Effectiveness of Periarticular Cocktail Injection in Pain Management of Patients Undergoing Total Knee Arthroplasty

Vol 43 | January 2022 | page: 10-13 | Priya Ranjan Acharya

DOI: 10.13107/ojot.2022.v43i01.026


Authors: Priya Ranjan Acharya [1]

[1] Department of Orthopaedics, SCB Medical College, Cuttack, Odisha, India.

Address of Correspondence

Dr. Priya Ranjan Acharya
Department of Orthopaedics, SCB Medical College, Cuttack, Odisha, India.
E-mail: priyaranjanacharya190394@gmail.com


Abstract

Introduction: Total knee arthroplasty is a procedure that can improve quality of life, and it is performed in increasing numbers every year because of the increase in the elderly population due to improved medical technology. However, the problem is that patients avoid this operation because of postoperative pain, which affects patient satisfaction and delays recovery and rehabilitation.
There are many modalities to improve operative pain control, such as femoral nerve blocks, epidural anaesthesia, and periarticular injections. These modalities have been shown to reduce post-operative pain and increase patient satisfaction. Periarticular injection was reported to have good efficacy in controlling pain, cost-effectiveness, a few side effects, and ease of use. This method can be used by every surgeon without further training, unlike techniques like epidural anaesthesia or femoral nerve blocks, which require experience and further training.
Material and Methods: The study was conducted in the Department of Orthopaedics at SCB Medical College & Hospital, Cuttack, Odisha. All the IPD patients who got admitted to the Dept. of Orthopaedics were taken as the study subject total of 30 cases were selected during study period out of which 15 were cases and 15 controls.
Observation and Discussion: In Group A, R/L TKA was done in 3/12 patients and in Group B, R/L TKA was done in 8/7. All the Group A patients experienced less pain than the baseline parameters(p<0.05) following TKA. Post-operative evaluation of Range of motion in between 2 Groups there was significant difference in between the two Groups A and B as it was comparatively more in POD1, POD2, POD3, POD7, DOD AND 3 months after follow up in Cocktail Group A. Knee Society Score in POD3 was found to be 100 and 90 in Group A and Group B respectively.
Conclusion: This study has several strengths. First, it is a well powered, randomized study. Second, we included follow-up beyond the initial hospitalization. Third, the injection medications we used are available through any hospital pharmacy and are easily administered during the surgical procedure, so our findings could be generalized for any joint reconstruction surgeon.
Keywords: Total knee replacement, Periarticular injection, Pain management


References

1. Maheshwari AV, Blum YC, Shekhar L, Ranawat AS, Ranawat CS: Multimodal Pain Management after Total Hip and Knee Arthroplasty at the Ranawat Orthopaedic Center: Clinical Orthopaedics and Related Research, (2009) 467:1418–1423.
2. David S, Pereira SD, de Albuquerque RA, Silva MZ, Fernandes RJC, Colavolpe PO: Local periarticular analgesia in total knee Arthroplasty: ActaOrtop Bras. 2017;25(2):81-4.
3. Kelley TC, Adams MJ, Mulliken BD, Dalury DF: Efficacy of Multimodal Perioperative Analgesia Protocol With Periarticular Medication Injection in Total Knee Arthroplasty: A Randomized, Double-Blinded Study: The Journal of Arthroplasty (2013), Page 1-4.
4. Shah V, Upadhyay S, Shah K: Multimodal cocktail injection relieves post operative pain and improves early rehabilitation following Total knee replacement: a prospective blinded and randomized study: Journal on Recent Advances in Pain, Jan-April 2017; 391):14-24.
5. Nair VS, Radhamony NG, Rajendra R, Mishra R: Effectiveness of intraoperative periarticular cocktail injection for pain control and knee motion recovery after total knee replacement: Arthroplasty Today 5 (2019) 320-324.
6. Martin NJ, Padmanabhan V, Pindis JJ: Efficacy of Periarticular Cocktail Injection in Rheumatoid Patients Undergoing Total Knee Replacement: Indian Journal of Orthopaedics: 2020 (112-124).
7. Vendittole PA, Makinen P, Drolet P; A multimodal analgesia protocol for total knee arthroplasty: a randomized control trial: Journal of Bone joint Surg Am : 2006: Feb: 88(2):282-289.
8. Koh IJ, Kang YG, Chang CB, Kwon SK, Seo ES, Seong SC, et al. Additional pain relieving effect of intraoperative periarticular injections after simultaneous bilateral TKA: a randomized, controlled study. Knee Surg Sports TraumatolArthrosc Off J ESSKA. 2010;18(7):916–22.
9. Todd CA, Mariano ER. Best multimodal analgesic protocol for total knee arthroplasty. Pain Manag. 2015;5(3):185–96.

How to Cite this Article: Acharya PR |  Effectiveness of Periarticular Cocktail Injection in Pain Management of Patients Undergoing Total Knee Arthroplasty | Odisha Journal of Orthopaedics & Trauma | January 2022; 43: 10-13.

