Publications by authors named "Alok Agrawal"

Free non-vascularised fibular grafts are an autologous grafting option that requires a simple technique and minimal expertise to replicate. However, due to limited intrinsic biological activity, they are less preferred than their vascularised counterparts for reconstructing large bone defects. We present a case of a female child in her middle childhood with limb length discrepancy due to extensive femoral diaphyseal bone loss following successful treatment of chronic osteomyelitis of the femur.

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Article Synopsis
  • * The procedure is uncommon outside of oncological cases, often resorting to amputation for patients who have severe complications from other surgeries and insufficient bone for traditional implants.
  • * A case study is presented where TFR successfully treated a periprosthetic fracture in a patient after a car accident, with positive clinical and radiological results observed over a four-year follow-up.
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C-reactive protein (CRP) binds to phosphocholine (PCh)-containing substances and subsequently activates the complement system to eliminate the ligand. The PCh-binding function of CRP has been conserved throughout evolution from arthropods to humans. Human CRP, in its structurally altered conformation at acidic pH, also binds to amyloid-β (Aβ) and prevents the formation of Aβ fibrils.

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Background Managing intertrochanteric fractures presents challenges for orthopedic surgeons, not only in fixing the fracture but also in preventing and managing associated complications, especially in the vulnerable geriatric population. Cephalomedullary nails are commonly used for surgical fixation due to their favorable functional profile, which preserves the hip's abductor lever arm and proximal femur anatomy. However, there's a lack of data comparing two major options: proximal femoral nail (PFN) and proximal femoral nail anti-rotation (PFNA).

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Osteosarcoma (OS), a primary malignant bone tumor, poses significant challenges in diagnosis and prognosis. It is a painful medical burden, and treating it is still a difficult issue. Osteopontin (OPN), a multifunctional extracellular matrix protein, has emerged as a promising biomarker in this context.

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Currently, India has become one of the largest economies of the world in which tourism and hospitality have significantly contributed; however, the growth rate of tourism industry has been greatly affected during the COVID-19 pandemic. In this study, we have used the modeling approach to analyze and understand the growth pattern of Indian tourism industry. To achieve this, we consider the data of international tourist arrivals before and after the lockdown.

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The biosynthesis of C-reactive protein (CRP) in the liver is increased in inflammatory diseases including rheumatoid arthritis. Previously published data suggest a protective function of CRP in arthritis; however, the mechanism of action of CRP remains undefined. The aim of this study was to evaluate the effects of human CRP on the development of collagen-induced arthritis (CIA) in mice which is an animal model of autoimmune inflammatory arthritis.

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Background: Methadone take-home doses for opioid dependence treatment are strictly regulated due to diversion and overdose concerns, so patients must visit the clinic daily for dispensing. This was also done in India until the COVID-19 pandemic, when lockdown restriction compelled take- home dispensing of methadone. This study examined experience of patients who received take- home methadone during COVID-19 pandemic in India.

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Background: India has a population capacity of 1.2 billion people. With a worldwide aging population, the prevention and management of osteoporosis has become a significant healthcare challenge.

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Introduction: Pipkin type 4 fracture is defined as hip dislocation with femoral head fracture and concomitant acetabular rim fracture. These fractures are rare. Neglected fractures develop adaptive changes in the acetabulum, femoral head, and soft tissues around the hip joint, leading to hip arthritis.

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Introduction: The prevalence of avascular necrosis (AVN) of the femoral head in sickle cell anemia is 50% whereas untreated cases lead to total hip replacement. The recent development in cellular therapy paves the way to utilize autologous adult live-cultured osteoblasts (AALCO) in the management of AVN of the femoral head secondary to sickle cell anemia.

Case Report: We performed AALCO implantation in sickle cell anemia cases with AVN of the femoral head and were followed up for 6 months with the regular recording of visual analog score and modified Harris Hip Score.

