A randomized controlled trial on oblique incisions for ACL reconstruction: Minimizing sensory deficit without compromising outcome.

Aim: This randomized controlled trial aimed to evaluate the impact of different incision types (oblique, vertical, and horizontal) for hamstring graft harvest on sensory disturbances and functional outcomes after anterior cruciate ligament (ACL) reconstruction.

Methods: A total of 118 patients were randomized into three groups: oblique incision (n = 40), vertical incision (n = 40), and horizontal incision (n = 38). Sensory deficits were assessed using Von Frey Filaments at three weeks, three months, and six months postoperatively.

Evaluating transosseous anchorless repair for arthroscopic rotator cuff surgery: a comparative study with double row anchor repair.

Background: This retrospective observational study compared outcomes of arthroscopic rotator cuff surgery using double row anchor repair (DRR) versus transosseous anchorless repair (TAR) in patients with small to large full-thickness rotator cuff tears.

Methods: A total of 42 patients underwent DRR (n=20) or TAR (n=22) between January 2022 and May 2023. Patients were matched based on age, sex, body mass index, and tear severity.

Does Proprioception-Based Rehabilitation Enhance Functional Outcome in Total Knee Arthroplasty? A Prospective Randomised Study.

Introduction: Rehabilitation after Total Knee Arthroplasty (TKA) often includes proprioceptive exercises to prevent falls, but studies on proprioceptive training have yielded conflicting findings. This study aims to explore impact of proprioceptive training on functional performance after TKA.

Methods: Eighty patients who underwent unilateral TKA were randomly assigned to a proprioceptive exercise (PE) group or a routine exercises (RE) group.

Analgesic eluting bone cement: A novel approach for targeted pain management in total knee arthroplasty - An in-vitro study.

Background: The average rate of patient dissatisfaction following total knee arthroplasty (TKA) is 10%. Multi-modal analgesia is the present standard of pain management after TKA. Studies show that with multi-modal analgesia, approximately 60% of patients experience severe knee pain following surgery, while around 30% experience moderate pain.

Coronal Plane Alignment Classification of Arthritic Knees in a South Indian Population and Functional Outcome Comparison Post-mechanical Alignment Total Knee Arthroplasty.

Study Background: Mechanical alignment has always been considered as the gold standard in total knee arthroplasty (TKA), but various other coronal alignment strategies have been proposed to enhance native knee kinematics and thus elevate patient satisfaction levels. Coronal plane alignment of the knee (CPAK) classification introduced by MacDessi is a simple yet comprehensive system to classify knees based on their coronal plane alignment. It categorizes knees into nine phenotypes based on medial proximal tibial angle (MPTA) and lateral distal femoral angle (LDFA).

A direct saphenous nerve block in TKA: A surgeon friendly technique! Cadaveric study.

Introduction: Effective management of postoperative pain in total knee arthroplasty (TKA) poses a significant challenge for surgeons. Achieving rapid recovery without pain and promoting early ambulation in immediate and early postoperative periods are essential for patient satisfaction. There are many pain management protocols including nerve blocks.

Functional outcomes in single stage bilateral ACL reconstruction with a maximum follow up of 10 years.

Background: Bilateral ACL injuries are a rarity and there is no particular consensus on whether this rare problem has to be tackled in stages or in a single stage. There are a few studies and case reports in the literature about the outcomes in single staged bilateral Anterior cruciate ligament reconstruction (ACLR). This study is focused on functional outcomes after a single staged bilateral ACLR, as well as impact of simultaneity of the injury, meniscal tears, notch stenosis and hyperlaxity.

When to Do Selective Patellar Resurfacing in Total Knee Arthroplasty: A Decision-Making Algorithm Based on Pre-operative and Intra-operative Findings.

Background: Persistent anterior knee pain post total knee arthroplasty (TKA) is a significant cause of patient dissatisfaction. Selective patellar resurfacing is commonly practiced for primary total knee replacement (TKR) but there is a paucity in literature regarding its decision making.

Study Objective: This study aims to develop a decision-making algorithm for selective patellar resurfacing using Hospital for Special Surgery Patello-femoral Assessment score (HSS PFA score), weight-bearing patellofemoral X-ray, and intraoperative cartilage wear assessment based on the Outerbridge classification.

Effect of ascending and descending medial open wedge high tibial osteotomy on patella height and functional outcomes-a retrospective study.

Background: High tibial osteotomy (HTO) is a popular joint-preserving option for medial compartmental osteoarthritis. However, this is associated with alterations in the patellar height (PH) and tibial slope (TS). This study aims to compare the effect of ascending (AMHTO) and descending medial opening wedge HTO (DMHTO) on patella height, posterior tibial slope and functional outcomes.

The Modified PROMT Score: A Better Prognosticative Tool to Assess Traumatic Meniscal Tear Reparability.

Background: Considering various factors that influence meniscal repairability, Ortho One PROMT score (OPS) was proposed in 2019. With an increased understanding of factors influencing meniscal repair and by analysis of OPS predictions and repair results, a modified PROMT score (MPS) has been formulated. The objective of this study is to assess the superiority of MPS over OPS.

Trends in Primary Anatomical Single-Bundle Anterior Cruciate Ligament Reconstruction Practice in Adult Patients Prevalent Among Arthroscopy Surgeons of Six Southern States of India.

Background: Although guidelines from multiple scientific studies decide the general trend in ACLR practice, there is often a variation between scientific guidelines and actual practice.