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A Rare Case of Osteoblastoma of Calcaneum with Secondary Aneurysmal Cyst Like Changes and its Management- A Case Report

Vol 43 | January 2022 | page: 50-53 | Arulkumar Nallakumarasamy, Rajkumar Arya, Ajit Singh, Rahul Yadav, Devanshu Mohaniya

DOI: 10.13107/ojot.2022.v43i01.034


Authors: Arulkumar Nallakumarasamy [1], Rajkumar Arya [1], Ajit Singh [1], Rahul Yadav [1], Devanshu Mohaniya [1]

[1] Department of Orthopedics, Institute of Medical Sciences, Banaras Hindu University, Uttar Pradesh, India.

Address of Correspondence

Dr. Arulkumar Nallakumarasamy,
Department of Orthopedics, Institute of Medical Sciences, Banaras Hindu University, Uttar Pradesh, India.
E-mail: arulmmcian@gmail.com


Abstract

Background: Osteoblastoma is a rare bone forming neoplasm and it is very rare to present with secondary cystic changes that too in the heel bone. The incidence is <0.6 % among all and its prevalence is yet to be reported in our population. owing to its rare presentation the early diagnosis of Osteoblastoma of calcaneum with secondary aneurysmal cyst like changes are difficult and hence affects the outcome.
Material: In this report we detailed the diagnostic methods and surgical management of osteoblastoma of calcaneum associated with secondary aneurysmal cyst like changes in a 12year old boy with 2 year follow up.
Result: It shown that the expansile lytic lesion was healed at appropriate time period and ankle & subtalar range of movements were satisfactory with no limitation in inversion and eversion.
Conclusion: Benign expansile bone tumors in heel bone are difficult to find in the literature. This study addresses the diagnostic modality, proper surgical management in terms of approach and using sandwich bone grafting technique to improve the long term functional outcome.
Keywords: Osteoblastoma of calcaneum, Secondary aneurysmal cyst like changes, Curettage and bone grafting.


References

1. Mcleod RA, Dahlin DC, Beabout JW. The spectrum of osteoblastoma. AJR Am J Roentgenol. 1976;126 (2): 321-5.
2. Amacher AL, Eltomey A. Spinal osteoblastoma in children and adolescents. Childs Nerv Syst. 1985; 1:29–32.
3. Huvos AG. Bone tumors: Diagnosis, treatment and prognosis. Philadelphia: W.B Saunders Co; 1979. pp. 33–46.
4. Zileli M, Cagli S, Basdemir G, Ersahin Y. Osteoid osteomas and osteoblastomas of the spine. Neurosurg Focus. 2003;15:E5.
5. Saccomanni B. Aneurysmal bone cyst of spine: a review of literature. Arch Orthop Trauma Surg. 2008;128: 1145–7.
6. Marco Pavanello , Ilaria Melloni , Pietro Fiaschi , Alessandro Consales , Gianluca Piatelli , Marcello Ravegnani , Paolo Nozza , Carlo Gandolfo , Armando Cama. A rare case of osteoblastoma associated to aneurysmal bone cyst of the spine. Case report. Br J Neurosurg. 2016;30(1):106-9.
7. Hongtao Hu , Jianxin Wu , Liang Ren , Xianze Sun , Feng Li , Xiaojian Ye. Destructive osteoblastoma with secondary aneurysmal bone cyst of cervical vertebra in an 11-year-old boy: case report. Int J Clin Exp Med. 2014 Jan 15;7(1):290-5.
8. Mishra A, Pruthi N, Nandeesh BN, Shukla D. Cervical Spine Osteoblastoma with an Aneurysmal Bone Cyst in a 2-Year-Old Child: A Case Report. Pediatr Neurosurg. 2019;54(1):46-50.
9. Balancing spinal stability and future mobility in the cervical spine: surgical treatment of a case of osteoblastoma with secondary aneurysmal bone cyst. Ramme AJ, Smucker JD.Spine J. 2011 May;11(5):e5-12.
10. Tarantino R, Piccirilli M, Anichini G, Delfini R. Benign osteoblastoma of the odontoid process of the axis with secondary aneurysmal bone cyst component: a case report. Neurosurg Rev. 2008; 31:111–5.

How to Cite this Article: Nallakumarasamy A, Arya R, Singh A, Yadav R, Mohaniya D | A Rare Case of Osteoblastoma of Calcaneum with Secondary Aneurysmal Cyst Like Changes and its Management: A Case Report | Odisha Journal of Orthopaedics & Trauma | January 2022; 43: 50-53.

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First Editorial (May 1979) – The Journal of Odisha Orthopaedic Association

Vol 41 | January 2020 | page: 2 | RCM


Authors: RCM [1]

