Biofilms-What Should the Orthopedic Surgeon know?

Background: Musculoskeletal infections are a major source of morbidity for orthopedic and trauma patients, are associated with prolonged treatment times, and, unfortunately, suffer from poor functional outcomes. Further complicating the issue, antimicrobial resistance (AMR) is increasingly impacting the treatment of musculoskeletal infections with a diminishing repertoire of effective antibiotic agents for some highly resistant pathogens. Most orthopedic surgical procedures involve implants, and the formation of bacterial biofilms on these implants is now recognized as a major factor contributing to the failure of antibiotic therapy in orthopedic surgery.

A Cost-Effective Novel Surgical Technique of Core Decompression with Bone Marrow Aspiration Concentrate: A Preliminary Cadaveric Study.

Introduction: Core decompression supplemented by stem cell incorporation is an upcoming field of research in avascular necrosis of the femoral head. Plugging the canal to avoid loss of the concentrate injected has been recognized as a crucial step to improve the efficacy of the procedure. We describe a new surgical technique that results in native bone plug formation and eliminates the need for any additional blocker.

The burden of post-traumatic amputations in a developing country - An epidemiological study from a level I trauma centre.

Background: With the rapidly growing population and expanding vehicle density on the roads, there has been an upsurge in road accidents in developing countries. Knowledge about the causes and patterns of trauma-related amputations helps in the formulation of strategies for limb savage, timely management, and effective rehabilitation.

Objective: To study the epidemiology, demographic profile, and outcomes of post-trauma amputations at a level I tertiary care centre in North India.

Modified cerclage wiring in comminuted transolecranon fracture-dislocations of the elbow.

Transolecranon fracture-dislocations are a result of high-energy trauma, caused due to axial loading of the flexed forearm, with associated anterior dislocation of the ulna with respect to the distal humerus. The usual management of these comminuted and unstable fractures is by using locking compression plates via the dorsal approach. However, plating in cases of poor soft tissue coverage and open wounds can be precarious.

A Prospective Study Evaluating Factors Affecting Functional Outcome in Patients with Floating Elbow Injury.

Background: Floating elbow injuries are complex injuries. Due to frequent association with severe soft tissue injuries and polytrauma, they have unpredictable functional outcome. This prospective study is aimed to evaluate the factors affecting functional outcome.

Thermal imaging in total knee replacement and its relation with inflammation markers.

Total knee replacement is an end-stage surgical treatment of osteoarthritis patients to improve their quality of life. The study presents a thermal imaging-based approach to assess the recovery of operated-knees. The study focuses on the potential of thermal imaging for total knee replacement and its relation with clinical inflammatory markers.

Role of supplemental teriparatide therapy in management of osteoporotic intertrochanteric femur fractures.

Background: Despite the surgical advances, obtaining the desired outcome in osteoporotic intertrochanteric femur fractures is still a tough row to hoe for the surgeons. Consequently, the interest of the researchers has shifted towards establishing a holistic approach for managing such injuries. Teriparatide, a recombinant form of human parathyroid hormone, is a novel drug that has been proved to hasten fracture healing and in both animals and humans.

Prominent Resident's Ridge as a Potential Cause of Anterior Cruciate Ligament Impingement: A Case Report.

Background: The resident's ridge is an arthroscopic landmark that is consistent with the anterior border of the anterior cruciate ligament (ACL) femoral attachment. The identification of the landmark allows for accurate graft placement.

Case Report: We report a case of a 30-year athletic individual with an ACL-deficient knee, who had an abnormally large resident's ridge, abutting the midsubstance of the torn ACL; the residual femoral attachment was behind the ridge.

Orthopedic Residency in a Tertiary Care Hospital of India: Positives, Negatives and Perspectives for Change.

Background: Orthopaedic residency training is a 3-year period of preparation that converts a raw medical student into a proficient orthopaedic surgeon. Due to wide variations at different centers in India, the program in a tertiary hospital is presented, in an attempt to improve the overall levels of training.

