Outcome of Bone Transport Using Ilizarov External Fixator in Infected Non-union of Tibia with Large Bone Defects: Comparison of Those with 5-10 cm Bone Defect with Those Having ≥ 11 cm Bone Defect.

Background: Ilizarov external fixation has become the treatment of choice for infected non-union of tibia. Varying degrees of bone loss and different strategies of treatment in the published reports make comparing outcomes difficult. This study hopes to bridge this gap in the literature by focussing exclusively on bone transport in patients with bone loss of 5 cm or more.

High Recurrence Rates of Hyperextension After Total Knee Arthroplasty in Asian Patients With Preoperative Knee Hyperextension: A Prospective Observational Study.

Introduction: Genu recurvatum is a well-known problem in total knee arthroplasty (TKA) in patients with and without neuromuscular disorders. Hyperextension of the knee joint does not reoccur significantly following adequate correction during TKA is the generally accepted notion. The literature regarding the reoccurrence of genu recurvatum in patients after TKA with preoperative genu recurvatum is scarce.

Vascularized Ulnar Transposition and Ulno-scapholunate Fusion for Reconstructing Campanacci Grade 3 Giant Cell Tumor of Distal Radius: Technique and a Series of 5 Cases.

Campanacci grade 3 distal radius giant cell tumors are difficult to treat and just doing a curettage and bone grafting is insufficient. These lesions are associated with a high chance of recurrence. We are presenting our technique and series of 5 patients who underwent enbloc excision and ulna transposition with ulno-scapholunate fusion.

Revision Anterior Cruciate Ligament Reconstruction in the Nonathlete Population.

Background: There is considerable literature about revision anterior cruciate ligament (ACL) reconstruction in athletes vut there is little published evidence about the same in the nonathletes. The injury itself may remain underdiagnosed and untreated in nonsports persons. This study highlights the high incidence of ACL injury in the nonathletic patient cohort, revision rates, and the outcomes of revision ACL reconstruction.

Lateralization of Tibial Plateau Reference Point Improves Accuracy of Tibial Resection in Total Knee Arthroplasty in Patients with Proximal Tibia Vara.

Background: The tibial cut referenced to the center of the intercondylar eminence often leads to varus malalignment in the presence of preexisting proximal tibia vara. The purpose of this study was to investigate the effect of lateralization of the lateral tibial plateau reference point (based on the amount of proximal tibia vara) on the postoperative coronal plane alignment.

Methods: In this prospective cohort study, 62 patients (95 knees) with osteoarthritis and proximal tibia vara underwent primary total knee arthroplasty using a lateral tibial plateau reference point for the extramedullary jig.

Adjacent Disc Stress Following Floating Lumbar Spine Fusion: A Finite Element Study.

Study Design: Experimental study.

Purpose: The study aimed to develop a finite element (FE) model to determine the stress on the discs adjacent to the fused segment following different types of floating lumbar spinal fusions.

Overview Of Literature: The quantification of the adjacent disc stress following different types of floating lumbar fusions has not been reported.

Choice of surgical approach for capitellar fractures based on pathoanatomy of fractures: outcomes of surgical management.

Unlabelled: The understanding of the anatomic configuration of the fractures of the capitellum has enhanced in the last few years, and the classification of these fractures continues to evolve. It is essential to tailor the surgical approaches to these fractures based on the state-of-the-art classifications. Thirty-three patients with fractures of the capitellum were included in this retrospective study.

Lateralization of Femoral Entry Point to Improve the Coronal Alignment During Total Knee Arthroplasty in Patients With Bowed Femur.

Background: Intramedullary jigs are most often used for distal femoral bone cuts in total knee arthroplasty (TKA). However, the accuracy of bone cuts in the distal femur may be affected by the presence of diaphyseal deformities of the femur.

Methods: Sixty-three patients (88 knees) with lateral bowing of the femur underwent primary TKA using a lateralized femoral entry point for intramedullary femoral guide.

Long-Term Effects of Segmental Lumbar Spinal Fusion on Adjacent Healthy Discs: A Finite Element Study.

Study Design: Experimental study.

Purpose: The aim of the study was to develop a finite element (FE) model to study the long-term effects of various types of lumbar spinal interventions on the discs adjacent to the fused segment.

Overview Of Literature: Earlier FE studies have been limited to one particular type of fusion and comparative quantification of the adjacent disc stresses for different types of surgical interventions has not been reported.

Patellar tendon or hamstring graft anterior cruciate ligament reconstructions in patients aged above 50 years.

Background: The treatment of anterior cruciate ligament (ACL) injury consists of arthroscopic ACL reconstruction with patellar tendon or hamstring graft. Satisfactory results have been reported so far in the younger age group. Dilemma arises regarding the suitability of ACL reconstruction in patients aged 50 years and above.

Calcar femorale grafting in the hemiarthroplasty of the hip for unstable inter trochanteric fractures.