[1] Department of Orthopaedics, Odisha, India

Address of Correspondence

Dr. RCM,
E-mail: ojot.editor@gmail.com


The first born is always the most loved one. It represents the hope and aspiration for the future. So also, the first volume of the journal of Orissa Orthopaedic Association, which is born today. It represents the long-cherished desire of all of us to start a forum, where the work of the orthopaedic surgeons of the state can be put forth and the topics discussed. Orthopaedic surgery is making great stride all over the world. From replacement to immune response, the problems are numerous, there scope vast. We in Orissa are doing our best and must keep pace with the scientific development in India and abroad. It is said that even if you are in the right track you will get run over if you just seat there.
Accidents, diseases, and deformities which constitute our speciality is an ever-increasing problem of the society. Orthopaedics in Orissa is comparatively new but thanks to the sincerity and ability of the orthopaedic surgeons of the state. It has established itself and commanding respect. Now the time has come when we must look to the future and move forward with new ideas so that the younger surgeons will carry on the tradition that is being created. This journal is one of the steps to lead us in the direction in this context, if we look back to the beginning of that great pioneering journal, the JBJS it will be seen that after the war the pioneer surgeon foresaw the vast explosion of orthopaedic surgery that was certain to occur. They had long been acquainted to communicate by correspondence, but the theatre of war had introduced them to personal confrontation, and they felt the need to communicate more and more. This desire led to the beginning of JBJS first in USA and then in UK.
The future of orthopaedics lies in the development of research and its application. The young surgeons of today must be encouraged to conduct research. They must be guided to pursue new ideas so that the science of Orthopaedics in the state is enriched. This is where the journal has an important role to play. It will provide ample scope to all of us to look at each other’s work. Evaluate and then us all pray to the health and prosperity of this new infant, that is born today.


How to Cite this Article: RCM | First Editorial (May 1979) – The Journal of Odisha Orthopaedic Association | Odisha Journal of Orthopaedics & Trauma | January 2020; 41: 2.  


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Comparison of the Outcomes of Intra-articular Distal Femur Fracture Managed With Distal Femoral Nail and Locking Compression Plate: A Prospective Study

Vol 42 | Januar 2021 | page: 12-15 | Manoranjan Mallick, Gopal Chandra Sethi, Abinash Ray, Debi Prasad Nanda


Authors: Manoranjan Mallick [1], Gopal Chandra Sethi [1], Abinash Ray [1], Debi Prasad Nanda [1]

[1] Department of Orthopaedics, SCB Medical College, Cuttack, Odisha, India.

Address of Correspondence

Dr. Debi Prasad Nanda,
SCB Medical College, Cuttack, Odisha, India.
E-mail: drdebiortho@gmail.com


Abstract

Background: The treatment of intraarticular distal femur fracture still remains a debatable issue. The need for anatomical reduction and maintenance of the joint congruity while giving the patient a painless mobile knee is quite challenging. There is little Indian literature evidence comparing the functional outcome after treatment with distal femoral nail and locking compression plate in these group pf fractures. We decide to clear this gap in knowledge by this current study.
Material and methods: This was a prospective study Of 20 patients with closed intra-articular distal femoral fracture treated either with distal femoral nail and locking compression plate. It was carried out in the Department of Orthopaedics, SCB Medical College, and Cuttack during the period of August 2017 to November 2019 and functional results are analysed with 100 point scores by Neer et al i.e. Neer’s criteria.
Result: Average healing time was better in the case of nailing (15.2 weeks) than plating (18 weeks) which was assessed both clinically and radiologically. The average knee flexion range of motion was better in the case of nailing (112°)than plating (93°). With Neer’s score, an Excellent result was obtained in 90% cases in nailing comparing to only 30% with plating where a fair and poor result was obtained in 10% cases in nailing comparing to 70% with plating.
Conclusion: In the present study, retrograde nailing was found to be a better fixation system for both extra as well as intra-articular fractures(type C1 & type C2) of distal femur with better outcome in terms of range of movements, early mobilization, union and less operative time and blood loss.
Keywords: Intra-Articular Fractures; Bone Plates; Range of Motion; Articular.


References

1. Arneson TJ, Melton LJ 3rd, Lewallen DG, et al. Epidemiology of diaphyseal and distal femoral fractures in Rochester, Minnesota, 1965-1984. Clin orthop.1988;234:188-94.
2. Schandelmaier P, Partenheimer A, Koenemann B, et al. Distal femoral fractures and LISS stabilization. Injury 2001; 32 Suppl 3:SC55-63.
3. Gurkan V, Orhun H, Doganay M, Salioğlu F, Ercan T, Dursun M, et al. Retrograde intramedullary interlocking nailing in fractures of the distal femur. Acta Orthop Traumatol Turc. 2009; 43:199-205.
4. Smith WR, Ziran BH, Anglen JO, Stahel PF. Locking plates: tips and tricks. J Bone Joint Surg Am. 2007; 89(10):2298-307.
5. Markmiller M, Konrad G, Südkamp N: Femur-LISS and distal femoral nail for fixation of distal femoral fractures: are there differences in outcome and complications? Clin Orthop Relat Res. 2004; 426:252-257.
6. Lujan TJ, Henderson CE, Madley SM, Fitzpatrick DC, Marsh JL, Bottlang M. Locked plating of distal femur fractures leads to inconsistent and asymmetric callus formation. J Orthop Trauma. 2010; 24:156-62.
7. Herrera DA, Kregor PH, Cole PA, Levy B, Jonsson A, Zlowodzki M. Treatment of acute distal femur fractures above a total knee arthroplasty: Systematic review of 415 cases (1981-2006) Acta Orthopaedics. 2008; 79(1):22-27
8. Gao K, Gao W, Huang J, Li H, Li F, Tao J, Et Al. Retrograde Nailing Versus Locked Plating Of Extra-Articular Distal Femoral Fractures: Comparison Of 36 Cases. Med Princ Pract. 2013; 22:161-66.
9. Neer II CS, Grantham SA, Shelton ML. Supracondylar Fracture of the Adult Femur. The Journal of Bone & Joint Surgery. 1967; 49A:591-613.
10. Henderson CE, Lujan TJ, Kuhl LL, Bottlang M, Fitzpatrick DC, Marsh JL. Healing Complications Are Common After Locked Plating for Distal Femur Fractures. ClinOrthopRelat Res 2011 June; 469(6): 1757-1765
11. Markmiller M, Konrad G, Sudkamp N. Femur-LISS and distal femoral nail for fixation of distal femoral fractures: are there differences in outcome and complications? ClinOrthopRelat Res. 2004; (426):252-257
12. Kumar A, Jasani VM Butt MS. Management of distal femoral fractures in elderly patients using retrograde titanium supracondylar nails. Injury, 31(3): 169-73, Apr 2000
13. Ingman AM. Retrograde intramedullary nailing of supracondylar femoral fractures: Design & Development of a New Implant. Injury, 33(8); 707-12: Oct 2002
14. Leggon RE, Feldmann DD. Retrograde Femoral Nailing: A Focus On The Knee. Am J Knee Surg. 2001; 14:109-118.
15. Hoskins W, Sheehy R, Edwards ER, Hau RC, Bucknill A, Parsons N, Griffin XL. Nails or plates for fracture of the distal femur? Bone Joint J. 2016; 98-B:846-50.

