25 results match your criteria: "Sunshine Bone and Joint Institute[Affiliation]"

Purpose: This study aimed to evaluate the impact of Robotic-Assisted Total Hip Arthroplasty (RATHA) versus Conventional Total Hip Arthroplasty (CTHA) on perioperative blood loss and blood transfusion requirements in patients with hip arthritis.

Methods: This was a prospective cohort study, conducted at a high-volume tertiary care center from January 2021 to January 2023. Two hundred patients undergoing primary THA, were equally divided between RATHA (using the MAKO SmartRobotics system) and CTHA cohorts.

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 Metacarpal fractures are common and have various treatment options, but understanding their morphometry is crucial for optimizing fixation techniques and reducing complications. Accurate assessment of metacarpal anatomy is challenging in conventional radiographs but feasible with computed tomography (CT) scans, which offer precise views. This study aimed to provide accurate anatomical data on metacarpals within an Indian population using CT scans and to compare the results with existing literature.

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 The first web space of the hand plays a crucial role in determining the hand's span. Our study aims to examine and quantify the first web space angle in both hands of adult individuals within the Indian population with no upper limb pathologies. The primary objective of this study is to establish normative data.

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Purpose: This study investigates the radiological outcomes of robotic-assisted total hip arthroplasty (RATHA) compared to manual total hip arthroplasty (mTHA), addressing the ongoing debate on the effectiveness of RATHA in achieving superior implant positioning accuracy.

Methods: A prospective cohort of 212 patients (103 robotic, 109 manual) underwent THA and were evaluated for postoperative radiological outcomes, focusing on the inclination and anteversion angles of the acetabular cup. Outlier prevalence was assessed based on angles outside the defined Lewinnek safe zones.

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Article Synopsis
  • Animal models for orthopedic training raise ethical and availability concerns, leading to the exploration of 3D-printed silicone tendon models as a cleaner, reusable alternative for flexor tendon repair training.
  • A study with 25 trainees compared porcine tendon models and 3D-printed models, assessing factors like accuracy, understanding of anatomy, and realist tissue feel, finding that both models performed well but had distinct strengths.
  • The conclusion emphasizes that while the 3D-printed model is a cost-effective and hygienic option, combining it with the porcine model can offer a more comprehensive and effective training experience for enhancing suturing skills.
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Robotic-assisted total knee arthroplasty (RATKA) has been shown to achieve more accurate component positioning and target alignment than conventional jig-based instrumentation; however, concerns remain regarding its adoption since it is associated with steep learning curves, higher operational costs, and increased surgical time. This study aims to compare the operating times of three cohorts of patients undergoing simultaneous bilateral TKA, i.e.

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Combining non-vascularized fibula and cancellous graft in the masquelet technique: A promising approach to distal femur compound fracture management with large defects.

Injury

February 2024

Consultant Orthopaedic Surgeon, Sunshine Bone and Joint Institute, Kims- Sunshine Hospital, Penderghast Road, PG Road, Opposite Parsi Dharamsala, Paradise, Secunderabad, 500003, Telangana, India.

Introduction: Compound fractures of the distal femur with large defects pose a significant challenge in management, with several options available, including external fixators, bone grafting, the Masquelet-induced membrane technique, and free vascularized fibular grafts. The Masquelet-induced membrane technique involves placing a cement spacer in the defect to create a biologically active membrane. In the second stage, the gold standard for filling the defect is an autologous cancellous bone graft of 1-2 mm in size.

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Introduction: With the growing prevalence of robotic-assisted total knee arthroplasty (RATKA), the significance of effectively addressing complex deformities using this approach is gaining widespread recognition. This article underscores the importance of a novel mid-resection workflow specifically tailored for RATKA in cases with complex deformities.

Case Report: A 58-year-old female patient diagnosed with severe osteoarthritis in both knees and a stiff left knee underwent RATKA utilizing a mid-resection workflow.

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Introduction: Posterior-stabilized (PS) total knee arthroplasty (TKA) prostheses are characterized by an articulation between the polyethylene tibial post and the cam of the femoral component. Tibial post-fractures, traumatic and non-traumatic, are uncommon but catastrophic complications. We report a rare and unusual case of complete atraumatic erosion of the tibial post after PS-TKA.

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This study aimed to compare two alignment strategies in the same patient undergoing simultaneous bilateral robotic-assisted TKA (SB-RATKA): mechanical alignment (MA), the gold-standard, and functional alignment (FA), a balance-driven, personalized alignment strategy. The outcome measures included quantitative assessment of soft-tissue release, incidence of knee balance, and post-operative pain. This was a prospective, self-controlled, randomized-controlled trial involving 72 patients who underwent SB-RATKA using the MAKO® robotic system with comparable grades of deformity and pain in both knees.

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Background: Frailty is an underutilized prognostic parameter in the geriatric population. Our study aimed to analyse the frailty incidence, its transition over 1 year and its influence on complication rate in patients undergoing elective robotic-assisted total knee arthroplasty (TKA).

Methods: This was a retrospective study wherein an accumulation of deficits model was used to evaluate frailty of 435 consecutive patients undergoing primary unilateral Mako-assisted cemented TKA between January 2020 and July 2021.

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Purpose: Patellar resurfacing has long been a contentious subject in TKA with no consensus and the literature yielding disparate results. The aim of this study was to evaluate the long-term functional outcomes and complications of patients undergoing primary TKA without patellar resurfacing (non-resurfacing).

Methods: This study retrospectively analysed 9346 patients who underwent primary manual jig-based TKA without patellar resurfacing at a single high-volume arthroplasty centre between 2010 and 2018.

