not be mixed with money back clauses. The ideal life cover amount depends on income, financial obligations, and future goals. Dave Ramsey’s Rule of Thumb suggests getting coverage 10–12 times your income, while the Life Insurance Amount Formula calculates needs by adding outstanding debts, projected family expenses such as kid’s education and marriage, annual expenses, and deducting current savings and investments. The White Coat Investor recommends a 30-year term life insurance policy for simplicity, and it is generally wise to have life insurance until children become financially independent and you have enough money to care for your spouse.

Mediclaim Policy
Mediclaim coverage is crucial for orthopedic surgeons and their families in India to cover the financial impact of medical emergencies. Factors to consider include the sum insured, network hospitals, and pre-existing sickness coverage. For major cities like Delhi or Mumbai, an insured amount of Rs 10 lakh per person is recommended. For households of two adults and one child, Rs 30 lakh is recommended. Pre-existing diseases disclosure is essential to avoid reimbursement issues like refusal of claim. Health insurance portability allows policyholders to switch insurance companies for better coverage or services, without forfeiting any accrued renewal benefits waiting period for pre-existing diseases. However, portability is only available 45 days before policy renewal.

Fixed Deposit
Fixed deposit plans provide greater interest rates than savings accounts, making them an appealing long-term investment option. Early withdrawals, on the other hand, may result in penalties or lesser returns. Before investing, it is important to examine the bank’s trustworthiness, interest rate offered, scheme duration, and other terms and conditions. It should be noted that the interest produced by these schemes is taxable.

Gold and Gold Bonds
Gold and Sovereign Gold Bonds (SGBs) are attractive investment alternatives for doctors in India because they provide a buffer against inflation and a secure harbor for funds. Gold is a desirable asset that gains with time, but there are expenditures to consider such as storage and maintenance. SGBs, which were introduced in November 2015, are government securities priced in grams of gold with a set annual interest rate of 2.5% and an 8-year maturity with tax advantages. Individuals, HUFs, trusts, universities, and charity institutions are all eligible investors.

Mutual Funds
Mutual funds have several benefits, including diversification, expert management, liquidity, and cost. Doctors can invest in mutual funds and can invest on their own or use an advisor. Systematic Investment Plans (SIPs) are a popular option for doctors to engage in mutual funds because they allow them to contribute small sums on a regular basis and profit from the power of compounding. Before investing, it is critical to assess several mutual fund options, such as direct investment, which lowers the expense ratio, and consider variables such as the fund’s performance history, fund manager track record, fund stock portfolio, and investment strategy. One of the simplest methods is to invest in index mutual funds, which provide identical returns to indexes such as the Nifty50.

Equity Stocks
India’s economic might is increasing. As a result, equity stocks provide long-term development and capital appreciation potential for investors. Doctors should examine market risks carefully and diversify their investment portfolios. They can invest in large-cap stocks with a track record of consistent growth, such as Asian Paints and Pidilite, and equities traded funds, such as Nifty Bees, or seek professional assistance in developing a portfolio that is matched with their financial goals and risk tolerance. SIPs are popular for investing in equities companies. Due to stock market volatility, the investment horizon should be more than 5 years to expect returns of 12–15%.

Professional Indemnity
In India, professional indemnity insurance is essential for orthopedic specialists since it protects legal responsibilities resulting from medical malpractice lawsuits. It shields doctors against financial risks such as judgments, arbitration fees, medical harm, punitive damages, restitution, attorneys’ fees, legal costs, and penalties. For orthopedic surgeons, the insurance should give continuity of coverage for liability from previous years of practice, offer out-of-court settlement, and have a minimum sum insured of 1 crore. The sum guaranteed is also determined by insurance period (any one year AOY) and accident times (any 1 time AOT). For complete coverage and dependable service, it is critical to renew the policy on time and to pick a renowned insurance provider. Various medical organizations, such as Maharashtra Orthopaedic Associations, have professional indemnity programs.