How to Cite this Article: Mallick M, Sethi GC, Ray A, Nanda D| Comparison of the Outcomes of Intra-articular Distal Femur Fracture Managed With Distal Femoral Nail and Locking Compression Plate: A Prospective Study | Odisha Journal of Orthopaedics & Trauma | January-June 2021; 42(1): 12-15.

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Short Term Outcomes of Tumor Resection and Reconstruction by Megaprosthesis Around Knee: An Analysis with Review of Literature

Vol 42 | Issue 1 | January-June 2021 | page: 34-36 | Bikram K Kar, Mukund M. Ojha, Sandeep Kumar Yadav, Alok Chandra Agrawal, Harshal Sakale


Authors: Bikram K Kar [1], Mukund M. Ojha [1], Sandeep Kumar Yadav [1], Alok Chandra Agrawal [1], Harshal Sakale [1]

[1] Department of Orthopaedics, AIIMS Raipur, Chattisgarh, India.

Address of Correspondence

Dr. Mukund M. Ojha,
AIIMS Raipur, Chattisgarh, India.
E-mail: mukund1203@gmail.com


Abstract

In this modern era, limb reconstructive surgeries have become a standardized procedure for malignant tumour of lower limbs. We performed limb salvage surgeries for tumour around the knee with en-bloc resection and subsequent reconstruction with a mega prosthesis. A total of six cases of malignant and locally aggressive tumour around the knee were operated, on from 2017 to 2018, with resection and mega prosthetic reconstruction. Interpretation of functional outcome after surgery was performed with musculoskeletal tumour society score (MSTS). Complications like infection, local recurrence of tumour, implant failure and distant metastases were evaluated during each follow up. Postoperatively, one patient developed superficial infection; the rest cases were uneventful. Patients were regularly followed for one year, and none of them developed any sign of deep infection, local recurrence of tumours, implant failure or distant metastases. At the beginning of treatment, the average MSTS score was 8.83, which showed a significant increment to 25.83 after 12 months of follow up. Albeit few cases were operated on, we draw this inference from our short term experience that mega prosthesis acts as a boon to orthopaedic surgeons in musculoskeletal tumour management, thereby uplifting the quality of life of patients.
Keywords: Limb salvage surgery; Osteosarcoma; Giant cell tumour; Megaprosthesis.


References

1. Chauhan A, Joshi GR, Chopra BK, Ganguly M, Reddy GR. Limb salvage surgery in bone tumors: a retrospective study of 50 cases in a single center. Indian J Surg Oncol. 2013;4(3):248–254. doi:10.1007/s13193-013-0229-8.
2. Ilyas I, Kurar A, Moreau PG, Younge DA. Modular megaprosthesis for distal femoral tumors. Int Orthop. 2001;25 (6):375–377. doi: 10.1007/s002640100290.
3. Orlic D, Smerdelj M, Kolundzic R, Bergovec M. Lower limb salvage surgery: modular endoprosthesis in bone tumor treatment. Int Orthop. 2006;30(6):458–464. doi:10.1007/s00264-006-0193-9
4. Enneking WF, Spanier SS, Goodman MA. A system for the surgical staging of musculoskeletal sarcoma. Clin Orthop Relat Res. 1980;(153):106–120.
5. Van der Heijden L, Dijkstra PD, van de Sande MA, et al. The clinical approach toward giant cell tumor of bone. Oncologist. 2014; 19(5):550–561. doi:10.1634/theoncologist.2013-0432
6. Gkavardina A, Tsagozis P. The use of megaprostheses for reconstruction of large skeletal defects in the extremities: a critical review. Open Orthop J. 2014;8:384–389. Published 2014 Oct 17. doi:10.2174/1874325001408010384.
7. https://www.rtog.org/LinkClick.aspx?fileticket=zPqFk5qbR5I%3D&tabid=40.
8. Kamal AF, Rubiansyah P. Clinical outcome of various limb salvage surgeries in osteosarcoma around knee: Megaprosthesis, extracorporeal irradiation and resection arthrodesis. Ann Med Surg (Lond). 2019;42:14–18. Published 2019 Apr 24. doi:10.1016/j.amsu.2019.04.005.
9. Tiwari A, Jain S, Mehta S, Kumar R, Kapoor G, Kumar K. Limb salvage surgery for osteosarcoma: Early results in Indian patients. Indian J Orthop. 2014;48(3):266–272. doi:10.4103/0019-5413.132511.
10. Xu M, Peng D, Peng H, Chen X, Li Z, Li Z. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2010;35(3):267–272. doi:10.3969/j.issn.1672-7347.2010.03.013
11. Kamal AF, Muhamad A. Outcomes of En bloc resection followed by reconstruction of giant cell tumor around knee and distal radius. A case series. Ann Med Surg (Lond). 2019;49:61–66. Published 2019 Dec 6. doi:10.1016/j.amsu.2019.11.019.
12. Kapoor SK, Thiyam R. Management of infection following reconstruction in bone tumors. J Clin Orthop Trauma. 2015;6(4):244–251. doi:10.1016/j.jcot.2015.04.005.

