This study aimed to evaluate the outcomes and complications of a new distraction holiday technique, to optimize and shorten regenerate healing in patients treated with Ilizarov fixation for critical tibial bone defects. This prospective observational study included patients who underwent Ilizarov fixation for critically sized tibial defects (> 6 cm) due to varying etiologies at a tertiary care center between 2018 and 2023 with a minimum 2-year follow-up.
Emerging research emphasizes the critical relationship between the hip and spine affecting implant positioning in total hip arthroplasty (THA). While spino-pelvic parameters and mobility patterns have been well described in Western populations, corresponding data from Asian patients undergoing THA remain limited. The primary objective of this study was to evaluate preoperative spino-pelvic parameters in Asian patients undergoing THA. The secondary objectives were to classify these patients using the hip-spine classification system and to compare the observed distribution with existing literature.
Posterior tibial slope (PTS) is believed to influence range of motion (ROM) and functional outcomes after total knee arthroplasty (TKA), particularly in cruciate-retaining and posterior-stabilized designs. However, limited data exist on its impact in mobile-bearing systems. This study evaluated whether variations in PTS affect ROM and patient-reported outcome measures (PROMs) following mobile-bearing TKA using the Buechel-Pappas design.
Accurate flexion–extension gap balancing is critical in total knee arthroplasty (TKA), influencing postoperative stability and longevity. Femoral component flexion in the sagittal plane has been suggested as a means to adjust gap balance; however, its impact across different implant designs remains unclear.
Introduction Despite the increasing demand for total knee arthroplasty (TKA) in elderly patients, outcomes in this demographic remain uncertain due to their higher comorbidity burden and perioperative risks. This study aimed to assess and compare patient-reported outcomes (PROMs), readmission rates, and complications after primary TKA in elderly patients (aged 70 years or older at the time of surgery) versus a matched cohort of younger patients aged <70 years.
vascular necrosis (AVN) of the femoral head has been observed to occur after COVID-19, especially if steroids were taken. However, the knowledge about its progress in these cases is lacking. We aimed to evaluate the progress of a disease after post-COVID AVN and the effect of various treatments.
Total knee arthroplasty (TKA) improves pain relief and function in end-stage arthritis. While coronal alignment has been well studied, the impact of femoral component flexion in the sagittal plane on outcomes remains underexplored. This study examines the effect of femoral component flexion on patellofemoral outcomes, using the Kujala anterior knee pain scale, and overall functional results after robotic-assisted TKA.
Bilateral total knee arthroplasty (TKA) can be performed using simultaneous, staggered, or staged approaches. While simultaneous TKA minimizes hospitalization and anesthesia exposure, it is associated with increased perioperative risks. The staggered approach, involving two procedures within the same hospitalization, is proposed as a middle ground, but remains underexplored.
Total knee arthroplasty (TKA) significantly alleviates pain and improves functionality in patients with end-stage knee osteoarthritis. However, postoperative sleep disturbances remain a common issue affecting quality of life (QOL) and rehabilitation.
Introduction Fracture fixation techniques have evolved significantly over the past century, yet core principles remain centered on biomechanical stability and biological preservation. Mini plate systems have emerged as valuable adjuncts in orthopedic trauma, addressing limitations of conventional techniques such as K-wires and clamps, particularly in complex fractures with comminution or osteoporosis. This study evaluates the applications, outcomes, and complications of mini plates in fracture management.
This study examines the evolving trends in the adoption of robotic technology in arthroplasty across India, highlighting growth patterns, key drivers, clinical benefits, economic considerations, and challenges unique to the Indian healthcare landscape. It provides insights into how robotics is shaping joint replacement practices and future directions for wider implementation.
Total knee arthroplasty (TKA) improves pain relief and function in end-stage arthritis. While coronal alignment has been well studied, the impact of femoral component flexion in the sagittal plane on outcomes remains underexplored. This study examines the effect of femoral component flexion on patellofemoral outcomes, using the Kujala anterior knee pain scale, and overall functional results after robotic-assisted TKA.
Introduction The decision to retain or sacrifice the posterior cruciate ligament (PCL) during total knee arthroplasty (TKA) is debated among surgeons. This study aimed to determine the effects of PCL removal on gap balancing, bone-cut thickness, and component positioning. Methods This prospective study included 70 consecutive patients with varus deformity undergoing Mako (Stryker Orthopaedics, Fort Lauderdale, FL, USA) robot-assisted TKA between January 2022 and June 2022.
