Outcomes of total knee arthroplasty in arthritis using functional knee score

Background: Knee being a major weight bearing joint, arthritis of the knee is a common problem. Over time various conservative measures have been used to alleviate the arthritic pain, but complete pain relief has rarely been achieved. Total Knee Arthroplasty has an established place in the treatment of knee arthritis and is an effective surgical modality that provides immediate pain relief and enhances quality of life. Though most patients were satisfied by the immediate outcome of the surgery, further detailed interrogation revealed concern and inability to perform activities they previously used to do, thus arising the need for an objective method to measure the true outcome.Methods: There are very few established objective scoring methods to evaluate the outcome following a Total Knee Arthroplasty. In our study, we have used the ‘Functional Knee Score’ for the 30 patients with arthritis who underwent TKA using the midvastus approach under tourniquet cover.Results: The majority of the patients were from the age group of 61-70 years which accounts for 36.7% of patients in our study. The mean functional new knee society score preoperatively was 39.90 standard deviation of 3.055 which improved to 80.77 with standard deviation of 6.263 postoperatively, p<0.001.Conclusions: Using knee society functional score, 10 patients had excellent results, 16 had a good result, 4 patients a had fair result

Augmented Repair of Degenerative Tears of Tendo Achilles Using Peroneus Brevis Tendon: Early Results

Reconstruction of degenerated ruptures of the tendoachilles is a challenge. Ruptured tendons and the remaining tendon ends are abnormal. A number of methods have been described in literature reconstruct the tendoachilles, but with variable results. We used peroneus brevis tendon in 20 patients to augment the repair of degenerated tendoachilles tears by creating a dynamic loop as described by Teuffer et al. All patients were followed up for atleast 18 months. At the last postoperative visit, 18 out of 20 patients were able to do a toe raise. Eighty-five per cent of patients had excellent or good results and 15% had fair or poor results using modified Rupp scoring. Advantages offered by this procedure are the use of a single incision and mini incision and use of a dispensable tendon such as the peroneus brevis without entirely depending on the damaged tendon for healing

Patients with Blunt Traumatic Spine Injuries with Neurological Deficits Presenting to an Urban Tertiary Care Centre in Mumbai: An Epidemiological Study

INTRODUCTION: Traumatic spine injuries are on the rise. The literature is sparse regarding epidemiology of patients with traumatic spine injuries from this part of the world. OBJECTIVES: To analyse the following in patients with traumatic spine injuries with neurological deficits: demographic and social profile, common modes of injury, pre-hospitalisation practices, region of spine affected, severity of neurological deficit and the lay individuals’ awareness about traumatic spine injuries. METHODS: The study sample comprised 52 adult patients with traumatic spine injuries with neurological deficits. We collected data on demographic and social characteristics, mode of injury, pre-hospitalisation treatment, interval between injury and presentation, spine region affected and severity of neurological deficits and patient's knowledge about such injuries. RESULTS: The average patient age was 31.32y. The male: female ratio was 2.25:1, and the most common modes of injury were fall from height, followed by traffic accident. More than half of the patients suffered cervical spine injuries, followed by dorsolumbar spine injuries. Only 9.61% of patients received pre-hospitalisation treatment. All patients understood there could be complete functional recovery after treatment for traumatic spine injuries. CONCLUSION: There is a growing need to improve railway and roadway safety equipment and to make it accessible and affordable to the susceptible economically weaker population. Attempts should be made to increase awareness regarding traumatic spine injuries

Functional and radiological outcomes of thoracolumbar traumatic spine fractures managed conservatively according to Thoracolumbar Injury Severity Score

Aim: To study the functional and radiological outcomes in cases managed conservatively for single-level traumatic thoracolumbar spine fractures without neurological deficit. Materials and Methods: In this prospective study design, thirty patients who presented to tertiary care hospital and diagnosed with posttraumatic thoracolumbar vertebral fracture without any neurodeficit were recruited. All the patients were managed conservatively as per the protocol which included bed rest, spinal braces, and physiotherapy. Adequate analgesia was given wherever necessary. The patients were followed at regular intervals up to a maximum of 2 years. Clinically visual analog scale (VAS) score and Roland Morris Disability Questionnaire (RMDQ)-24 were assessed and radiologically local vertebral kyphosis, scoliosis, and loss of body height were noted at each follow-up. Results: The data was statistically analyzed and the results were as follows. Thoracolumbar fractures were more in young adults (<26 years) and more so among the males (80% cases). The most common fracture type in our study was compression fracture. The most common site involved in our study was L1 vertebra (36.7%). There was a significant decrease of VAS score (pain score) in 79% cases with the maximum decrease in type A1 fracture. The mean RMDQ-4 score in our study was 5.53. The overall progression of kyphosis was 1.9°. There was no relation found between the kyphotic deformity and the clinical outcomes (VAS and RMDQ-24 scores). Canal size changes were found to be insignificant at the end of 2 years compared to baseline. Conclusion: Study showed favorable outcomes in terms of return to daily activities, making it a good option in managing Type A1 dorsolumbar fractures. Though there was a progression of kyphosis but no neurological deficit was seen