How to Cite this Article: Kar BK, Ojha MM, Yadav SK, Agrawal AC, Sakale H | Short Term Outcomes of Tumor Resection and Reconstruction by Megaprosthesis Around Knee: An Analysis with Review of Literature | Odisha Journal of Orthopaedics & Trauma | January-June 2021; 42(1): 34-36.

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Cemented Total Hip Arthroplasty with Sub trochanteric Femoral Shortening Osteotomy, a Cost-effective Procedure to Manage Advanced Osteoarthritis of Hip Joint: A Case report and Review of Literature

Vol 42 | January 2021 | page: 31-33 | Sunil Kumar Dash, Rabindra Kumar Mohapatra, Abhimanyu Madhual, Srikant Mishra, Bibhudutta Mall, Priti Ranjan Patra


Authors: Sunil Kumar Dash [1], Rabindra Kumar Mohapatra [1], Abhimanyu Madhual [1], Srikant Mishra [1], Bibhudutta Mall [1], Priti Ranjan Patra [1]

[1] Department of Orthopaedics, Hi-Tech Medical College and Hospital, Bhubaneswar, Odisha, India.

Address of Correspondence

Dr. Bibhudutta Mall,
Hi-Tech Medical College and Hospital, Bhubaneswar, Odisha, India.
E-mail: bibhuduttamall_013@live.com


Abstract

A 60-year-old male had a history of Avascular Necrosis (AVN) with advanced secondary osteoarthritis of both hip joints. Total Hip Arthroplasty (THA) concomitant with subtrochanteric femoral shortening osteotomy using a cemented stem was performed. The subtrochanteric osteotomy was performed with an amount of osteotomy equal to the amount of distal translation of the hip centre to the original acetabulum. The pelvic obliquity improved, and the subjective leg length discrepancy disappeared after the surgery.
Keywords: Cemented total hip arthroplasty; Subtrochanteric femoral shortening osteotomy; Open reduction and internal fixation.


References

1. Noble PC, Kamaric E, Sugano N, Matsubara M, Harada Y, Ohzono K, Paravic V. ; Three-dimensional shape of the dysplastic femur: implications for THR. ClinOrthopRelat Res. 2003; 417: 27–40.
2. Bao N, Meng J, Zhou L, Guo T, Zeng X, Zhao J.; Lesser trochanteric osteotomy in THA for treating CROWE type-IV developmental dysplasia of hip. IntOrthop. 2013; 37(3):385–390. doi: 10.1007/s00264-012-1758-4
3. David J.YasgurSteven, A.StuchinEdward M.Adler, Paul E.DiCesare; Subtrochanteric femoral shortening osteotomy in THA for high-riding DDH; The Journal of ArthroplastyVolume 12, Issue 8, December 1997, Pages 880-888
4. Charity JAF, Tsiridis E, Sheeraz A, et al. Treatment of Crowe IV high hip dysplasia with THA using the Exeter stem and shortening derotational subtrochanteric osteotomy. J Bone Joint Surg Br 2011;93B:34–8.
5. Kawai T, Tanaka C, Ikenaga M, et al. Cemented total hip arthroplasty with transverse subtrochanteric shortening osteotomy for Crowe grope IV dislocated hip. J Arthroplasty 2011;26:229–35.
6. Sonohata M, Tajima T, Kitajima M, et al. Total hip arthroplasty combined with double-chevron subtrochanteric osteotomy. J OrthopSci 2012;17:382–9.
7. Gurney B. Leg length discrepancy; Gait Posture 2002; 15:195–206
8. Bizzard D, Nickel BT, Seyler TM, et al. The impact of lumbar spine disease and deformity on total hip arthroplasty outcomes; OrthopClini N Am 2016;47:19–28

How to Cite this Article: Dash SK, Mohapatra RK, Madhual A, Mishra S, Mall B, Patra PR | Cemented Total Hip Arthroplasty with Sub trochanteric Femoral Shortening Osteotomy, a Cost-effective Procedure to Manage Advanced Osteoarthritis of Hip Joint: A Case report and Review of Literature | Odisha Journal of Orthopaedics & Trauma | January 2021; 42: 31-33.