Methods: A 17-member committee comprised of sports surgeons with experience of a minimum of 10 years of arthroscopy surgery finalized a survey questionnaire consisting of concepts in ACL tear management and perioperative trends, intraoperative and post-operative practices regarding single-bundle anatomic ACLR. The survey questionnaire was mailed to 584 registered sports surgeons in six states of south India.

Current concepts review in the management of subscapularis tears.

Subscapularis (SSc) is the prime internal rotator of shoulder. It is the most powerful rotator cuff muscle, maintaining the anterior force couple of shoulder. The tears in SSc as any other rotator cuff muscles might result from a traumatic event or more commonly from intrinsic degeneration.

Prophylaxis for preventing venous thromboembolism in knee arthroscopy and soft tissue reconstruction: consensus statements from an international panel of experts.

Purpose: There is a lack of consensus regarding need for Venous Thrombo Embolism (VTE) prophylaxis following arthroscopic knee surgery and open soft tissue knee reconstruction. Clear cut guidelines like ones for trauma surgery and arthroplasty do not exist and the published literature is limited to case reports with a few society guidelines. Given this lack of consensus, we conducted a modified Delphi questionnaire of international experts to provide recommendations on this topic.

Interlinked Hamstrings for Combined Anterolateral and Anterior Cruciate Ligament Reconstruction: A Novel Technique for ALL.

Background: Anterolateral ligament (ALL) reconstruction provides rotational stability in patients undergoing anterior cruciate ligament (ACL) reconstruction. The aim of this study was to assess the outcome of patients who underwent combined ACL and ALL reconstruction with a novel anatomic technique using hamstring tendon autograft and fixed loop suspensory device.

Methods: From 2016 to 2018, 25 patients who underwent combined reconstruction of ACL and ALL in our Institution were evaluated retrospectively.

Can ACL Tears be Restricted to Sports Injuries Alone? A Retrospective Analysis.

Background: The number of people injured following a road traffic accident (RTA) are as high as 2-5 crores around the world every year. The literature from western population suggests that ACL injuries are encountered mostly following high velocity sports injuries in clinical practise. But, in India there are a large group of individuals presenting with ACL injuries following RTAs.

Open Classic Latarjet Procedure Performed Using Freehand Technique-Surgical Technique and Outcome.

Introduction: Latarjet procedure is commonly performed for recurrent anterior shoulder instability with glenoid side bone loss. Classic Latarjet procedure can be performed using specially designed drill guides, jigs, or by freehand technique. Here we have described a technical note on classic Latarjet procedure performed with freehand technique utilizing simple rulers and caliper.

Management Guidelines for Infection After ACL Reconstruction: Expert Opinion Statement Based on the Modified Delphi Survey of Indian Arthroscopy Surgeons.

Aim: Infection after anterior cruciate ligament (ACL) reconstruction, though rare, is a potentially devastating complication and the evidence-based recommendation on the various topics in its management is limited. The purpose of this study was to develop recommendations for the prevention and management of infections in ACL reconstruction surgery by performing a structured expert consensus survey using Delphi methodology.

Materials And Methods: 22 topics of relevance in the prevention and management of infection following ACL reconstruction were chosen from an extensive literature review.

Lateral Epicondylitis-Narrative Review on Surgical Options for Recalcitrant Cases.

Purpose: Lateral epicondylitis or lateral elbow tendinopathy is a common condition which needs to be addressed appropriately. This condition usually responds well to non-operative treatment. However, an orthopaedic physician needs to be aware of the recalcitrant cases and equip surgical armamentarium to provide adequate care.

All arthroscopic medial meniscus inside out repair- Technical note.

Concomitant meniscal injuries are common in patients with anterior cruciate ligament (ACL) insufficiency. Along with ACL reconstruction, meniscal repair offers better outcomes. This requires multiple incisions for both procedures.

Concurrent Anterior Cruciate Ligament and Medial Patellofemoral Ligament Reconstruction: A Case Report and Literature Review.

Anterior cruciate ligament (ACL) insufficiency in combination with patellar instability are rare occurrences and are difficult to treat. Failure to address patellar instability in such cases may place excessive strain on ACL graft leading to graft rupture. We present three such cases treated by concurrent ACL and medial patellofemoral ligament (MPFL) reconstruction with hamstring tendon autografts.

A new scoring system for prediction of meniscal repair in traumatic meniscal tears.

Purpose: Traditionally, MRI has not been used to predict meniscus tear reparability. An attempt has been made in this study to predict meniscal reparability using MRI, and a new scoring system to help with the same has been developed and tested.

Methods: Thirty repaired menisci were compared with equal number of meniscectomy cases retrospectively.

Mechanical assessment of tripled hamstring tendon graft when using suspensory fixation for cruciate ligament reconstruction.

Background: Tripling semitendinosus tendon for ACL graft preparation facilitates creation of longer and thicker grafts. Our objective was to evaluate the mechanical difference between tripled tendon grafts, prepared by three methods, by comparing with quadrupled tendon graft.

Methods: Bovine hind-foot hoof extensors were allocated to four groups.

Functional outcome of an early anterior cruciate ligament reconstruction in comparison to delayed: Are we waiting in vain?

Background: Surgical techniques of ACL reconstruction (ACLR) have evolved over the past three decades along with debate regarding timing of reconstruction. It was a widespread belief that the timing of surgery was an important factor in determining the resulting stiffness after ACLR. Delayed rather than early reconstruction of the ACL is the current recommended treatment since it is thought to give a better functional outcome.