Pulsed lavage is associated with better quality of bone-cement-implant interface in knee arthroplasties (TKA/UKA) compared to syringe lavage in vitro; however, clinical data are missing: A systematic review.

Purpose: The purpose of this systematic review is to analyse the available literature to ascertain the optimal method of bone preparation to improve the quality of bone-cement-implant interface with either pulsed lavage or syringe lavage in both total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA).

Methods: A comprehensive search was conducted across MEDLINE, Scopus and Embase databases until July 2023. Both inclusion and exclusion criteria were clearly stated and used to identify all the published studies.

Revision ACL reconstruction in female athletes: current concepts.

The challenge of revision anterior cruciate ligament (ACL) reconstruction lies in its complexity, varied presentation, and technical intricacies. A successful ACL reconstruction should allow patients to safely return to preinjury activities. However, it is only sometimes simple, and many risk factors and concurrent pathologies come into play.

An Unexpected Intra-operative Encounter of Anterior Tibial Vessels Entrapment in the Fracture of Tibial Pilon: A Case Report and Literature Review.

We present a rare case of a comminuted tibial pilon fracture with entrapment of anterior tibial vessels in fracture site, which was unexpectedly discovered intra-operatively. Following safe extrication of vessels and fracture fixation through minimally invasive approach, the patient recovered uneventfully. Phenomenon of anterior neurovascular entrapment should be kept in mind while dealing with high-energy tibial pilon fractures.

Misery of Orthopaedic Surgeon: Delayed Diagnosis of Pseudoaneurysm of Profunda Femoris Artery Following Fixation of Intertrochanteric Femoral Fracture: A Case Report and Review of Literature.

Introduction: Pseudoaneurysm of profunda femoris artery is an uncommonly reported vascular mishap after orthopedic procedures around proximal femur. Diagnostic dilemma and resulting delay are quite common due to varied clinical presentations.

Case Presentation: Herein, we report a case of a 65-year-old lady who was diagnosed in our institution with pseudoaneurysm of profunda femoris artery 3 months after getting operated for intertrochanteric fracture of right femur in a private hospital.

Orthopedic Surgeons' Nightmare: Rare Case of Retained Gauze Piece after Wrist Surgery Masquerading as Soft-Tissue Tumor.

Introduction: Retention of cotton-based gauze or sponge in surgical field, variously called as gauzoma, gossypiboma, textiloma, and muslinoma, is an unexpected and untoward human error that carries sinister consequences for patients and surgeons. Although reported at various surgical sites, no such case has been reported so far in upper limb after wrist surgery.

Case Report: Here, we present a case of gauzoma in a 24-year-old male who was operated for his right side distal radius fracture at a private hospital.

Hamstring graft diameter above 7 mm has a lower risk of failure following anterior cruciate ligament reconstruction.

Purpose: Multi-stranded hamstring-tendon autografts have been widely used for anterior cruciate ligament reconstruction (ACLR) surgeries. Recently, smaller diameter hamstring autografts have been linked with the risk of failure or graft rupture. However, there is limited evidence concerning the optimal diameter of the hamstring autografts for ACLR.

Prospective Evaluation of Outcome of Acetabular Fractures Managed by Anterior Intrapelvic Approach.

Introduction: Anterior Intrapelvic (AIP) approach has emerged, in the last two decades, as a promising approach for fixation of anterior acetabular fractures. This prospective study was conducted to analyze our results with this approach and suggest the indications for its rationale usages in a developing country.

Materials And Methods: All patients with acetabular fractures, which required anterior fixation, were operated by AIP approach and prospectively evaluated between October 2013 and January 2018.

Is mini-open intramedullary nailing an effective intervention for adult femoral diaphyseal fractures in odd hours? A prospective case-control functional outcome and radiation safety study.

Background: Closed intramedullary (IM) nailing among various modalities is one of the commonest sought out procedure in current practice for management of femoral-diaphyseal fractures (FDF) following trauma. However, it has some limitations like prolonged procedural duration, high radiation exposure and a steep learning curve. Therefore, with limited resources in odd hours and at a high patient turnover center where closed reduction can be a challenge, we adopted a modified mini-open technique which can overcome the limitations of closed reduction technique.