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Aim: This study aimed to compare the patient-reported functional outcomes and patient satisfaction after medial Unicompartmental Knee Arthroplasty (UKA) versus Total Knee Arthroplasty (TKA), performed for anteromedial osteoarthritis (AMOA) of the knee in patients from an Indian population, at a minimum 3-year follow-up.

Methods: This is a prospective matched cohort study (1:2 ratio). One hundred and one UKA cases were matched to 206 TKA cases by propensity score matching for age, body mass index (BMI), gender distribution, and the Charlson Comorbidity Index (CCI).

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Introduction: The use of modular implants for revision TKA are ever increasing in number due to their definitive advantage over their monoblock counterparts by providing the surgeon with the versatility needed to achieve equal gaps and manage bone defects. This superiority comes at the cost of certain unique complications attributable to its modular design such as loosening and fractures at the areas of component coupling that are prone to fatigue failure with suboptimal fixation.

Case Report: We present a case of modular femoral component failure in a 59-year man of Asian decent after revision TKA secondary to disengagement and migration of the extension stem locking bolt of a Total Condylar-III prosthesis.

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Background: Intraoperative periprosthetic fracture (IF) is an under-reported complication in primary total knee arthroplasty (TKA). This study aimed to audit the outcomes and complication rates in patients encountering IF during primary TKA and propose a new classification for its management.

Methods: A nested case-control study was performed at a tertiary referral hospital where 50 patients encountering IF during primary TKA operated by a single surgeon team between January 2016 to May 2021, were compared with 150 (3:1) age-, gender- and implant-matched patients not encountering IF.

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Introduction: Distal humerus fractures constitute around 0.2 to 7% of all fractures, 30% of all humerus fractures, most common in young adults, are due to high energy trauma and in old age due to osteoporosis. A common step in all currently available approaches is to identify the ulnar nerve, expose, mobilise, and retract this from its surrounding bed or in situ release.

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Introduction: Optimal flexion-extension gap balancing is an important factor in outcomes after total knee arthroplasty. Knees with varus deformities are commonly associated with a greater degree of lateral laxity both in extension and flexion. Residual lateral laxity could be encountered by surgeons during component trialling after robotic-assisted total knee arthroplasty (RATKA), necessitating additional medial soft tissue release for a thicker insert.

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Radiological Evaluation of the Phenotype of Indian Osteoarthritic Knees based on the Coronal Plane Alignment of the Knee Classification (CPAK).

Indian J Orthop

December 2022

Sunshine Bone and Joint Institute, Sunshine Hospitals, PG Road, opposite Parsi Dharamsala, Paradise, Sappu Bagh Apartments, Jogani, Ramgopalpet, Secunderabad, Hyderabad, Telangana 500003 India.

Background: Understanding constitutional alignment of the lower limb is essential to optimize alignment strategies during total knee arthroplasty. The coronal plane alignment of knee (CPAK) classification system was proposed as a comprehensive assessment tool based on coronal alignment and variations in joint line obliquity (JLO). This prospective observational cross-sectional study aimed to evaluate the phenotype of knees in the Indian population based on the CPAK system.

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Background: Isolated antero-medial osteoarthritis (AMOA) of the knee is a distinct pattern of arthritis. Medial arthritis of the knee in select patients can be managed with uni-compartmental arthroplasty (UKA), with studies showing shorter hospital stay, faster rehabilitation and reduced medical complications in the post-operative period compared to TKA. However, the prevalence of AMOA in Indian patients with osteoarthritis of the knee is unknown.

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Pre-operative planning and templating with 3-D printed models for complex primary and revision total hip arthroplasty.

J Orthop

September 2022

Sunshine Bone and Joint Institute, Sunshine Hospital, Penderghast Road, PG Road, Opposite Parsi Dharamsala, Paradise, Secunderabad, 500003, Telangana, India.

Background: Complex primary and revision THR requires comprehensive understanding of abnormal bony anatomy. Evaluation and classification of acetabular bone defects is essential to manage them appropriately. It is difficult to appreciate complex defects using conventional 2-Dimensional radiological modalities.

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Background: Robotic-assisted total knee arthroplasty (RATKA) has been proven to improve accuracy of component positioning and reducing alignment target outliers. However, the clinical benefit of robotics is often debated. Recent studies have shown reduced pain and faster recovery in the immediate post-operative period and may be associated with improved PROMs and satisfaction.

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Introduction: Robotic technology in total knee arthroplasty has been proven to improve accuracy of component positioning, achieve alignment targets, and balance the knee objectively. However, the utility of robotics in correction of severe varus deformities of the knee has not been investigated in detail. The aim of this paper was to establish the utility and describe the technique of robotic-arm assisted total knee arthroplasty (RA-TKA) in achieving pre-balance in severe varus deformities of the knee.

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Article Synopsis
  • - The study investigates the effectiveness of combining a single-shot adductor canal block (ACB) with ropivacaine infusion through an intra-articular catheter (IAC) after total knee arthroplasty (TKA) to improve pain relief compared to ACB alone.
  • - Results showed that patients receiving the combined treatment experienced significantly lower pain scores at various postoperative intervals and had better knee flexion compared to those receiving just ACB with a placebo.
  • - Fewer patients in the combined treatment group needed additional pain relief for breakthrough pain, indicating that the approach may enhance overall pain management after surgery.
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Purpose: To report outcomes of Debridement, Antibiotic therapy and Implant Retention (DAIR) for periprosthetic knee joint infections (PJI) in the Indian population and to study factors influencing outcomes.

Methods: This was a Retrospective study of 80 cases of acute PJI after total knee arthroplasty who were treated by DAIR, within 2 weeks of onset of infection. A standardised institutional management protocol was applied to all cases.

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