Functional Outcome of Arthroscopic Reconstruction of Anterior Cruciate Ligament Injuries Using Semitendinosis-Gracilis Graft

To determine the functional outcome of arthroscopic ACL reconstruction using semitendinosis- gracilis graft, in patients with anterior cruciate ligament tears. Materials and Methods: This is a prospective observational study, of the patients Aged >18 years to <55 years old, who underwent, Arthroscopic reconstruction of anterior cruciate ligament injuries using semitendinosis-gracilis graft, at Chettinad Hospital and Research Institute (CH&RI), during the period, 11/3/2020 to 15/4/2021(13 months). Follow up period till 15/10/2021. Patients satisfying the inclusion criteria, alone were included, in this study. Total 36 patients were included in this study. The patients, were followed up, at the end of the 3rd, 6th month, from the date of surgery. Results: The mean age of the patients of the study was 33.03 ± 8.89 years with minimum age of 20 years and maximum age of 55 years. In present study at 3 months, 66.67% of patients had fair lysholm score followed by 22.22% had poor score and 11.11% of cases had good score. The mean lysholm score at 3 months was 74.58 ± 8.12 with minimum score of 58 and maximum score of 86. At 6 months 63.89% of patients had good lysholm score followed by 30.56% of cases had excellent score and 5.56% of cases had fair score with mean lysholm score at 6 months was 91.47 ± 5.78 with minimum score of 78 and maximum score of 100. The mean knee society score of patients at 3 months was 76.83 ± 5.71 with minimum score of 61 and maximum score of 86. The mean knee society score at 6 months was 92.97 ± 5.58 with minimum score of 77 and maximum score of 100. The mean distance in single hop test was 81.39 ± 11.05cms with minimum distance of 51cms and maximum distance of 103cms. Conclusion: ACL reconstruction with semi-tendinosis and gracilis graft gives good functional outcomes which might be due to the advancements in the surgical techniques and fixation device

Functional and radiological outcome following proximal fibular osteotomy in patients with knee osteoarthritis: a prospective study

Background: Osteoarthritis of knee is a common joint disease, with a prevalence of about 30 percent of individuals older than 60 years of age. Medial compartmental OA Knee, is by far the most prevalent variant of degenerative tibio-femoral joint disease and makes upto 90% of uni-compartment knee OA. Proximal Fibular Osteotomy (PFO), which essentially is resection of upper fibular diaphysis, had become increasingly adopted for the surgical intervention in the last decade. Aim: To Assess the functional and radiological Outcome In Patients Who Had Medial Compartment Knee Arthritis following Proximal Fibular Osteotomy. Materials and methods: The study was done in the Department of Orthopaedics, at Chettinad Hospital & Research institute, Tamil Nadu. The study population included total 22 cases with knee medial compartmental osteoarthritis and underwent Proximal Fibular Osteotomy. Results: In our study, mean age group of cases was 52.51 years. The mean post-operative VAS was 1.4 which was significantly lesser than pre-operative value. Significant improvement in the functional and clinical outcome, was observed. The post-operative medial joint space and knee joint ratio, were significantly enhanced.Conclusion: PFO is a suitable option for pain relief, as well as to achieve a painless knee ROM to benefit activities of daily life in patients with medial compartment osteoarthritis

Functional outcome following arthroscopic single row repair in degenerative rotator cuff tear

Background: Rotator cuff disease encompasses a wide range of pathology from minimal bursal or articular side irritation and tendonitis to severe degenerative rotator cuff arthropathy. Rotator cuff pathology affects adults of all ages and other shoulder afflictions must be ruled out by careful history and physical examination. Arthroscopic surgery allows for a shorter recovery time and predictably less pain following procedure than any open surgery. Materials and methods: We did a prospective study on 32 patients of age more than 40 years of age with degenerative rotator cuff tear, who met the inclusion criteria and were operated using single row technique of arthroscopic rotator cuff repair and were followed up at 1 month, 3 months and 6 months and pain, function, muscle power and range of movements were assessed by ASES and UCLA scoring system. Results: The mean age of the patients was found to be 54.94 years. The Male: Female ratio in our study was found to be 3:1. The average ASES score in the pre-operative and post-operative period was found to be 22.66 and 89.53 respectively. The average UCLA score in the pre-operative and post-operative period was found to be 8.97 and 29.13 respectively. Conclusion: Arthroscopic rotator cuff repair with single row repair provides early pain relief and improves mobility, strength as well as patient satisfaction post operatively

A prospective study in management of lumbar radiculopathy patients with selective nerve root block

