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.

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).

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.

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.

Role of Arthroscopy in Various Ankle Disorders.

Introduction: Ankle arthroscopy has come a long way since it was thought, it is not feasible because of tight joint and anatomical characteristics of ankle joint. The same anatomical features like capsular attachment and safe accessory portals are used to access the whole joint even with a rigid arthroscope. Ankle distraction method was routinely used to access the anterior ankle.

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.

Carbon nanofiber amalgamated 3D poly-ε-caprolactone scaffold functionalized porous-nanoarchitectures for human meniscal tissue engineering: In vitro and in vivo biocompatibility studies.

We developed customizable biomolecule functionalized 3D poly-ε-caprolactone (PCL) scaffolds reinforced with carbon nanofibers (CNF) for human meniscal tissue engineering. 3D nanocomposite scaffolds exhibited commendable mechanical integrity and electrical properties with augmented cytocompatibility. Especially, the functionalized 3D (10wt% CNF) scaffolds showed ~363% increase in compressive moduli compared to the pristine PCL.

Tissue engineering of human knee meniscus using functionalized and reinforced silk-polyvinyl alcohol composite three-dimensional scaffolds: Understanding the in vitro and in vivo behavior.

Tissue engineered constructs with rapid restoration of mechanical and biological properties remain a challenge, emphasizing the need to develop novel scaffolds. Here, we present a multicomponent composite three-dimensional scaffold structure with biomimetic reinforcement and biomolecule functionalization for meniscus tissue engineering. The scaffold structure was developed using 3:1 silk fibroin (SF) and polyvinyl alcohol (PVA).

Modified Elmslie-Trillat Procedure for Distal Realignment of Patella Tendon.

Patellofemoral dysfunction, due to either a patellofemoral malalignment or patellar instability, is a complex and debilitating condition that significantly decreases the knee function. Conservative management may yield significant clinical outcomes; however, when morphologic anomalies are identified, the surgical approach should be employed. Hence, several surgical procedures have been described in the scientific literature aiming the correction of underlying extensor mechanism malalignments.

Augmentation of Patellar Tendon Repair With Autologous Semitendinosus Graft-Porto Technique.

Patellar tendon ruptures can lead to significant functional deficiency of the extensor mechanism of the knee. These injuries, because of their inherent nature and associated complications, may require a complex treatment and remains a challenge for orthopaedic surgeons. Current surgical techniques present significant complications, including patellar fracture, damage to patellar articular cartilage, and abnormal patella height.

Clinical and radiologic outcome of arthroscopic rotator cuff repair: single-row versus transosseous equivalent repair.

Background: There is ongoing controversy regarding the ideal repair modality for rotator cuff tear, with single-row (SR) repair and double-row transosseous equivalent (TOE) repair as the main contenders.

Methods: This study included 415 patients who underwent arthroscopic rotator cuff type I (complete coverage of the greater tuberosity footprint) or II (incomplete coverage) repair between January 2006 and December 2012. SR repair followed the conventional protocol.

Silk-PVA Hybrid Nanofibrous Scaffolds for Enhanced Primary Human Meniscal Cell Proliferation.

In this study, silk fibroin nanofibrous scaffolds were developed to investigate the attachment and proliferation of primary human meniscal cells. Silk fibroin (SF)-polyvinyl alcohol (PVA) blended electrospun nanofibrous scaffolds with different blend ratios (2:1, 3:1, and 4:1) were prepared. Morphology of the scaffolds was characterized using atomic force microscopy (AFM).

Outcome of arthroscopic subscapularis tendon repair: Are the results improving with improved techniques and equipment?: A retrospective case series.

Background: Rotator cuff tears are a common cause of shoulder pain and dysfunction. More recently, there has been a renewed interest in understanding the subscapularis tears. There are multiple articles in the literature showing the short term results of isolated subscapularis tendon repair.

Medial patellofemoral ligament reconstruction in patellar instability.

Background: Medial patellofemoral ligament (MPFL) is one of the major static medial stabilising structures of the patella. MPFL is most often damaged in patients with patellar instability. Reconstruction of MPFL is becoming a common surgical procedure in treating patellar instability.