Study of functional outcome of total hip arthroplasty in a series of cases of hip pathologies done in rural population

Background: The objective of the study was to assess the functional outcome of total hip arthroplasty (THA) done in a series of cases of hip pathologies rural population.Methods: A retrospective randomized controlled study conducted in 50 cases of hip arthritis (38 males and 12 females)  treated with uncemented THA for an average follow-up of  2 years  at department of orthopedics MGM Medical College, Kamothe, Navi Mumbai. Harris hip scoring system was used for the functional scoring and the postoperative radiographs were assessed by Gruen zones for the femoral component and DeLee and Charnley zones for the acetabular component. All patients were evaluated pre operatively and post operatively 3 months 6 months, 12months, 2years with Harris Hip score.Results: 81% of our patients scored 85 points or better for a rating of excellent by Harris hip score system. 90% patients had little /no pain post operatively, whereas walking ability improved and was unlimited in 80% of the patients post operatively. Harris hip score improved from 40 to 80. 80.5% -excellent, 13.80% -good, 5.7% -fair results. Poor results were not seen in any patient.Conclusions: THR provided excellent pain relief, adequate stability, and remarkable range of motion in severely painful, refractory hip. A significant improvement was seen at two year follow-up.

Functional outcome of intertrochanteric fractures treated with bipolar hemiarthroplasty

Background: Comminuted intertrochanteric fractures with severe displacement are common in elderly patients. These patients have poor bone quality and conventional osteosynthetic procedures frequently lead to non-union and metal failure. The primary goals of treatment are stable fixation and early rehabilitation. There are a many treatment for intertrochanteric fractures but our study is on unstable intertrochanteric fractures which are challenging for a surgeon. The aim of this study was to evaluate the results of cemented bipolar hemiarthroplasty as an alternative to other treatment modalities such as DHS or PFN. 21 elderly patients with comminuted and unstable intertrochanteric fractures underwent cemented bipolar hemiarthroplasty.Methods: This study includes 22 cases of intratrochantric fracture. Mean age of patients was 73.3 (range 60 - 91). All patients are treated with bipolar hemiarthoplasty. Patients are followed up for a mean period of 6 months (range 3-9 months).Results: These patients were evaluated using the Harris hip scoring system. 21 out of 22 had excellent to fair outcomes. Conclusions: In our study of 22 patients, 21 had excellent to fair outcomes with primary cemented bipolar hemiarthroplasty. Bipolar hemiarthoplasty offers good functional outcome and early weight bearing and mobilization

Prospective study of clinical and functional outcome of total knee replacement in osteoarthritic knee

Background: Total knee arthroplasty (TKA) is now a reliable treatment for osteoarthritis.  The aim of this study was to study the clinical and functional outcome of total knee arthroplasty using knee society score and to find association between knee functional score and knee clinical score.Methods: We conducted a prospective analysis of 40 cases of osteoarthritis knee patients at a tertiary care centre in Mumbai over a period of two years.  Those patients who underwent total knee arthroplasty were assessed clinically and functionally using knee society score.Results: The mean preoperative knee clinical score (KCS) was 49.40±13.79 which was increased to a postoperative score of 86.08±5.64 at the end of 6 month. Similarly the mean preoperative knee functional score (KFS) was 32.75±11.79 which was increased to a postoperative score of 84.43±9.59 at the end of 6 month. There was significant increase in KCS and KFC score during follow up at 1, 3 and 6 month interval. There was significant association between knee functional score and knee clinical score at every interval.Conclusions: Total knee arthroplasty improves the functional ability of the patient and the ability of the patient to get back to pre-disease state, which is to have a pain free mobile joint, as reflected by the improvement in the post-op knee clinical score and knee functional score

To evaluate the efficacy of platlet rich plasma injection in chronic lateral epicondylitis (tennis elbow)

Background: Platelet-rich plasma helps in repair because of its growth factor. Platelet-rich plasma has been used in humans for its healing properties. Increased concentration of growth factors and secretory proteins at may increase the process of healing on a cellular level. The PRP increases the incorporation of cells, proliferation, and differentiation in tissue regeneration of the cell involved.  This study was done to check the effectiveness of PRP injections in patients with chronic lateral epicondylitis or tennis elbow.Methods: This study was done on the patients visiting the orthopaedic OPD at MGM medical college and hospital, kamothe, Navi Mumbai. Total number of patients for this study was 40 out of which 32 were male and 8 were females. The mean age of the patients was 48.1years (range 17-82 years).Study period was 3 months. Stastical tool used is visual analog score.Results: Successful treatment was taken as more than 20% reduction i.e.(24 out of 40 patients)  in visual analog score after 3 month. The mean VAS score was decreased from 6.98 to 4.91 after 3 months in males. While in females, mean VAS score was decreased from 6.66 to 5.22 after 3 months of PRP injection in lateral epicondylitis. Conclusions: Treatment of patients with PRP with chronic lateral epicondylitis or tennis elbow with PRP reduces pain and increases function of the affected elbow joint