Background: The sliding screw-plate devices and cephalo-medullary nail devices have performed well in stable inter-trochanteric fractures in patients with reasonably good quality of bone. However, their suboptimal performance in comminuted fractures in the presence of osteoporotic bone has prompted many surgeons to consider bipolar hemiarthroplasty as the primary modality of management of comminuted inter-trochanteric fractures in elderly patients. However, long term stability of the hemiarthroplasty implant also may be compromised due to the presence of postero-medial bone loss at the area of the calcar.

PCL-retaining versus PCL-substituting TKR - Outcome assessment based on the "forgotten joint score".

Background: Posterior cruciate ligament (PCL) retention or sacrifice figures prominently among the current controversies in total knee arthroplasty (TKA). Even though biomechanical advantages and disadvantages have been claimed for each type of TKA, clinical studies have not shown significant differences in the outcomes.

Methods: In this retrospective study, the recently introduced "forgotten joint score" (FJS) was used to assess whether any differences exist between the two types of total knee replacement (TKR).

Relative Contribution of Upper and Lower Lumbar Spinal Segments to Flexion/Extension: Comparison between Normal Spines and Spines with Disc Disease in Asian Patients.

Study Design: Prospective cohort study.

Purpose: To evaluate the contribution of upper and lower lumbar segments to flexion and extension of the lumbar spine in normal and diseased spines.

Overview Of Literature: The specific contributions of upper and lower lumbar segments during flexion/extension have rarely been reported.

Single locking compression plate fixation of extra-articular distal humeral fractures.

Background: Earlier literature on fixation of distal third humeral fractures describes the use of elaborate modification of existing implants, custom-made implants and dual plating. These modifications have the disadvantages of limitations of hardware availability and cost as well as longer surgical exposure to accommodate the plates. The aim of this study was to assess the effectiveness of osteosynthesis of extra-articular diaphyseal fractures of the distal third of the humerus using a single 4.

PET/CT study of temporal variations in blood flow to the femoral head following low-energy fracture of the femoral neck.

Earlier studies on femoral neck fractures have assessed the blood flow in either the pre- or postoperative period and information is lacking regarding changes in vascular flow to the femoral head after injury. Sixty-two adults with low-energy intracapsular femoral neck fractures were studied prospectively. Mean patient age was 57.

Outcome of locking compression plates in humeral shaft nonunions.

Background: Nonunion of diaphyseal fractures of the humerus are frequently seen in clinical practice (incidence of up to 15% in certain studies) and osteosynthesis using dynamic compression plates, intra medullary nails and Ilizarov fixators have been reported previously. Locking compression plates (LCP) are useful in the presence of disuse osteoporosis, segmental bone loss and cortical defects that preclude strong fixation. We report a prospective followup study of the outcome of the use of LCP for humeral nonunion following failed internal fixation in which implants other than LCP had been used.

A study on polyethylene stresses in mobile-bearing and fixed-bearing total knee arthroplasty (TKA) using explicit finite element analysis.

Mobile-bearing total knee arthroplasty designs were thought to be associated with lesser stresses on the polyethylene (PE) insert as compared to fixed-bearing designs. The wear rate of the PE liner was felt to be less in the mobile-bearing knees due to the decrease in the stresses. However, a reevaluation of the biomechanics of the mobile-bearing design is necessary due to the recent clinical reports on the long-term outcome of mobile-bearing knees which have not demonstrated any significant benefit in terms of implant survival and polyethylene wear rate.

Isolated posterior instrumentation for selected cases of thoraco-lumbar spinal tuberculosis without anterior instrumentation and without anterior or posterior bone grafting.

Purpose: The aim of this prospective study is the analysis of the clinical and radiological outcomes of active thoraco-lumbar spinal tuberculosis treated with isolated posterior instrumentation without any posterior bone grafting or anterior inter-body bone grafting or anterior instrumentation.

Methods: The study was a prospective follow-up of 25 patients with active thoraco-lumbar spinal tuberculosis who underwent posterior spinal instrumentation with pedicle screws and rods. These patients had posterior stabilization of the involved segment of the spine without anterior or posterior bone grafting.

Modified Ponseti method of management of neonatal club feet.

The aim of this study was to assess the outcome of a new protocol for the management of neonatal clubfeet that can be considered as a modification of the Ponseti method. The modifications consisted of performing the tenotomy of the Achilles tendon prior to the application of the first cast and using only one cast for a period of 3 weeks following tenotomy. We applied the modified method in 50 children (82 club feet) and assessed the degree of deformity using the Pirani and the Dimeglio scoring systems.

A theoretical comparison of the models of prevention of research misconduct.

The current methods of dealing with research misconduct involve detection and rectification after the incident has already occurred. This method of monitoring scientific integrity exerts considerable negative effects on the concerned persons and is also wasteful of time and resources. Time has arrived for research administrators to focus seriously on prevention of misconduct.

Dealing with misconduct in biomedical research: a review of the problems and the proposed methods for improvement.

The increasing complexity of scientific research has been followed by increasing varieties of research misconduct. Dealing with misconduct involves the processes of detection, reporting, and investigation of misconduct. Each of these steps is associated with numerous problems which need to be addressed.