Evaluating axial alignment and knee phenotypes in a young Indian population, using X-rays converted to three-dimensional bone models, and their relevance in total knee arthroplasty.

Purpose: The standard principle of total knee arthroplasty (TKA) targeted by most orthopaedicians is the alignment of the lower limb in a neutral mechanical axis. However, for several patients the neutral mechanical alignment is not normal. Aligning these patients to a neutral mechanical axis may not result in desirable outcomes as it may feel unnatural.

Femur Shaft Fracture in a Polio Patient.

Introduction: Although poliomyelitis is on the verge of eradication, the survivors of this disease are still living with its complications. Polio survivors with its musculoskeletal complications will continue to be a part of our population for many more decades'. Although poliomyelitis in itself is not common today, fractures in polio affected patients' limbs are a common entity and are difficult to manage with common fracture management protocols.

A Study of Surgical Accuracy with X-Ray-Based Patient-Specific Instrument (X3DPSI) vs Conventional Instrument in Total Knee Arthroplasty Surgeries.

Introduction: Patient-specific instruments (PSI) have been shown to be a good solution in getting accurate bone cuts in total knee arthroplasty (TKA) in many studies. However, the need for an extra CT/MRI makes the existing PSI method costly and unsafe. X-ray-based PSI can solve these problems, if proven to be accurate.

CT-Based 3D Reconstruction of Lower Limb Versus X-Ray-Based 3D Reconstruction: A Comparative Analysis and Application for a Safe and Cost-Effective Modality in TKA.

Aim: Patient Specific Instrumentation (PSI) with 3D bone models have been used to improve the outcomes of Total Knee Arthroplasty (TKA). The PSI, however, needs a CT (Computed tomography)/MRI scan to reproduce a bone-based model. However, CT is not a routine imaging method in the TKA and has challenges such as high radiation exposure and increased investigation cost.

Gossypiboma: What Happens When a Mop is Left in a Thigh for ten Years.

Introduction: Gossypiboma is an iatrogenic lesion, caused by a retained surgical sponge in the operating field. It is an extremely rare event following musculoskeletal procedures and has devastating medicolegal consequences. It is hardly ever reported, and hence, the incidence is difficult to determine.

Is obesity a contraindication for simultaneous bilateral total knee arthroplasty? A prospective case-control study.

Aim: Total Knee Arthroplasty (TKA) for decades has been an effective treatment modality for chronic arthritis of the knee. However, there is scarcity of literature comparing the functional outcomes of simultaneous bilateral TKA in obese patients with non-obese Indian population. We conducted this study to evaluate the functional outcomes and complication rates of simultaneous bilateral TKA in obese patients matched control with non-obese patients.

Tuberculosis (T.B.) masquerading as tumor. An 8-year study on 25 cases of long bone tuberculosis presenting as tumors.

Aim: To highlight radiological features and emphasize the need for tissue diagnoses to confirm bone pathology. Tuberculosis is known to present without constitutional symptoms and with unconventional imaging features mimicking sarcomas as shown in our series of 25 patients; where the imaging and biopsy protocols at our institute helped to solve these diagnostic dilemmas.

Material And Methods: We retrospectively analyzed clinical and radiological features and tissue diagnoses in 25 patients referred to the department of orthopedic oncology with radiological suspicion of tumor.

Is vitamin D deficiency behind the scenes for high incidence of Giant cell tumor amongst the Indian population? Unraveling the vitamin D - RANKL association.

Introduction: The major neoplastic and proliferative component of GCTB is the stromal tumor cells; that they have shown no evidence of bone destruction, instead the massive tissue destruction appears to be a result of tumor induced osteoclastogenesis. The discovery of receptor activator of nuclear factor kB (RANK) and RANK binding ligand (RANKL) uncovered the bone homeostasis and molecular mechanism by which multiple compounds (including vitamin D) regulated osteoclast differentiation; a function mediated by osteoblastic cells and osteoclast-precursor cells.

Hypothesis: In a country burdened by vitamin D deficiency, causal relation between hypovitaminosis D and GCTB was hypothesized based on the vitamin D mediated RANKL expression and osteoclastogenesis, as India is also a population with higher incidence of GCTB as compared to Western populations described in the literature.

Bizarre Parosteal Osteochondromatous Proliferation- A Case Series of Typical and Atypical Presentations.

Introduction: Bizarre parosteal osteochondromatous proliferationis a distinct entity which requires proper radiological and pathological distinction for correct surgical management.

Case Report: We present a series of four cases which were misdiagnosed by the treating surgeons, reporting radiologists and pathologists due to clinical and investigatory consistencies with other benign or malignant orthopedic tumors. Due to common diagnostic errors of these uncommon tumors, the patients had recurrence and required multiple invasive procedures which could have been avoided with high index of suspicion.

Radiation-Induced Wound Infections in Operated Soft Tissue Sarcomas: An Unbelievable Challenge in a Series of Five Cases.

Introduction: The standard modality for the treatment of soft tissue sarcomas is a wide excision followed by radiation therapy either in the form of external beam radiation or brachytherapy. Radiation therapy thus is an integral part of management and limb salvage in these cases. This, however, subjects the irradiated tissue to a greater risk for necrosis and local infection.