Efficacy of platelet rich plasma injection in treatment of plantar fasciitis

Background: Platelet rich plasma is a recently introduced therapy for treatment of chronic painful conditions in orthopaedics, it acts mainly by promoting healing process. PRP has an increased concentration of platelets which initiate tissue repair by releasing growth factors. Increased concentrations of autologous platelets yield high concentrations of growth factors, subsequently leading to intensified healing of soft tissue on a cellular level. This study was conducted to evaluate the efficacy of platelet rich plasma injection in treatment of plantar fasciitis.Methods: This study was conducted on the patients coming to orthopaedic OPD at MGM medical college and hospital, kamothe, Navi Mumbai. Total of 40 planter fasciitis cases were taken in this study. Out these 40 patients 23 were Male and 17 were female. The mean age 45.85 (range 25-75). Patients were followed up for 3 months with regular interval and at each visit vas score was evaluated and noted.Total duration of study was 3 months from October 2016 to December 2016.Results: The mean pre injection vas score was 7.15 (Male – 7.13, Female – 6.70). The mean vas score at time of follow up after one week was 6.20 (Male – 6.22 Female – 6.18). The mean vas score at time of follow up after 6 week was 5.62 (Male – 5.66 Female – 5.70).  The mean vas score at time of follow up after 3 months was 3.20 (Male – 3.13 Female – 3.29). Conclusions: PRP in plantar fasciitis shows promising short term results providing patients with gradual sustained pain relief, improving daily function and lifestyle activity level. However long term results needs to be evaluated

Functional outcome of radial head replacement in isolated radial head fractures

Background: Proximal radial fractures are common type of fracture around the elbow joint. These commonly occur after an episode of fall on the outstretched arm. These fractures can occur in isolation or with other associated injuries. Among these comminuted radial head fractures are commonly associated with secondary injuries and instability of the elbow joint. Management of the radial head in such cases is very important in restoring stability of the elbow joint and starting early mobilization. This study will assess functional outcome of radial head replacement in isolated radial head fractures using Mayo elbow performance score.Methods: Over a period of 24 months a total of 18 patients (male 12 and female 6) with isolated radial head fractures were included in the study. All of these patients had MASON type III fractures or above. Radial head replacement arthroplasty was done for irreparable radial head fractures and early mobilization was started. Functional outcome was calculated postoperatively with help of the Mayo elbow score on follow-up at 1, 3 and 6 month interval.Results: On the basis of Mayo elbow performance scores, 13 patients had excellent results; 3 had good results; and 2 had fair results. Mean Mayo elbow score was 88.33 (SD 11.11) after 6 month follow up. None of the patients had elbow instability after radial head replacement. Conclusions: Treatment of irreparable radial head fractures with radial head prosthesis along with soft-tissue reconstruction shows satisfactory results. Early mobilization of the elbow after operation is the key for restoration of elbow range of motion and function

To assess the effects of platelet rich plasma application on pain in osteoarthritis knee

Background: Platelet rich plasma (PRP) is a concentrate extract of platelets from autologous blood. It is known to increase growth factor of plasma and helps to heal the injured tissue. Platelet-rich plasma (PRP) is an autologous biologic treatment including patients own plasma, containing growth factors released from platelets. The rationale for the use of PRP is to stimulate the natural healing cascade and tissue regeneration by an increase release of platelet-derived factors directly at the site of treatment. This study is done to assess the effects of platelet rich plasma application on pain in osteoarthritis knee.Methods: Total of 40 cases was included in this study (18 male and 22 females) with mean age of 57.3 (Range 35-75). All patients received intra-articular PRP injection. This study was conducted on the patients coming to orthopaedic department at MGM medical college and hospital, Navi Mumbai.Results: In this study it was found that there is decrease in pain on vas pain score, with increasing time. We followed up the patients for period of 3 months. We found that average mean VAS score was decreased from 6.0 to 4.13 after follow up of 3 months after a single dose of intra-articular PRP injection. Conclusions: PRP is an effective treatment for pain in OA knee. It is one of the new approaches in the field of orthopaedics to solve the issues of pain management