Car Insurance
Before purchasing car insurance for doctors in India, it is crucial to consider the following factors: company reputation, coverage, exclusions, deductible, claim process, premium payment frequency, add-on options such as cashless facility, customer service, claim settlement ratio, and online buying option. The Insured Declared Value is the market price of a car and the maximum sum insured if the car is stolen or damaged beyond repair. The insurance premium is also directly proportional to IVD; hence, an appropriate IVD is important. The Incurred Claim Ratio (ICR) is the total claim amount paid by the insurance company in relation to the total premium amount collected in a financial year. A high ICR indicates good compensation settlement. By considering these factors, doctors can make informed decisions and get the most value for their money when purchasing car insurance in India.

Real Estate
Residential, commercial, real estate crowdfunding, raw land, and real estate investment trusts are all types of real estate investments in India. These investments enable investors to diversify their portfolios while also generating rental income or capital appreciation over time. Doctors should evaluate their property’s location, thorough property registration documents check, and any legal concerns relating to the property to make informed judgments. They should define their investment goals and risk tolerance, as well as perform extensive study on market trends, property valuations, demographics, and possible future growth.

Retirement Planning
Retirement planning is important in India for a variety of reasons, including financial stability, addressing increased life expectancy, managing inflation and healthcare expenses, taking advantage of tax breaks, and gaining peace of mind during the post-retirement era. Early in their careers, Indian doctors should begin planning for retirement, diversifying their retirement portfolio to spread risk and maximize returns, considering tax-efficient retirement planning strategies such as the Public Provident Fund and the National Pension System, budgeting for health-care expenses, and seeking professional advice. Starting early investment uses power of compounding which dramatically increase their retirement savings over time, while diversifying their portfolio can help balance risk and reward. Seeking competent financial counsel can assist Indian physicians in making educated judgments and navigating the complex retirement planning alternatives.

Conclusion
Finally, we must diagnose our own financial literacy. We must learn and study to clear blind spots in our financial knowledge. Finally, just as we utilize our medical knowledge to operate and treat our patients, we should use our financial knowledge to be financially independent, wealthy, and to assist others in achieving their life goals.

 

 

How to Cite this article: Vatkar AJ, Kale S. 10 Important Financial Investments for Orthopods in India. Journal of Clinical Orthopaedics 2023;8(2):03-04.

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Does inequality prevail in treatment of fairer sex in orthopaedics?

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Journal of Clinical Orthopaedics | Vol 8 | Issue 2 |  Jul-Dec 2023 | page: 01 | Nicholas A Antao

DOI: https://doi.org/10.13107/jcorth.2023.v08i02.572

Authors: Nicholas A Antao [1]

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

Address of Correspondence
Dr. Nicholas A Antao,

Department of Orthopaedics, Holy Spirit Hospital, Mumbai, India.
Chief Editor Journal of Clinical Orthopaedics
Managing Trustee of FIAMC BioMedical Ethics Centre
Past President of Bombay Orthopaedic Society
Past President Of Indian Arthroscopy Society
Past Editor of Indian Journal of Orthopaedics
E-mail: narantao@gmail.com

Editorial

From times immemorial, women has had the difficult road to travel, may be their values in societal position, their active participation and understanding and realisation of their voice in matters of legislation, not to say the least in day to day contribution still needs to be appreciated despite working full time24/7.
When I was a resident in the seventies, I often used to wonder, why the Opd’s were full of womenfolk as compared to men in chronic ailments of musculoskeletal pains carrying a with them , a thick pad of opd papers with only written legible prescription was ctall (continue all). On the other hand, the numbers were higher for male gender in trauma and sports injuries. To attend the OPDs, probably was an outing for them, getting away from daily chores of unrecognised and unappreciated, housebound work of 24/7.
The most research subjects were males than females and the surprising feature was absent of consent when it came to consent for surgery, as if their presence does not matter and their place needs to be at home alone. It was accepted that they are not the bread winners but only the homemakers and medical expenditure on them was not very fruitful. It was after the 1993 the National Institute of Health made a declaration to deliver equal high quality of care and effective management to all and not to make gender biased discrimination.
As we crossed the twentieth century and went into the 21st century, a forward progressive thinking brought about sea of change, when women started working in offices, took up to education, excelled more than men in education and in financial matters , thereby becoming independent and therefore demanded equality of status. There are now ever increasing number of women not only doing Orthopaedics but also superspecialising in sub specialist and attracting female patients and thus competing with their male counterparts. So you no longer see the world” destined for men only “ operating today, because of the need felt to give equal opportunity to all without any bias and discrimination of social status and circumstances to attain their full potential.
Nowadays you see more women readily agree to consent for surgery, since more and more educated young men and women tend to accompany their mother for being operated because they insure their parents for medical treatment and feel satisfied emotionally and morally as they are giving back to them to reciprocate their loved and care. But still in some developing and underdeveloped countries for want of insurance agencies and abilities, there opportunities of facilities of care are lacking and therefore the male counterpart still is preferred for surgery over female patient. The female patient has more ailments of osteoporosis, osteoarthrosis and musculoskeletal problems than the male counterparts and the need to be promptly treated, to keep the pillar and backbone of the family healthy and not disabled.
In developed countries, many joint replacement registries show, increasing number of female patients getting operated for joint replacement surgery and even for sports related injuries, implying that the ratio is changing to the prevailing order earlier.
This reversing trend is better for society as the female patient becomes multitasked and well respected needs to be equally cared for and given the importance.

