Arthroplasty – What was interesting in 2020?

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

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

[1] Consultant Ortho & Joint Replacement Surgeon

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

Address of Correspondence
Dr. Harish Bhende,
Consultant Ortho & Joint Replacement Surgeon


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

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

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

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

Author: Abhishek Arun Nerurkar [1]

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

Address of Correspondence
Dr. Abhishek Arun Nerurkar,
M.S. Orthopaedics., D.N.B. Orthopaedics., F. Sports Medicine and Arthroscopy, Germany, F. Advanced Hip and Knee Joint Reconstruction (SICOT)


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

How to Cite this article: Nerurkar A. What has evolved in the Management of Anterior Cruciate Ligament Injuries First Half of 2020 When World was facing the Pandemic and the So-Called “New Normal”. Journal of Clinical Orthopaedics Jan-Jun 2021;6(1): 84-86.

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Recent and Relevant Literature in 2020 on Trauma Around Shoulder

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


1. Ganz R, Noesberger B. Treatment of scapular fractures. Hefte Unfallheilkd 1975;126:59-62.
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.
4. Rauer T, Boos M, Neuhaus V, Ellanti P, Kaufmann RA, Pape HC, et al. Inter-and intraobserver agreement of three classification systems for lateral clavicle fractures-reliability comparison between two specialist groups. Patient Saf Surg 2020;14:4.
5. Kim DW, Kim DH, Kim BS, Cho CH. Current concepts for classification and treatment of distal clavicle fractures. Clin Orthop Surg 2020;12:135-44.
6. Cho CH, Kim BS, Kim DH, Choi CH, Dan J, Lee H. Distal clavicle fractures: A new classification system. Orthop Traumatol Surg Res 2018;104:1231-5.
7. Tutuhatunewa ED, Stevens M, Dams OC, van Son J, Louhanepessy RD, Krabbe PF, et al. Exploring patient satisfaction after operative and nonoperative treatment for midshaft clavicle fractures: A focus group analysis. BMC Musculoskelet Disord 2020;21:560.
8. Mannambeth R, Kirzner NB, Moaveni AK. Can displaced extraarticular fractures of the scapula be stabilized through a direct lateral-column approach. J Clin Orthop Trauma 2020;11 Suppl 4:S626-30.
9. Bi AS, Kane LT, Butler BA, Stover MD. Outcomes following extraarticular fractures of the scapula: A systematic review. Injury 2020;51:602-10.
10. Soler-Peiro M, García-Martínez L, Aguilella L, Perez-Bermejo M. Conservative treatment of 3-part and 4-part proximal humeral fractures: A systematic review. J Orthop Surg Res 2020;15:347.
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.
12. Zastrow RK, Patterson DC, Cagle PJ. Operative management of proximal humerus nonunions in adults: A systematic review. J Orthop Trauma 2020;34:492-502.
13. Gutkowska O, Martynkiewicz J, Urban M, Gosk J. Brachial plexus injury after shoulder dislocation: A literature review. Neurosurg Rev 2020;43:407-23.

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 ”

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.


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


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19. Trofa D, Rajaee SS, Smith EL. Nationwide trends in total shoulder arthroplasty and hemiarthroplasty for osteoarthritis. Am J Orthop 2014;43:166-72.
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22. Griffin JW, Hadeed MM, Novicoff WM, Browne JA, Brockmeier SF. Patient age is a factor in early outcomes after shoulder arthroplasty. J Shoulder Elbow Surg 2014;23:1867-71.
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28. Robertson TA, Bentley JC, Griscom JT, Kissenberth MJ, Tolan SJ, Hawkins RJ, et al. Outcomes of total shoulder arthroplasty in patients younger than 65 years: A systematic review. 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

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


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


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7. Goyal, D. R. The Classifications of the Chondral Lesions. in The Illustrative Book of Cartilage Repair (ed. Goyal, D. R.) 43–56. (Springer International Publishing, 2021). doi:10.1007/978-3- 030-47154-5_6.
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18. Hangody, L. The Illustrative Osteochondral Cylinder Transfer Techniques for Cartilage Repair: The Mosaicplasty Technique. in The Illustrative Book of Cartilage Repair (ed. Goyal, D. R.) 105–122 (Springer International Publishing, 2021). doi:10.1007/978-3-030-47154-5_11.

19. Ramos, N., Mandelbaum, B. & Banffy, M. The Illustrative Membrane Based Autologous Chondrocyte Implantation for Cartilage Repair. in The Illustrative Book of Cartilage Repair (ed. Goyal, D. R.) 147–156 (Springer International Publishing, 2021). doi:10.1007/978-3-030-47154-5_14.
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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

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


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

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.


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.


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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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