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Functional Outcome of Tripled Semitendinous Autograft for ACl Reconstruction: A Retrospective Study

Vol 42 | January2021 | page: 16-20 | Amit Das, Tapas Kumar Panigrahi


Authors: Amit Das [1], Tapas Kumar Panigrahi [1]

[1] Department of Orthopaedics, SCB Medical College & Hospital, Cuttack, Odisha, India.

Address of Correspondence

Dr. Amit Das,
SCB Medical College & Hospital, Cuttack, Odisha, India.
E-mail: dasamit374@gmail.com


Abstract

Hamstring tendons have become the most accepted grafts for ACL reconstruction. Harvesting only semi-T instead of SemiT-G from the pes anserinus can reduce the deficit of the knee flexor strength and improve the functional recovery without weakening the reconstructed ligament. A Retrospective study was conducted on 63 patients who underwent anatomical ACL reconstruction using tripled semitendinosus graft fixed with interferential screws. The average length of the Semitendinosus graft was 25cm. The cases had an average follow up upto 24 months. Functional evaluation informs radiological laxometry and objective knee scores in the forms of IKDC, Lysholm and Tegner scores. The mean Lysholm score improved from 49 (35-65) pre-op to 86 (55-100) on follow-up. The Tegner score improved from 4+1 to 5+1. The IKDC(International knee documentation committee) score improved from pre-op A=2cases, B=7, C=15, D=39 to Post-op A=28, B=22, C=10, D=3 respectively. 4 cases have pivot shift positive (6%) including 3 cases of traumatic graft ruptures at a mean age of 9.3 months. After radiological laxometry, 48 cases have anterior laxity <3mm, 6 cases have 3-5mm and 4 cases have >5 mm laxity. Tripled ST graft is an adequate graft for ACL reconstruction in the Indian population, considering the varied anthropometry and squatting habit. It obviates the need for harvesting the gracilis, yet retains adequate strength for use as an ACL graft.
Keywords: Tripled Semi Tendinosus graft; Knee scores; Gracilis.


References

1. Feller JA, Webster KE (2003) : A randomized comparison of patellar tendon and hamstring tendon anterior cruciate ligament reconstruction. Am J Sports Med 31:564–573
2. Freedman K, D’Amato M, Nedeff D, Kaz Ari, Bach B (2003) Arthroscopic anterior cruciate ligament reconstruction: a metaanalysis comparing patellar tendon and hamstring tendon autografts. Am J Sports Med 31:2–11
3. Prodromos C (2007) The anterior cruciate ligament reconstruction and basic science. 2ST/2Gr, 4ST, and 3ST/2Gr techniques: deciding which hamstring configuration to use. Saunders, pp 110–114 .
4. Gobbi A (2010) Single versus double hamstring tendon harvest for ACL reconstruction. Sports Med Arthrosc 18(1):15–19
5. Viola RW, Sterett WI, Newfield D, Steadman JR, Torry MR (2000) Internal and external tibial rotation strength after anterior cruciate ligament reconstruction using ipsilateral semitendinosus and gracilis tendon autografts. Am J Sports Med 28:552–555
6. Tashiro T, Kurosawa H, Kawakami A, Hikita A, Fukui N (2003) Influence of medial hamstring tendon harvest on knee flexor strength after anterior cruciate ligament reconstruction. A detailed evaluation with comparison of single-and double-tendon harvest. Am J Sports Med 31(4):522–529
7. Aune A, Holm I, Risberg MA, Jensen HK, Steen H (2001) Fourstrand hamstring tendon autograft compared with patellar tendonbone autograft for anterior cruciate ligament reconstruction: a randomized study with two-year follow-up. Am J Sports Med 29:722–728
8. Bizzini M, Gorelick M, Munzinger U, Drobny T (2006) Joint laxity and isokinetic thigh muscle strength characteristics after anterior cruciate ligament reconstruction: bone patellar tendon bone versus quadrupled hamstring autografts. Clin J Sport Med 16:4–9
9. Feller JA, Webster KE (2003) A randomized comparison of patellar tendon and hamstring tendon anterior cruciate ligament reconstruction. Am J Sports Med 31:564–573
10. More RC, Karras BT, Neiman R, Fritschy D, Woo SL-Y, Daniel DM. Hamstrings – an anterior cruciate ligament protagonist: an in vitro study. AmJ Sports Med 1993;21:231±237
11. BeardDJ,KyberdPJ,FergussonCM,DoddCA.Proprioceptionafterruptureoftheanteriorcruciateligament.JBoneJointSurg 1993; 75B: 311±315
12. Ardern CL, Webster KE, Taylor NF, Feller JA (2010) Hamstring strength recovery after hamstring tendon harvest for anterior cruciate ligament reconstruction: a comparison between graft types. Arthroscopy 26(4):462–469
13. Segawa H, Omori G, Koga Y, Kameo T, Iida S, Tanaka M (2002) Rotational muscle strength of the limb after anterior cruciate ligament reconstruction using semitendinosus and gracilis tendon. Arthroscopy 18(2):177–182
14. Nakamura N, Horibe S, Sasaki S, Kitaguchi T, Tagami M, Mitsuoka T, Toritsuka Y, Hamada M, Shino K (2002) Evaluation of active knee flexion and hamstring strength after anterior cruciate ligament reconstruction using hamstring tendons. Arthroscopy 18(6):598–602
15. Nakamura N, Horibe S, Sasaki S et al: Evaluation of active knee flexion and hamstring strength after anterior cruciate ligament reconstruction using hamstring tendons. Arthroscopy, 2002; 18(6): 598–602
16. Coombs R, Cochrane T. Knee Flexor Strength Following Anterior Cruciate Ligament Reconstruction with the Semitendinosus and Gracilis Tendons. Int J Sports Med 2001; 22: 618±622
17. Riley williamsIII,JonHyman,FRankPetrigliano,TamaraRozental,THomas 1,Wickiewicz.Anterior cruciate ligament reconstruction with a four stranded hamstring tendon Autograft.Journal Of BOne and Joint surgery.volume86(2):february 2004.
18. Zysk,StefanP,KRuger,Andreus,Baur,Andrea,Vielhelmann,Andreas and Refior,Hans J.(2000).Tripled Hamstring Anterior Cruciate Ligament Reconstruction with EndobuttonFixation:A 23 year follow up study of 35 patients.Acta Orthopaedica,71:(4),381-386.
19. Lipscomb A,JohnstonK,SynderB,WarburtonJ,Gilbert P. Evaluation of hamstring strength following use of semitendinosus and gracilis tendons to reconstruct the anterior cruciate ligament.The American Journal of Sports Medicine10(6):340-342
20. Hayri Baran Yosmaoglu , Gul Baltaci ,Hamza Ozer , Ahmet Atay .Effects of additional gracilis tendon harvest on muscle torque, motor coordination, and knee laxity in ACL reconstruction.KneeSurg Sports TraumatolArthrosc (2011) 19:1287–1292
21. Williams RJ,HymanJ,PetriglianoF,RozentalT,WickiewiczTL.Anterior cruciate ligament reconstruction with a four-strand hamstring tendon autograft.J Bone Joint Surg Am(2004)feb;86(2):225-32.

