Anthropometry of Proximal Tibia in Patients Undergoing Total Knee Replacement at a Tertiary Care Hospital.

Introduction Total knee arthroplasty is the standard of care treatment for advanced knee osteoarthritis. However, patients frequently continue to have pain and disability after surgery, with one of the most common reasons being a bone-implant mismatch. Notably, there is a significant difference reported in proximal tibia morphometry between Asian and Caucasian populations, and the currently available implants do not account for the anthropometric variations observed across ethnicities.

Survey of awareness and attitudes to the management of fragility fractures among the membership of the Asia Pacific Orthopaedic Association.

Unlabelled: A survey of awareness and attitudes to the management of fragility fractures among the membership of the Asia Pacific Orthopaedic Association conducted in 2022 found considerable variation in care across the region. A Call to Action is proposed to improve acute care, rehabilitation and secondary fracture prevention across Asia Pacific.

Purpose: Fragility fractures impose a substantial burden on older people and their families, healthcare systems and national economies.

A single-center, single-blinded, randomized, parallel-group, non-inferiority trial to compare the efficacy of a 22-gauge needle versus a 15 blade to perform an Achilles tendon tenotomy in 244 clubfeet-study protocol.

Background: Achilles tendon tenotomy is an integral part of the Ponseti method, aimed at correcting residual equinus and lack of dorsiflexion after correction of the adductus deformity in clubfoot. Percutaneous tenotomy using a number 15 scalpel blade is considered the gold standard, resulting in excellent results with minimal complications. The use of a large-bore needle to perform Achilles tendon tenotomies has been described in literature, but a large-scale randomized controlled trial is currently lacking.

Percutaneous Achilles tendon tenotomy in clubfoot patients with a 22 gauge needle in a low-resource setting.

Ponseti treatment has been well-established as the gold standard for the treatment of idiopathic clubfoot in high-income countries and middle- and low-income countries (LMICs). The tenotomy is usually performed in the clinic using a scalpel blade under local anesthesia. However, we believe that by adapting the technique from Minkowitz .

Eight-year Review of a Clubfoot Treatment Program in Pakistan With Assessment of Outcomes Using the Ponseti Technique: A Retrospective Study of 988 Patients (1,458 Clubfeet) Aged 0 to 5 Years at Enrollment.

Objective: To conduct an 8-year retrospective review of a clubfoot treatment program using the Ponseti technique with close monitoring of outcomes.

Methods: Between October 2011 and August 2019, 988 children with 1,458 idiopathic clubfeet were enrolled, ages ranging from new born up to 5 years. Ponseti treatment was used, and progress was monitored by comparing mean Pirani scores at enrollment (P1), initiation of bracing (P2), and end of treatment (P3) or most recent visit (P4) for children under treatment.

Serum Vitamin D Levels in Patients With Distal Radius Fractures Presenting to a Tertiary Care Hospital.

Objective To compare the frequency of serum vitamin D levels in patients with and without distal radius fracture. Introduction Hypovitaminosis D is a common problem worldwide. Deficiency of vitamin D is not only associated with musculoskeletal problems, but also with chronic diseases like diabetes mellitus, cardiovascular disease and cancer.

Inter-observer variation of the Schatzker and Khan classification of Tibial plateau fractures: Cohort study.

Objective: To compare the inter-observer reliability of Shatzker classification and Khan Classification of Tibial plateau fractures.

Methods: This retrospective cohort study was conducted at The Indus Hospital, Karachi, Pakistan. Radiographs of 50 patients who presented with tibial plateau fractures from March 2015 to November 2016 were collected.

Flat Top Talus: Complication of Ponseti Method or Overcorrection?

Purpose Deformation of talus in idiopathic clubfoot is a common problem both surgically and after treatment with the Ponseti technique, although the cause of deformation and its clinical impact on the function of the ankle is not yet known. The goal of this research was to evaluate factors leading to talar dome deformation (flat-top talus) after the Ponseti technique Methods This was a single-center, cross-sectional study. Fifty patients with virgin idiopathic clubfoot were enrolled from our consecutive series of data from August 2017 to January 2018 from our clubfoot patients who completed their casting and bracing protocol.

Nottingham Hip Fracture Score as a predictor of 3 months postoperative mortality in patients undergoing surgical fixation of hip fractures: A prospective study.

Objective: Nottingham Hip Fracture Score was utilized to evaluate its efficacy to identify high risk pateints interms of 3 months postoperative mortality.NHFS comprises of seven independent predictors that were incorporated into a risk score to identify patients who were high risk for post-operative mortality with hip fracture..

Slipped capital femoral epiphysis after treatment of femoral neck fracture.

Slipped capital femoral epiphysis (SCFE) in children after treatment of femoral neck fracture is a very rare condition. This complication should be recognized promptly and treated urgently. The risk of development of this complication can be minimized by anatomical reduction of the fracture and stable internal fixation of the fracture.

Frequency of Vertebral Fractures in Patients presenting with Hip Fractures.

Objective: To determine the frequency of vertebral fractures in patients presenting with hip fractures.