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Introduction: Bilateral neck of femur stress fractures is rare clinical presentation in elderly population. Diagnosis of such fractures when presented can be difficult with inconclusive radiographs and hence their early diagnosis by high index of suspicion and their management can avoid further complications in this age group. In this case series, we report three elderly patients with different predisposing factors for their fractures and treatment options chosen with detailed discussion about the management.

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The structure of wild-type pentameric C-reactive protein (CRP) is stabilized by two calcium ions that are required for the binding of CRP to its ligand phosphocholine. CRP in its structurally altered pentameric conformations also binds to proteins that are denatured and aggregated by immobilization on microtiter plates; however, the identity of the ligand on immobilized proteins remains unknown. We tested the hypotheses that immobilization of proteins generated an amyloid-like structure and that amyloid-like structure was the ligand for structurally altered pentameric CRP.

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Introduction: In this modern era, limb reconstructive surgeries have become a standardized procedure for malignant tumor of lower limbs. We performed limb salvage surgeries for tumor around the knee with en bloc resection and subsequent reconstruction with a megaprosthesis.

Methods: A total of six cases of malignant and locally aggressive tumor around the knee were operated on from 2017 to 2018, with resection and mega prosthetic reconstruction.

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C-reactive protein (CRP) is synthesized in hepatocytes. The serum concentration of CRP increases dramatically during the acute phase response. In human hepatoma Hep3B cells, maximal CRP expression occurs in cells treated with the combination of IL-6 and IL-1β.

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Introduction: Incidence of non-union of fracture involving the supracondylar region of femur in an elderly is increasing due to bone loss from trauma and availability of poor quality bone in geriatric population. Distal femur megaprosthesis can provide a single stage solution for resistant non-union of supracondylar femur.

Case Report: We are reporting two cases of non-union of supracondylar femur with implant failure treated with distal femoral tumor megaprosthesis.

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Background: Calcaneal osteomyelitis is a complicated entity and much more challenging to treat. We present a case of calcaneal osteomyelitis treated with debridement, curettage and filling bone defect with antibiotic mixed calcium sulphate pellets.

Case Report: A female patient presented with pain, swelling and purulent discharge from the left heel.

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Article Synopsis
  • * Forty-four SCD patients with ONFH were compared to 24 SCD patients without ONFH, using enzyme-linked immunosorbent assay (ELISA) to measure IL-33 levels, confirmed through high-performance liquid chromatography (HPLC).
  • * Results showed no significant difference in IL-33 levels between the two groups (2.05 pg/mL vs. 1.50 pg/mL), and the findings suggest that IL-33 cannot be used as a reliable marker
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  • A 12-day-old male infant was diagnosed with a right elbow deformity, characterized by inability to flex the elbow and misalignment visible on imaging.
  • The condition was identified as an elbow dislocation, which was successfully treated through surgical intervention involving open reduction and fixation with Kirschner wires.
  • One year later, the child exhibits a stable elbow joint with functional movement, indicating positive long-term outcomes after addressing congenital dislocation potentially caused by underdeveloped skeletal components.
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Background and objective The anterior cruciate ligament (ACL) has an essential role in preserving the function and stability of the knee joint. It acts primarily to prevent anterior tibial translation. Arthroscopic ACL reconstruction using quadrupled hamstring graft is the widely practiced modality for treating ACL injuries nowadays.

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Giant cell tumor (GCT) is classically described as a locally aggressive, epiphyseo-metaphyseal osteolytic tumor occurring in young adults. They are mostly seen in long bones while some are also found in the iliac bone and spine and a very small proportion occurs in hand bones. Due to the rarity of GCT in metacarpal, there is a paucity of treatment options available.

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Giant cell tumor (GCT) of the bone is a locally aggressive neoplasm and usually managed with extended curettage and adjuvant therapy, which is associated with reduced risk of recurrence. The juxta-articular distal radius giant cell tumor is challenging due to the destruction of subchondral bone and articular cartilage, making it difficult to salvage the wrist joint anatomy and function. Various methods described include wide resection and reconstruction of allograft or centralization of the ulna with wrist arthrodesis.

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