How to Cite this Article: Das A, Panigrahi TK | Functional Outcome of Tripled Semitendinous Autograft for ACl Reconstruction: A Retrospective Study | Odisha Journal of Orthopaedics & Trauma | January-June 2021; 42(1): 16-20.

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From The Editor’s Desk

Vol 42 | January 2021 | page: 01 | Nirmal Chandra Mohapatra


Authors: Nirmal Chandra Mohapatra [1]

[1] Department of Orthopaedics, SCB Medical College, Cuttack, Odisha, India.

Address of Correspondence

Dr. Nirmal Chandra Mohapatra,
SCB Medical College, Cuttack, Odisha, India.
E-mail: ojot.editor@gmail.com


From The Editor’s Desk

Cataclysmic changes have shaken our world in the last year. The COVID-19 pandemic has changed the way we work as well as the way we think. Everybody had to act instantly and spontaneously. Orthopaedic training and practice were massively hit as social distancing norms set in. It was bewildering to think, how orthopaedic education for students especially postgraduates would continue under such circumstances. OJOT in a coordinated manner along with all the MS and DNB training institutes of the state started a PG Webinar series to cater to the intermediate vacuum during shutdown and lockdowns.

On the publishing front, we were already incorporating changes that would help us to continue with the journal in these uncertain times. The changes are gradual but noticeable. OJOT released its first online issue (Volume 41, issue 10) last year. From this year the journal has been converted into a biannual periodical as the number of contributions rises sharply. This issue is the first biannual release after 41 years of journal publication! The journal has gradually started being accepted by abstracting agencies. In the last six months, we received indexing from a few major agencies.

We are gradually planning a subspecialty focus to cater to future requirements. Presently we are hoping for indexing by major MCI recognised agencies. Journal guidelines are being built up to enhance the quality of submissions. The path ahead is tough, but we are confident of achieving the targets that have been put forth with sustained support from the association members.


How to Cite this Article: Mohapatra NC | From the Editor’s Desk | Odisha Journal of Orthopaedics & Trauma | January 2021; 42: 01.

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Suprapatellar Nailing of the Tibia: Indications, Advantages, Disadvantages, Surgical tips and tricks

Vol 42 | January 2021 | page: 08-11 | Saurav N. Nanda, Saswat Samant, Govind VJ, Ashok Gachhayat, Sumanyu Kumar Tripathy, Debashish Mishra


Authors: Saurav N. Nanda [1], Saswat Samant [1], Govind VJ [1], Ashok Gachhayat [1], Sumanyu Kumar Tripathy [1], Debashish Mishra [1]

[1] Department of Orthopaedics, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India.

Address of Correspondence

Dr. Saurav N. Nanda,
Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India.
E-mail: saurav.scb@gmail.com


Abstract

Extra-articular proximal tibial fractures account for approximately 10% of all tibial fractures. In proximal tibial shaft fractures, surgeons have struggled with inadequate maintenance of reduction, suboptimal reaming, and poor placement of the nail resulting in malalignment and further complications.The primary indication for suprapatellar nailing is probably an extra-articular proximal tibia fracture. Suprapatellar intramedullary nailing is a safe and easy method for treating extra-articular proximal tibia fractures without causing malalignment and without resorting to additional fixation methods.