Methods: This prospective study was conducted at The Indus Hospital, Karachi, from May 2018 to November 2018. All patients above 40 years presenting with hip fractures were enrolled and a dorsal lumbar lateral view radiograph was obtained to investigate for vertebral fractures.

Musculoskeletal Infection in Pediatrics: Assessment of the 2018 International Consensus Meeting on Musculoskeletal Infection.

The Second International Consensus Meeting (ICM) on Musculoskeletal Infection was held in July 2018 in Philadelphia, Pennsylvania. This meeting involved contributions from an international multidisciplinary consortium of experts from orthopaedic surgery, infectious disease, pharmacology, rheumatology, microbiology, and others. Through strict delegate engagement in a comprehensive 13-step consensus process based on the Delphi technique, evidence-based consensus guidelines on musculoskeletal infection were developed.

Time-driven activity-based costing of total knee replacements in Karachi, Pakistan.

Introduction: Osteoarthritis of the knee has been identified as the most common disability in Pakistan. Total knee replacement (TKR) surgery is the curative treatment for advanced osteoarthritis of the knee; however, cost remains one of the barriers to effective and timely service delivery.

Objective: We conducted a time-driven activity-based costing (TDABC) analysis of TKR to identify major cost drivers and areas for process improvement.

The frequency of Deep Vein Thrombosis in patients with hip fractures.

Objective: To find out the frequency of deep vein thrombosis in hip fracture patients.

Methods: The prospective, cross-sectional study Was conducted at Indus Hospital, Karachi, from November 2016 to September 2017, and comprised patients with hip fractures who were scanned for the presence of deep vein thrombosis on both lower limbs preoperatively at the time of presentation and postoperatively on post-op day 3 and day 28. No thrombo-prophylaxis was provided to the patients.

Significance Of Pirani Score at Bracing-Implications for Recognizing A Corrected Clubfoot.

Background: The aim of clubfoot treatment by Ponseti method is to achieve a corrected foot, with at least 15° dorsiflexion and 70° abduction, and fit comfortably into a brace at the recommended setting. This study aimed to acknowledge the validity and reliability of the Pirani scoring system, while investigating if a corrected clubfoot has a Pirani score of zero. The study hypothesized that a corrected clubfoot may or may not have a Pirani score of zero.

The pulley suture: A reliable option for closure of selected soft tissue defects under tension- three years experience of a tertiary care hospital.

Objective: To assess the outcome of closure of soft tissue defects through pulley suture in different clinical situations.

Methods: The descriptive chart review was conducted at The Indus Hospital, Karachi, and comprised data from May 2008 to November 2011. A detailed questionnaire was developed to address variables of interest.

A comparative review of three techniques of syndactyly release.

Objective: To compare the outcome of three techniques of congenital syndactyly release; to identify factors leading to difference in outcome, and to identify the incidence of neurovascular abnormalities in various types of syndactyly.

Methods: The chart review was conducted at The Indus Hospital, Karachi, and comprised data of all patients who had undergone syndactyly release between August 2008 and December 2014. Three techniques of release were included as described in literature by Bauer, Skoog and Niranjan.

Anthropomorphic mismatch between distal femurs and a standard total knee replacement system in Pakistani population.

Aims: To compare the measurements of distal femurs of a Pakistani population and with the implants used.

Methods: The single-centre prospective cross-sectional study was conducted at the Indus Hospital, Karachi, from 01-06-2011 to 31-10-2011, and comprised total knee replacement patients. Surgeries were performed by the same team.

Perception about braces in parents of children with clubfoot.

Objective: To access the acceptability of Steenbeek brace by children undergoing clubfoot correction and their parents to ensure long-term compliance.

Methods: The cross-sectional study was conducted at the Indus Hospital, Karachi from October 2013 to March 2014. A trained researcher interviewed the person primarily responsible for bracing the child using a pre-coded questionnaire.

A comparison between orthopedic surgeon and allied health worker in pirani score.

Objective: To assess the strength of agreement for each of the Pirani assessment categories between an orthopaedic surgeon and allied health worker on scoring clubfeet.

Methods: The descriptive cross-sectional study was conducted at the Indus Hospital, Karachi, from November 2012 to June 2013, comprised children below 12 months of age with untreated unilateral or bilateral clubfoot deformity an allied health worker, who was a plaster technician, was given 1-week training in the Pirani Scoring method. The feet were scored by the surgeon and the paramedic independently.

Significance of strontium ranelate in healing of surgically fixed tibial diapyseal fractures treated with strontium ranelate vs placebo; a randomised double blind controlled trial.

Objective: To determine the surgical outcome of patients with axial cervical spine fractures.

Methods: The randomised double-blinded placebo-controlled clinical study was conducted at the Indus Hospital, Karachi, from August 2011 to August 2013. Patients were randomised to receive placebo or strontium ranelate postoperatively after surgical fixation of tibial diaphyseal fractures.

Using levels of evidence to compare clinical impact from research.

Objectives: Impact of medical institutions on clinical decision-making globally might be estimated by the level of evidence of their research articles. The aim of this study was to compare levels of evidence of articles for Pakistan.

Methods: We compared levels of evidence of articles from Pakistan, Nigeria, Japan, and the United States (U.