Introduction Total knee arthroplasty (TKA) is a well-established treatment for end-stage knee arthritis, providing substantial pain relief and functional improvement. However, the increasing need for revision TKA (RTKA) due to factors such as polyethylene wear, aseptic loosening, periprosthetic infection, and instability presents significant challenges.
Robotic-assisted technology in total joint arthroplasty (TJA) offers improved precision in component placement and alignment, addressing challenges, such as ligament imbalance, malalignment, and patient dissatisfaction. In India, where diverse healthcare settings exist, trends in robotic adoption remain underexplored. This study examines the adoption patterns and geographic distribution of robotic systems for TJA in India, highlighting market dynamics over the past 5 years.
This study aimed to evaluate the impact of Robotic-Assisted Total Hip Arthroplasty (RATHA) versus Conventional Total Hip Arthroplasty (CTHA) on perioperative blood loss, blood transfusion requirements, and early clinical outcomes. Methods: A prospective cohort study was conducted at a high-volume tertiary care center from January 2021 to January 2023.
Total hip arthroplasty (THA) is recognized as one of the most effective surgical procedures for the treatment of end-stage hip arthritis. However, the increasing number of primary THA cases has led to a corresponding rise in the frequency of revision surgeries, which are often more complex and challenging due to severe acetabular bone loss. In such cases, managing Paprosky type 3A and 3B defects requires precise implant design and advanced surgical techniques.
Surgical site infections (SSIs) are a significant challenge in postoperative care, leading to increased morbidity, extended hospital stays, and elevated healthcare costs. Traditional antimicrobial dressings, such as those containing silver or iodine, have limitations , including cytotoxicity and the potential for antimicrobial resistance. Dialkylcarbamoyl chloride (DACC)-impregnated dressings offer a novel approach, employing a physical mechanism to bind and remove bacteria without the use of chemical agents, thereby reducing the risk of resistance.
Surgical site infections (SSIs) represent a significant burden in healthcare, commonly occurring aftersurgical procedures and leading to prolonged recovery times and increased healthcare costs. Traditionalantimicrobial dressings pose risks such as antimicrobial resistance.
The emergence of antimicrobial resistance (AMR) has profoundly impacted the management of osteoarticular infections (OAIs), presenting significant challenges for healthcare systems worldwide. This review provides a comprehensive overview of the current landscape of AMR in OAIs, emphasizing the necessity for assertive and innovative strategies to combat this escalating health threat.
Dear Editor, Burns et al. recently published their study titled “Intra-articular Vancomycin Reduces Prosthetic Infection in Primary Hip and Knee Arthroplasty,” which investigated the clinical benefits of intraarticular antibiotic (IAA) vancomycin solution in reducing peri-prosthetic joint infection (PJI) rates after total knee arthroplasty (TKA) and total hip arthroplasty (THA).[1] This was a retrospective observational study of a single-surgeon case series, with data extraction from the Australian Orthopaedic Association National Joint Registry.
Introduction: Revision Total Knee Arthroplasty (RTKA) is a complex procedure challenged by significant bone loss, necessitating effective restoration techniques. This study investigates the clinical outcomes and complications of metaphyseal sleeves in RTKA with severe metaphyseal bone loss, aiming to evaluate their efficacy over a minimum four-year follow-up.
This study investigates the radiological outcomes of robotic-assisted total hip arthroplasty (RATHA) compared to manual total hip arthroplasty (mTHA), addressing the ongoing debate on the effectiveness of RATHA in achieving superior implant positioning accuracy.
OrthoTV, a name synonymous with orthopedic education, has carved a niche for itself in the medical world. OrthoTV is a global collaborative platform that streams videos, webinars, podcasts, and surgical videos. It also offers patient information and is considered the “Netflix of Orthopedic Videos” [1].
Introduction This study aims to investigate the complex decision-making process of patients in India when choosing surgeons for joint replacement surgery, with a focus on both clinical and non-clinical factors influencing their preferences. Methods This was a cross-sectional observational study conducted at the KIMS-Sunshine Hospitals, Hyderabad, a high-volume tertiary care institute in India, in which patients with end-stage osteoarthritis requiring primary total knee arthroplasty were evaluated using a self-administered questionnaire, which assessed both patient-related and surgeon-related factors in choosing their joint replacement surgeon.