Background: Prolapsed Intervertebral Disc (PID) was considered to be the commonest cause of sciatica among many others. Though the presentation of sciatica was paradoxical, in which, some people experienced sciatica without any disc prolapse on MRI/CT, whereas some people showed a prolapsed disc without experiencing any of the symptoms related to sciatica. This gave rise to different explanations that a disc prolapse in itself , is not enough to cause sciatica, and there might be some local chemical agents that might be the causative factor due to their insulting attitude on the nerve roots. Objectives: To study the functional outcome of patients with Posterior Lumbar Intervertebral disc prolapse (PLIVDP), Lumbar Canal Stenosis, and Lumbar radiculopathy after Selective Nerve Root Block at the corresponding level. Materials and Methods: A prospective cohort study on the functional outcome of patients with lumbar radiculopathy with Intervertebral disc prolapse or lumbar canal stenosis. Outcome measures used in this study are Owestry disability index score and Numerical rating scale. All patients had taken an MRI scan, which was classified according to the Michigan state university classification. After initial check up, pre-anaesthetic check up, selected patients were given Selective Nerve Root Block with Methyl Prednisolone and local anaesthetic Bupivacaine. Patients were scored at Immediate post Op, 3 weeks and 3 months after the injection was given and the data was collected. Results: A total of 127 patients were given Selective Nerve Root Block in the study period. Patients that were aged from 20-80 years were included. Average pre-injection ODI scores (in percent) were 75.24, at 1 month 20.52 and at 4 months 19.86, with a p value of <0.001. Mean NRS ratings pre injection were 8.73, Immediate post op were 1.89, at 4 weeks it was 1.48 and 4 months 1.27. Mean SLR (in degrees) Pre Injection was 48.3, Immediate was 80.00, at 4 weeks was 80.2 and at 4 months was 80.5. Conclusion: Selective Nerve Root Block is a good therapeutic procedure for pain management in the patients with Lumbar radiculopathy, and it can be used as a standard procedure, before advising the patient for any form of surger

Multi-messenger observations of a binary neutron star merger

On 2017 August 17 a binary neutron star coalescence candidate (later designated GW170817) with merger time 12:41:04 UTC was observed through gravitational waves by the Advanced LIGO and Advanced Virgo detectors. The Fermi Gamma-ray Burst Monitor independently detected a gamma-ray burst (GRB 170817A) with a time delay of ~1.7 s with respect to the merger time. From the gravitational-wave signal, the source was initially localized to a sky region of 31 deg2 at a luminosity distance of 40+8-8 Mpc and with component masses consistent with neutron stars. The component masses were later measured to be in the range 0.86 to 2.26 Mo. An extensive observing campaign was launched across the electromagnetic spectrum leading to the discovery of a bright optical transient (SSS17a, now with the IAU identification of AT 2017gfo) in NGC 4993 (at ~40 Mpc) less than 11 hours after the merger by the One- Meter, Two Hemisphere (1M2H) team using the 1 m Swope Telescope. The optical transient was independently detected by multiple teams within an hour. Subsequent observations targeted the object and its environment. Early ultraviolet observations revealed a blue transient that faded within 48 hours. Optical and infrared observations showed a redward evolution over ~10 days. Following early non-detections, X-ray and radio emission were discovered at the transient’s position ~9 and ~16 days, respectively, after the merger. Both the X-ray and radio emission likely arise from a physical process that is distinct from the one that generates the UV/optical/near-infrared emission. No ultra-high-energy gamma-rays and no neutrino candidates consistent with the source were found in follow-up searches. These observations support the hypothesis that GW170817 was produced by the merger of two neutron stars in NGC4993 followed by a short gamma-ray burst (GRB 170817A) and a kilonova/macronova powered by the radioactive decay of r-process nuclei synthesized in the ejecta

Localization and broadband follow-up of the gravitational-wave transient GW150914

A gravitational-wave (GW) transient was identified in data recorded by the Advanced Laser Interferometer Gravitational-wave Observatory (LIGO) detectors on 2015 September 14. The event, initially designated G184098 and later given the name GW150914, is described in detail elsewhere. By prior arrangement, preliminary estimates of the time, significance, and sky location of the event were shared with 63 teams of observers covering radio, optical, near-infrared, X-ray, and gamma-ray wavelengths with ground- and space-based facilities. In this Letter we describe the low-latency analysis of the GW data and present the sky localization of the first observed compact binary merger. We summarize the follow-up observations reported by 25 teams via private Gamma-ray Coordinates Network circulars, giving an overview of the participating facilities, the GW sky localization coverage, the timeline, and depth of the observations. As this event turned out to be a binary black hole merger, there is little expectation of a detectable electromagnetic (EM) signature. Nevertheless, this first broadband campaign to search for a counterpart of an Advanced LIGO source represents a milestone and highlights the broad capabilities of the transient astronomy community and the observing strategies that have been developed to pursue neutron star binary merger events. Detailed investigations of the EM data and results of the EM follow-up campaign are being disseminated in papers by the individual teams