 

Dr. Nicholas A Antao
M.S; D.N.B; F.C.P.S.
Professor and Head of Department of Orthopaedics, Holy Spirit Hospital
Chief Editor Journal of Clinical Orthopaedics
Managing Trustee of FIAMC BioMedical Ethics Centre
Past President of Bombay Orthopaedic Society
Past President Of Indian Arthroscopy Society
Past Editor of Indian Journal of Orthopaedics
E-mail: narantao@gmail.com

How to Cite this article: Antao NA. Does inequality prevail in treatment of fairer sex in orthopaedics? Journal of Clinical Orthopaedics 2023;8(2)01.

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A Two-Decade Odyssey: My Journey with the Bombay Orthopaedic Society

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Journal of Clinical Orthopaedics | Vol 8 | Issue 2 |  Jul-Dec 2023 | page: 02 | Sanjay Dhar

DOI: https://doi.org/10.13107/jcorth.2023.v08i02.574

Authors: Sanjay Dhar [1]

[1] Professor of Orthopaedics, Navi Mumbai, Consultant Apollo Hospital, Navi Mumbai, India.

Address of Correspondence
Dr. Sanjay Dhar
Professor of Orthopaedics, Navi Mumbai, Consultant Apollo Hospital, Navi Mumbai, India.
Email: drsanjaydhar@gmail.com

Editorial

Introduction: In the fall of 1993, I arrived at King Circle station, a young orthopaedic graduate from the strife-ridden town of Jammu. Bombay, as it was known then, offered me the opportunity to work in one of the finest trauma centers in the country, a dream come true for someone displaced by the violent turmoil in Kashmir.
Early Years and Professional Marvel (1993-2001): Working alongside esteemed colleagues such as NS Laud, VT Ingalhalikar, Joy Patankar, Ajay Puri, Ram Chaddha, and Arvind Goregaonkar felt like wielding a magic wand that turned everything to gold. Joining Sion Hospital, a professional marvel, was a significant leap for me. It was during this time that my friend, Ajay Puri, introduced me to the Bombay Orthopaedic Society (BOS), marking the beginning of a profound association.
Executive Committee Member (2001-2003): Becoming an executive committee member in 2001 opened doors within BOS’s inner circles. The society, free from bias and politics, focused on nurturing the orthopaedic fraternity. Its unique selling point was enhancing orthopaedic surgery and promoting holistic development.
Organising WIROC2003: The pinnacle of my involvement came when I organized WIROC2003, despite the personal adversity of losing my father. This flagship conference became a milestone, setting new standards in organization and academic excellence. From revolutionary conference organizing paradigms to creating academic events, BOS provided the freedom to unleash unrestrained creativity.
Secretaryship and Refining Programs (2016-2018): Elected as Secretary in 2016, my role was to refine existing programs and introduce fresh academic activities, maintaining BOS’s academic dominance. Initiatives such as PG classes, the launch of the Journal of Clinical Orthopaedics, and more showcased a burning desire to contribute to the society.
Presidency and Innovations (2023)): Now, as the President, I’ve introduced new programs like “Rising Star” and “Student of the Year” to recognize and inspire young talents. Tying it all together is WIROC 2023, with the theme “Brevis Longus Magnus,” aiming to solidify its status as the apex of orthopaedic education.
Future Aspirations and Legacy: After relinquishing my office, I envision BOS exploring areas like orthopaedic advocacy, motivating the younger generation, and fostering empathy for patients. BOS, with its unbiased education and commitment to excellence, stands as a beacon for orthopaedic education and treatment.
Conclusion: This two-decade journey from a reluctant newcomer to the President’s seat reflects the unique ethos of BOS. With a legacy of unwavering guidance from figures like LN Vora and Anand Thakur NS Laud, D D Tanna and many more who always stood up for BOS and it’s ethos. I shall leave with the confidence that BOS will continue to flourish, and maintain its place in exploring new frontiers in orthopaedic education and advocacy.