Introduction Animal models in orthopaedic surgical training have raised concerns about ethics and availability, prompting the search for non-animal alternatives. The 3D-printed silicone tendon model has emerged as a potential alternative due to its hygiene and reusability.
This study investigates the radiological outcomes of robotic-assisted total hip arthroplasty (RATHA) compared to manual total hip arthroplasty (mTHA), addressing the ongoing debate on the effectiveness of RATHA in achieving superior implant positioning accuracy.
The combination of core decompression and AALCO implantation shows promise as an effective treatment for AVN of the femoral head, with notable improvements in functional and radiological outcomes. This study supports the potential of orthobiologic approaches in AVN treatment, warranting further investigation through comprehensive randomized controlled trials.
50 patients with Kellgren-Lawrence grades II and III OA. Patients were randomly assigned (1:1) to receive either a single intra-articular SVF injection (group A) or a single intra-articular ICS (triamcinolone) (group B) injection. Group A experienced a notable reduction in pain, with VAS scores decreasing from 7.7 to 2.4 over 24 months, compared to a minor reduction from 7.8 to 6.2 in Group B. Our study demonstrated that intra-articular administration of SVF can lead to reduced pain and improved knee function in patients with primary knee OA
The mean operating times of the final 50 RATKA at the end of 1 yearimproved by about 36 min with all the SB-RATKA cases being completed in under 120 min. The efficiency of SB-RATKAimproved significantly with time and experience, resulting in shorter operational times within a year, revealing the potentialof robotic-assisted surgery to surpass conventional approaches in TKA in terms of operating room efficiency
The paper examines the physiological impacts of Whole Body Cryotherapy on cardiovascular, musculoskeletal, hematologic, hormonal, and metabolic systems. Specific orthopaedic applications discussed include its role in the management of fractures, osteoarthritis, osteonecrosis of the femoral head, osteomyelitis, adhesive capsulitis, tendinopathies, rheumatic pathologies, chronic pain syndromes, and fibromyalgia. The study also highlights the benefits and drawbacks of WBC, including its potential to improve athletic performance, recovery, mood, and well-being, while noting risks like frostbite and impaired muscle strength. WBC shows promise in enhancing bone health in athletes and providing relief in osteoarthritis and fibromyalgia patients. The paper underscores the need for further research to establish standardised protocols and understand long-term effects.
Intrawound vancomycin powder does not appear to reduce PJI/SSI rate in primary total knee arthroplasties, including high-risk groups. Although safe from a renal perspective, intrawound vancomycin was associated with an increase in postoperative aseptic wound complications. Intrawound vancomycin may not be effective in reducing the rate of PJI in primary TKA.
Scapholunate advanced collapse (SLAC) is a term used to describe a degenerative wrist condition that exhibits progressive instability, deformity, and arthritis. This condition affects both the radiocarpal and mid-carpal joints in the wrist
Introduction Neglected elbow dislocation is defined as a dislocation that is present for 3 weeks or longer. There is no available literature on neglected elbow dislocations, leading to ankylosis of the elbow joint.
Negative Pressure Wound Therapy (NPWT) is a well-established method to promote wound healing by delivering negative pressure (a vacuum) at the wound site. Enhancement of NPWT techniques may allow an innovative way of treating trauma and orthopaedic wounds which provide unique challenges.
Total joint replacement surgeries are standard procedures for managing end-stage hip or knee arthritis. Despite advances in technology, some patients experience dissatisfaction after total knee arthroplasty (TKA). Robotic technology has evolved significantly and has shown promise in improving component positioning, alignment, and surgical outcomes.
We have tried our best to compare the results of our study with the available literature on patellar resurfacing and have found that there is no major detrimental impact on patient functional outcome, pain, and complications with non-resurfacing of the patell..
Current treatment modalities for knee osteoarthritis (OA) provide symptomatic cures rather than reversing the pathology in the long term. An innovative regenerative therapy called “Gold Induced Cytokines” (GOLDIC®) was explored in various musculoskeletal diseases such as knee OA, lumbar canal stenosis, Achilles tendinopathy, and plantar fasciitis.
