Online ISSN: 2515-8260

Keywords : knee society score


Evaluation of functional and radiological outcome of distal femoral fractures fixed with locking compression plate by minimally invasive plate osteosynthesis

Dr. Nandram Saryam; Dr. Anil Chouksey; Dr. Raja Yadav; Dr. Rohit Kumar Marskole

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 254-267

Title: Evaluation of distal femoral fractures with locking compression plate using minimally invasive plate Osteosynthesis (MIPO) technique.Aim: To prospective and retrospective analysis of clinical and radiological outcome of distal femur fractures treated with locking compression plate by minimally invasive plate osteosynthesis (MIPO) technique.

A COMPARATIVE ANALYSIS OF ELEVATION OF DEPRESSED TIBIAL CONDYLE FRACTURE BY AUTOGENOUS BONE GRAFT AND HYDROXY APATITE CRYSTALS

Dr. I. Suresh, Dr. Adinarayana Roy.Gandi, Dr. Roshan Kumar B.N, Dr Deepak Varghese Kurian .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 424-441

BACKGROUND: Proximal tibial plateau fractures are serious and complex injuries that pose difficulty in management. Their management is challenging because of the severe displacement of the bony fragments, the concomitant depression and impaction of the cancellous subchondral bone, and the complications like Compartment syndrome, cartilage destruction, soft-tissue envelope damage, infection, knee instability, stiffness and arthritis.
OBJECTIVES: A comparative analysis of elevation of depressed tibial condyle fracture by autogenous bone graft and hydroxyl apatite crystals.
METHODS: A prospective study of 30 patients with Schatzker type II, III, V, and VI with depressed tibial plateau fractures were identified and divided into 2 groups, all the patients were treated by elevation of depressed tibial condyle fracture, patients in group A have been operated by using bone graft and in group B have been operated by using hydroxy apatite as void filler, 15 in each group.. The preoperative and intra operative and post operative data was noted and final evaluation was done using knee society score.
RESULTS: The patients were followed up at 1,3 and 6months, Fair results were seen in 53.30% of patients treated with bone graft and 80% of patients treated with hydroxyapatite crystals at one month, where as 46.70% of patients treated with bone graft and 20% of patients treated with hydroxy apatite crystals showed poor result at end of one month.93.3% of patients treated with bone graft and 86.7% patients treated with hydroxyapatite crystals showed excellent results, and 6.7% of patients treated with bone graft and 13.3% of patients treated with hydroxyapatite crystals have shown good results at 3 and 6 months.
CONCLUSION: We conclude that there was no much significant difference between functional outcome between both the groups but the complication of late collapse is higher in patients treated with bone graft when compared to those treated with hydroxyapatite crystals.

“A PROSPECTIVE STUDY OF FUNCTIONAL OUTCOME OF TOTAL KNEE REPLACEMENT IN OSTEOARTHRITIS OF KNEE”

Dr. K.M. Gopinath, Dr. Ravi N. Bavalatti, Dr. Roshan kumar B.N., Dr. Suresh I .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2651-2672

AIM AND OBJECTIVES: To evaluate the functional outcomes of Total Knee Arthroplasty.
METHODS: This is a prospective study of 20 cases who underwent Total knee replacement at Rajarajeshwari medical college and hospital, Bengaluru between June 2019 and May2021. Cases were taken according to inclusion and exclusion criteria. Patients were evaluated using Knee Society Score at regular follow up. In our study we had 28 female patients and 13male patients. Indications were OA in 19, RA in 1.. The average follow-up period was 22weeks.
RESULTS : In our study, pre-operatively all of our patients had moderate to severe pain, post- operatively 20 cases had mild pain. Preoperative average Flexion of 76 degrees was increased to 95 degrees post operatively. All the 20 knees had poor knee score of <60 preoperatively, postoperatively 42 knees had excellent score (80- 100) and 17 knees with good score (70-79). 38 patients had poor functional score(<60) and 3 patients with fair functional score (60-69) pre-operatively. Postoperatively 21 patients had excellent score (80-100), 11 patients with good score (70-79), 6 patients had fair score (60-69) and 3 patients had poor score(<60).

           CONCLUSION: Total knee arthroplasty is now a common and established surgical procedure. The functional outcome of the procedure is dramatic, durable, and satisfactory with high patient acceptance.

Multimodal Post-Operative Pain Management Using Intraoperative Periarticular Cocktail Injection In Total Knee Arthroplasties

Dr. Kailash Karur , Prof Nandakumar R , Dr. Santhosh Kumar G , Dr. Sripriya R

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 2994-3005

INTRODUCTION: Total knee arthroplasty (TKA) is one of the best methods for end stage osteoarthritis of knee joint that relieves pain and improves joint function. Most important problem which the patient suffers is postoperative pain, which has harmful effects on patient’s rehabilitation. The aim of our study was to assess the postoperative pain relief and functional outcome following use of combination of drugs which we used as intraoperative, periarticular cocktail injection.
MATERIALS AND METHODS: It is a prospective interventional study consisting of 40 TKA’s done in a single unit. All patients underwent TKA under spinal anaesthesia and underwent standard postoperative protocol. Intraoperative periarticular cocktail consisting of Bupivacaine 0.5% (20ml), Adrenaline 0.3 ml (1:1000), ketorolac 30mg/1ml, methylprednisolone 40mg//1ml, cefuroxime 750mg/10ml with 27.7 ml of normal saline to make total of 60ml solution was given. Assessment of pain was done by visual analogue scale (VAS) and functional assessment by knee society score postoperatively. The number of rescue analgesia used was recorded. 
RESULTS: Mean age of patients was 64 years (47-76) with females predominantly affected than males. Mean static VAS at 6 hours was 4.3 and dynamic VAS at 1st recording was 4.9. there was a strong correlation between Body Mass Index and Dynamic VAS at 1st and Dynamic VAS at 3rd   recording with p < 0.05. Patient satisfaction and functional scores improved postoperatively and there was a statistically significant improvement in knee ROM (P< 0.05). only 2 patients received more than 3 doses of rescue analgesia due to high BMI. No complications related to the infiltration of the local anaesthetic were observed.