 

 

How to Cite this article: Dhar  S. A Two-Decade Odyssey: My Journey with the Bombay Orthopaedic Society. Journal of Clinical Orthopaedics 2023;8(2):02.

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Editorial 2023

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Journal of Clinical Orthopaedics | Vol 8 | Issue 1 |  Jan-Jun 2023 | page: 01 | Dr. Nicholas Antao, Dr. Ashok Shyam

DOI: 10.13107/jcorth.2022.v08i01.546

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

[1] Department of Orthopaedics, Hill Way Clinic, Hill N Dale Building, 4th Floor, Hill Road, Bandra West, Mumbai, Maharashtra, India.

[2] Department of Orthopaedics, Sancheti Institute for Orthopaedics and Rehablitation, Pune, India.

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

Editorial 

Our last WIROC-22 issue was mainly on paediatrics articles from a well written, accepted and acclaimed symposium on “Office Orthopaedics in Paediatrics” This issue contains thought provoking articles that were not covered earlier in that symposium.

Whereas anterior knee pain in adults is quite complex, similar pain in the paediatrics age can be quite perplexing. A well written article here will help you to gather your thoughts and make precision diagnosis.
Any deformity in the child is quite disabling and depressing for the parent that they very keen to get treatment to correct the same as early as possible. Can you imagine the agony of the parent when their child has such a deformity congenital or acquired and they would be very keen to do everything on earth to free the child of the same? The role of braces is well discussed in this issue and will be very helpful in guiding them to avoid their fear.
Flat feet are a common entity often worrying the parent, that their ward is not walking properly, complaining about pain while walking, running or the shoes get worn out fast. The most information given in the article is to understand the difference between rigid flat feet and correctible flat feet and the associated tight tissues and joints to be notably corrected.
CTEV is a common congenital deformity of the feet and the evolution of Ponsetti’s method with Pirani’s score helps you to understand deeper into the problem and the knowledge how to correct the deformity through serial manipulation and plastering. The author has described the method very succinctly.
We all know how difficult is to get rid of pain of gouty arthritis with allopathic medicine and even surgical methods often do not give the desired results to make patient pain-free of the ailment. A multicentric study revealed that herbal therapy is more effective than allopathic therapy is very interesting and informative. Another multicentric review on non-operative treatment of early osteoarthrosis is interesting is indeed very interesting with Orthobiologics playing a major role in defining the its role and how effective it can be in the initial stages.
We are happy that this issue has multicentric study reviews which is very encouraging and the most important factor to take indexing of the journal to a higher level.
All of us are aware of how much the COVID took the toll of medical and para medics life, inter personal relationships, workplace issue and various other problems in the management of this pandemic. The article Burnout in COVID-19 residency highlighted the innumerable problems and issues the resident faced in tackling the pandemic. They concluded that the educators should consider pertinent instruction and interventions during the process of instructing resident doctors which is vital to save the life of the patient, resident, paramedics and better management of the patient and the burn out. An interesting, rare case report on giant cell tumor of the tendon sheath is very informative.

Finally, the article on prevention of sports injuries is an eye opener to counsel patients with sports injuries to prevent further deterioration of the injury.

 

Dr. Nicholas Antao,

Dr. Ashok Shyam.

How to Cite this article: Antao N, Shyam A. Editorial. Journal of Clinical Orthopaedics Jan-Jun 2023;8(1):01.

 

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