This study aimed to compare two alignment strategies in the same patient undergoing simultaneous bilateral robotic-assisted TKA (SB-RATKA): mechanical alignment (MA), the gold-standard, and functional alignment (FA), a balance-driven, personalized alignment strategy.
Posterior-stabilized (PS) total knee arthroplasty (TKA) prostheses are characterized by an articulation between the polyethylene tibial post and the cam of the femoral component. Tibial post-fractures, traumatic and non-traumatic, are uncommon but catastrophic complications. diseases such as knee OA, lumbar canal stenosis, Achilles tendinopathy,
Osteoarticular Tuberculosis (TB) of wrist joint is a rare, often misdiagnosed form of site affected by Mycobacterium Tuberculosis infection that can lead to severe disability and morbidity. This review aims to summarize the current literature on the diagnosis and management of Mycobacterium Tuberculosis infection of the wrist joint. diseases such as knee OA, lumbar canal stenosis, Achilles tendinopathy,
Gel-based autologous chondrocyte implantation (GACI) is known to have superior results when compared to conventional autologous chondrocyte implantation (ACI) in terms of delivery of chondrocytes to the articular cartilage surface with reproducible three-dimensional structural restoration.
IntroductionSMART sensor technology may provide the solution to bridge the gap between the current radiographic determination of fracture healing and clinical assessment. The displacement and rigidity between the fracture ends can be accurately measured using strain gauges. Progressively increasing stiffness is a sign of fracture consolidation which can be monitored using sensors.
Peri-prosthetic Joint Infection (PJI) after total knee arthroplasty (TKA) is a devastating complication. Intra-wound vancomycin powder has been shown to reduce infection rates in spine surgery.
Patellar resurfacing has long been a contentious subject in TKA with no consensus and the literature yielding disparate results. The aim of this study was to evaluate the long-term functional outcomes and complications of patients undergoing primary TKA without patellar resurfacing (non-resurfacing).
Avascular necrosis (AVN) of the femoral head is a type of osteonecrosis with the disruption of blood supply to the head of the femur. Management of AVN femoral head depends on the stage of the disease. In this case report, we elaborated on the biological therapy for bilateral AVN of the femoral head.
The use of modular implants for revision TKA are ever increasing in number due to their definitive advantage over their monoblock counterparts by providing the surgeon with the versatility needed to achieve equal gaps and manage bone defects.
Despite the continuous therapeutic development of biological DMARDs which has delayed disease progression in Rheumatoid arthritis, joint destruction is inevitable and end-stage arthritis remains the ultimate outcome, following which surgical intervention becomes a necessity.
Avascular necrosis (AVN) of the femoral head is a type of osteonecrosis with the disruption of blood supply to the head of the femur. Management of AVN femoral head depends on the stage of the disease.
The aim of this study is to compare the functional outcomes and osteoarthritis (OA) progression after anterior cruciate ligament (ACL) reconstruction with either hamstring autografts or allografts in people over 50.
The objective of the study was to evaluate the functional outcome of arthroscopic Bankart repair for anterior shoulder instability to assess whether the number and position of suture anchors plays a role in determining the functional outcome.
Proximal humerus fractures are common and debilitating injuries and their incidence is increasing especially in elderly. Treatment of unstable, displaced, and comminuted fractures of the proximal humerus remains a challenging issue and significant controversy exists regarding the best method of treating these fractures.
Standard open reduction and internal fixation techniques have been successful in restoring osseous alignment for proximal tibial fractures; however, surgical morbidity, especially soft tissue infection and wound necrosis, has been reported frequently. For this reason, several investigators have proposed minimally invasive methods of fracture reduction.
Post-operative pain management in Total Knee Arthroplasty (TKA) remains a challenging issue even though it is a commonly performed procedure today. Majority of the patients report severe pain following surgery due to which mobilization and early rehabilitation is hampered.
A basic understanding of the mechanism of fracture production has always aided in the treatment of specific fractures. Tibial plateau fractures are usually caused by high velocity trauma causing valgus or rarely varus force with or without axial loading as in road traffic accidents (Bumper fracture) or fall from a height.
Low back pain is one of the most common and disabling morbidities in the world and its relationship with spino-pelvic parameters is not yet fully understood in the Indian population. Our objective was to study the spino-pelvic parameters in patients who presented to the OPD with low back ache (LBA).