Binary Black Hole Mergers in the first Advanced LIGO Observing Run

The first observational run of the Advanced LIGO detectors, from September 12, 2015 to January 19, 2016, saw the first detections of gravitational waves from binary black hole mergers. In this paper we present full results from a search for binary black hole merger signals with total masses up to $100 M_\odot$ and detailed implications from our observations of these systems. Our search, based on general-relativistic models of gravitational wave signals from binary black hole systems, unambiguously identified two signals, GW150914 and GW151226, with a significance of greater than $5\sigma$ over the observing period. It also identified a third possible signal, LVT151012, with substantially lower significance, which has a 87% probability of being of astrophysical origin. We provide detailed estimates of the parameters of the observed systems. Both GW150914 and GW151226 provide an unprecedented opportunity to study the two-body motion of a compact-object binary in the large velocity, highly nonlinear regime. We do not observe any deviations from general relativity, and place improved empirical bounds on several high-order post-Newtonian coefficients. From our observations we infer stellar-mass binary black hole merger rates lying in the range $9-240 \mathrm{Gpc}^{-3} \mathrm{yr}^{-1}$. These observations are beginning to inform astrophysical predictions of binary black hole formation rates, and indicate that future observing runs of the Advanced detector network will yield many more gravitational wave detections

Search for Gravitational Waves Associated with Gamma-Ray Bursts during the First Advanced LIGO Observing Run and Implications for the Origin of GRB 150906B

We present the results of the search for gravitational waves (GWs) associated with γ-ray bursts detected during the first observing run of the Advanced Laser Interferometer Gravitational-Wave Observatory (LIGO). We find no evidence of a GW signal for any of the 41 γ-ray bursts for which LIGO data are available with sufficient duration. For all γ-ray bursts, we place lower bounds on the distance to the source using the optimistic assumption that GWs with an energy of ${10}^{-2}{M}_{\odot }{c}^{2}$ were emitted within the $16$–$500$ Hz band, and we find a median 90% confidence limit of 71 Mpc at 150 Hz. For the subset of 19 short/hard γ-ray bursts, we place lower bounds on distance with a median 90% confidence limit of 90 Mpc for binary neutron star (BNS) coalescences, and 150 and 139 Mpc for neutron star–black hole coalescences with spins aligned to the orbital angular momentum and in a generic configuration, respectively. These are the highest distance limits ever achieved by GW searches. We also discuss in detail the results of the search for GWs associated with GRB 150906B, an event that was localized by the InterPlanetary Network near the local galaxy NGC 3313, which is at a luminosity distance of $54$ Mpc (z = 0.0124). Assuming the γ-ray emission is beamed with a jet half-opening angle $\leqslant 30^\circ$, we exclude a BNS and a neutron star–black hole in NGC 3313 as the progenitor of this event with confidence >99%. Further, we exclude such progenitors up to a distance of 102 Mpc and 170 Mpc, respectively

Observation of Gravitational Waves from a Binary Black Hole Merger

On September 14, 2015 at 09:50:45 UTC the two detectors of the Laser Interferometer Gravitational-Wave Observatory simultaneously observed a transient gravitational-wave signal. The signal sweeps upwards in frequency from 35 to 250 Hz with a peak gravitational-wave strain of 1.0 × 10−21. It matches the waveform predicted by general relativity for the inspiral and merger of a pair of black holes and the ringdown of the resulting single black hole. The signal was observed with a matched-filter signal-to-noise ratio of 24 and a false alarm rate estimated to be less than 1 event per 203 000 years, equivalent to a significance greater than 5.1σ. The source lies at a luminosity distance of 410þ160 −180 Mpc corresponding to a redshift z ¼ 0.09þ0.03 −0.04 . In the source frame, the initial black hole masses are 36þ5 −4M⊙ and 29þ4 −4M⊙, and the final black hole mass is 62þ4 −4M⊙, with 3.0þ0.5 −0.5M⊙c2 radiated in gravitational waves. All uncertainties define 90% credible intervals. These observations demonstrate the existence of binary stellar-mass black hole systems. This is the first direct detection of gravitational waves and the first observation of a binary black hole merger

Prospects for Observing and Localizing Gravitational-Wave Transients with Advanced LIGO and Advanced Virgo.

We present a possible observing scenario for the Advanced LIGO and Advanced Virgo gravitational-wave detectors over the next decade, with the intention of providing information to the astronomy community to facilitate planning for multi-messenger astronomy with gravitational waves. We determine the expected sensitivity of the network to transient gravitational-wave signals, and study the capability of the network to determine the sky location of the source. We report our findings for gravitational-wave transients, with particular focus on gravitational-wave signals from the inspiral of binary neutron-star systems, which are considered the most promising for multi-messenger astronomy. The ability to localize the sources of the detected signals depends on the geographical distribution of the detectors and their relative sensitivity, and 90% credible regions can be as large as thousands of square degrees when only two sensitive detectors are operational. Determining the sky position of a significant fraction of detected signals to areas of 5 deg2 to 20 deg2 will require at least three detectors of sensitivity within a factor of ∼ 2 of each other and with a broad frequency bandwidth. Should the third LIGO detector be relocated to India as expected, a significant fraction of gravitational-wave signals will be localized to a few square degrees by gravitational-wave observations alone