Materials And Methods: PGIMER has produced many good surgeons who are well settled across the country and the world.

Application of 3D Printing in Hip and Knee Arthroplasty: A Narrative Review.

Introduction: Ideal surgical positioning and placement of implants during arthroplasty are crucial for long-term survival and optimal functional outcomes. Inadequate bone stock or defects, and anatomical variations can influence the outcomes. Three-dimensional printing (3DP) is an evolving technology that could provide patient-specific instrumentation and implants for arthroplasty, taking into account anatomical variations and defects.

Dual split and dislocation----a variant of Schatzker type-I tibial plateau fracture: A case report.

Schatzkter type-I tibial plateau fracture is a split fracture of the lateral tibial plateau in sagittal plane, consequent to valgus impaction caused by low velocity of trauma. However, a deep understanding of the different columns of the tibial plateau and patho-mechanisms of the injury led to the unmasking of atypical fractures around the tibial plateau. We have encountered 2 cases with unusual fracture pattern of the lateral tibial condyle caused by road traffic accidents.

Patient profiles of below knee-amputation following road traffic accidents - An observational study from a level 1 trauma centre in India.

Background: Primary amputation below the level of the knee joint is the most frequently performed amputation following trauma; however, data about incidence, patient profiling, and causative factors are seldom available in India.

Objective: To evaluate the profile and incidence of trauma-related amputations below the level of the knee joint at a level 1 trauma center.

Methods: An observational study over six months was conducted at a level 1 trauma center of north India.

Management and Outcome of a Complex Medial Tibial Plateau Fracture: A Case Report of a Rare Knee Varus Injury Variant.

Case: A 26-year-old patient who had a road traffic accident sustained a complex knee injury, which resulted in a comminuted fracture of the medial tibial plateau, along with undisplaced lateral collateral ligament (LCL) avulsion that was managed surgically with rim plating, resulting in a good outcome after 1-year follow-up.

Conclusion: The authors present a rare case of a combination of axial loading and varus injury to the knee, which caused splaying of the medial tibial plateau with an undisplaced LCL avulsion, managed with single rim plating, which is a relatively new method of fixation that obviated the need for 2 separate implants, with good functional outcome.

Non-union lateral femoral condyle Hoffa fracture: a case report.

An isolated Hoffa fracture of either of the femoral condyle is infrequently encountered. Owing to its rarity, it is often missed and subsequently results in non-union. The knowledge of its surgical management comes from the sporadically reported cases in the literature.

Functional Outcome of Surgically Treated Isolated Coronoid Fractures With Elbow Dislocation in Young and Active Patients.

Coronoid fractures are less frequent injuries seen in around one-tenth of patients with elbow dislocation. Any injury to the coronoid process can be associated with elbow instability, in which injury to collateral ligaments co-exists, resulting in a loss of congruency of the elbow joint. However, there is a scarcity of evidence regarding patients' management with elbow dislocation and associated coronoid fractures.

Bilateral Quadriceps Rupture in an Elite Weight Lifter: A Case Report and Review of Literature.

Simultaneous bilateral quadriceps tendon ruptures (QTR) are rare injuries in sportspersons; weightlifting, involving sudden eccentric contraction of the bilateral quadriceps, has the potential to cause this injury. We present a case of an elite weightlifter with bilateral quadriceps tear occurring during the "jerk" part of clean and jerk phase of weightlifting; single stage bilateral end to end repair was done, followed by 3 weeks of cast immobilisation. He then underwent a supervised rehabilitation protocol, leading to graduated strengthening of the muscles.

The effect of intra-articular allogenic platelet rich plasma in Dunkin-Hartley guinea pig model of knee osteoarthritis.

Objectives: To investigate the pathway for disease modifying effect of the PRP in osteoarthritis of knee.

Design: Two experimental models (group I and II) of Twelve Dunkin-Hartley guinea pigs each were enrolled as a part of a prospective controlled experimental study. One knee was enrolled for intervention and the other knee of the same animal used as control, the intervention being three intra-articular allogenic PRP injections given at a weekly interval.