Keywords: Suprapatellar nailing; Proximal tibia fracture; Nailing techniques.


References

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2. Attal R, Hansen M, Kirjavainen M, Bail H, Hammer O, Rosenberger R, et al. A multicenter case series of tibia fractures treated with the Expert Tibia Nail (ETN). Arch Orthop Trauma Surg 2012;132:975–84.
3. Tornetta P, Collins E. Semiextended position of intramedullary nailing of the proximal tibia. Clin Orthop Relat Res 1996;328:185–9.
4. Franke J, Hohendorff B, Alt V, Thormann U, Schnettler R. Suprapatellar nailing of tibial fractures–Indications and technique. Injury. 2016;47(2):495-501.
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8. Morandi M, Banka T, Gaiarsa GP, Guthrie ST, Khalil J, Hoegler J, Lindeque BG. Intramedullary nailing of tibial fractures: review of surgical techniques and description of a percutaneous lateral suprapatellar approach. Orthopedics. 2010;33(3):172–9.
9. Song SY, Chang HG, Byun JC, Kim TY. Anterior knee pain after tibial intramedullary nailing using a medial paratendinous approach. J Orthop Trauma. 2012;26(3):172–7.
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12. Courtney PM, Boniello A, Donegan D, Ahn J, Mehta S. Functional knee outcomes in infrapatellar and suprapatellar tibial nailing: does approach matter? Am J Orthop. 2015;44(12):E513–6.
13. Gaines RJ, Rockwood J, Garland J, Ellingson C, Demaio M. Comparison of insertional trauma between suprapatellar and infrapatellar portals for tibial nailing. Orthopedics. 2013;36(9):e1155–8.
14. Chan DS, Serrano-Riera R, Griffing R, Steverson B, Infante A, Watson D, Sagi HC, Sanders RW. Suprapatellar versus infrapatellar tibial nail insertion: a prospective randomized control pilot study. J Orthop Trauma. 2016;30(3):130–4.
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16. Yang, L., Sun, Y. & Li, G. Comparison of suprapatellar and infrapatellar intramedullary nailing for tibial shaft fractures: a systematic review and meta-analysis. J Orthop Surg Res 13, 146 (2018).
17. Brink O. Suprapatellar nailing of tibial fractures: surgical hints. Current orthopaedic practice. 2016;27(1):107–12.
18. Wang Z, Li SL, Wang XY, et al. Supra-patellar versus infra-patellar intramedullary nailing in treatment of tibial shaft fractures. China J Orthop Trauma 2016;18:283–9.
19. Hessmann, M.H., Buhl, M., Finkemeier, C. et al. Suprapatellar nailing of fractures of the tibia. Oper Orthop Traumatol (2020).

How to Cite this Article: Nanda SN, Samant S, Govind VJ, Gachhayat A, Tripathy SK, Mishra D | Suprapatellar Nailing of the Tibia: Indications, Advantages, Disadvantages, Surgical tips and tricks | Odisha Journal of Orthopaedics & Trauma | January-June 2021; 42(1): 08-11.

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Total Elbow Replacement in Rheumatoid Arthritis: A Case Report

Vol 42 | January 2021 | page: 24-27 | Amit Das, Saroj Kumar Parida


Authors: Amit Das [1], Saroj Kumar Parida [1]

[1] Department of Orthopaedics, SCB Medical College & Hospital, Cuttack, Odisha, India.

Address of Correspondence

Dr. Amit Das,
SCB Medical College & Hospital, Cuttack, Odisha, India.
E-mail: dasamit374@gmail.com


Abstract

Inflammatory arthropathies such as Rheumatoid arthritis represent the classic indication for
Total elbow arthroplasty(TEA). Indications have been expanded to include posttraumatic
osteoarthritis, acute distal humerus fractures, distal humerus nonunions and reconstruction
after tumour resection. Elbow arthroplasty successful in terms of pain relief, motion and
function. For elderly patients with deformity and ankylosis of the elbow due to Rheumatoid
arthritis, Total Elbow Arthroplasty is one of the valuable options. Here, we present a case of a
female patient suffering from the rheumatoid elbow with significant pain, deformity and
instability. The Semi Constrained hinge type elbow prosthesis was used. Clinico-radiological
follow up was done at 1 month, 3 months, 6 months, 8 months. In the present case at follow
up, supination was 70°, pronation 70°, flexion 135°. The mean Mayo elbow performance
score was 95 points. Clinico-radiologically the elbows were stable and no evidence of
loosening was seen. Elbow arthroplasty remains a valuable option for deformed and unstable
elbows especially in selective patients with crippling deformity of the elbow.
Keywords: Rheumatoid Arthritis; Total Elbow Arthroplasty; Semi-constrained prosthesis.


References

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How to Cite this Article: Das A, Parida SK | Total Elbow Replacement in Rheumatoid Arthritis: A Case Report | Odisha Journal of Orthopaedics & Trauma | January 2021; 42: 24-27.

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