An unusual pattern of posterior wall fracture of acetabulum.

Background: This study aims to describe an uncommon presentation of posterior wall acetabular fracture-dislocation with displacement of fracture fragment anterior to femoral head with its management and clinico-radiological outcome.

Methods: This retrospective review was performed at a Level I trauma centre over a period of six years. Hospital records, radiological database, operative register and follow-up data identified 7 patients with anteriorly lying posterior wall fragment of acetabulum.

Radiographic Quantification of Safe Zones for Screw Placement in the Femoral Neck: A Computed Tomography-Based Analysis.

Objectives: The purpose of this study is to design a radiographic map of the femoral neck showing proportion-based locations of the safe zones for screw placement with widest bony extents in anteroposterior and lateral radiographs using normal computed tomography-based data.

Methods: We analyzed computed tomography-based studies of 50 intact normal proximal femora equally from male and female subjects. Using software-developed radiographs, the proportionate locations of the maximal anteroposterior and cephalocaudal extents in both constricted zones were measured.

Effect of Time Lag from Injury to Surgery on the Temporal Expression of Growth Factors After Intramedullary Nailing of Isolated Fracture of Femur Shaft.

Background: Growth factors are considered to play an important role in the process of bone healing. This study assessed serum levels of transforming growth factor-β1 (TGF-β1) and vascular endothelial growth factor (VEGF) in patients undergoing intramedullary nailing for isolated fracture of femur shaft operated at various time lag from injury.

Patients And Methods: All patients between 18 and 60 years of age group operated for isolated femoral shaft fractures (AO/OTA32 A, B, C) were included.

Modified radiographic views to prevent the anterosuperior and posterosuperior bony violation during screw fixation of femoral neck fractures.

Introduction: The standard anteroposterior and lateral fluoroscopic projections used during femoral neck fracture fixation provide a two-dimensional representation of the cephalocaudal and anteroposterior extents of the femoral neck. The radiographic representation differs from the actual extent of the femoral neck. The anterosuperior (AS) and posterosuperior (PS) surfaces of the femoral neck are at risk of bony breach by the fixation screws and that may get easily missed with standard fluoroscopic views.

Overt metabolic bone failure as the initial manifestation of neglected primary hyperparathyroidism: An unusual presentation and review of current practice guidelines.

Varied symptomatology exists in hyperparathyroidism. The current approaches and evaluation of altered calcium homeostasis have led to the practice of early identification and subsequent management of the adenomas. Hence, bony manifestations (deformities, lesions, and fractures) termed to be end stage of bone metabolism failure, have rarely been encountered in the last two decades.

Reliability of relation between greater trochanter and center of rotation of femoral head in Indian population.

Purpose: Accurate limb length restoration forms an important aspect of reconstructive surgeries around the hip joint. Among the various intraoperative methods for accurate limb length restoration, the relation between the greater trochanter and the center of the femoral head has been conventionally used owing to its simplicity and replicability. The current study aims to study the normal relation between the greater trochanter and the center of rotation of the femoral head, its population-based variation and its gender-based and contralateral differences in the Indian population.

CT based management of high energy tibial plateau fractures: A retrospective review of 53 cases.

Objectives: The management of high energy tibial plateau fractures is a surgical challenge. Recently described Luo's classification is based on CT scans and is more objective with a better inter-observer agreement as compare to Schatzker and AO/OTA classifications. We describe the functional results of a series of 53 cases classified and managed according to the Luo's column concept.

Traumatic Pubic-type Anterior Dislocation of the Hip with an Ipsilateral Greater Trochanter Fracture: Case Report and Review of Literature.

Due to the inherent stability of the hip joint, hip dislocations constitute a relatively small proportion of all the traumatic dislocations encountered in the emergency department. Among them, the anterior type of hip dislocation is less common than the posterior type of dislocation. Anterior dislocations are usually associated with an injury to other, nearby structures like the acetabulum and femoral head.