Indian Journal of Public Health Research & Development

Vineet Pruthi ¹, Ashwani Ummat ², Manjeet Singh ³, Sonia Kochhar ⁴, Subodh Pathak ⁵, Vishesh Verma ¹, Aryan Sharma ¹

Affiliations
1 PG Resident MS Orthopaedics, Maharishi Markandeshwar Deemed to be University, Mullana, Ambala, IN
2 Professor Department of Orthopaedics, Maharishi Markandeshwar Deemed to be University, Mullana, Ambala, IN
3 Professor and Head, Department of Orthopaedics, Maharishi Markandeshwar Deemed to be University, Mullana, Ambala, IN
4 Associate. Professor, Department of Physiology, AIIMS, Bathinda5, IN
5 Assistant Professor, Department of Orthopaedics, Maharishi Markandeshwar Deemed to be University, Mullana, Ambala, IN

Abstract

Introduction: In cases of infected Nonunion of long bones Antibiotic coated nail provides mechanical support for the affected bone with delivery of high concentration of antibiotics for infection control and a conclusive environment for fracture healing. The aim of the study was to observe and study the treatment of infected non-union of long bones with antibiotic coated nailing in infection control and bony union. Material and Method: The study was conducted on 30 patients (male and female between the age of 18‑70 years). All patient on admission were subjected to detailed history, relevant investigations and thorough clinical examinations. Minimum follow-up period was 6 months. Radiological and blood investigations were done for infection control and bony union. Result: In the current study of 30 patients with mean age of 43.67 years, Infection control and bony union was achieved in 27 patients without any need for subsequent procedures. Current study provides an alternative to external fixation alone as a means of stabilizing non-unions while providing a high concentration of antibiotic locally for combating this difficult problem. Conclusion: The clinical results and final outcome after antibiotic coated I.M. nailing in infected nonunion of long bones are both satisfactory and reproducible as evident by the comparison of this present study with the previous literature available.

Keywords

Infected nonunion, antibiotic coated nail.

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Vishesh Verma ¹, Manjeet Singh ², Ashwani Ummat ³, Praveen Thivari ¹, Harsimarjit Kaur ⁴, Jasneet Chawla ¹, Vineet Pruthi ¹

Affiliations
1 P.G. Resident M/S Orthopaedics, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, IN
2 HOD Department Orthopaedics, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, IN
3 Professor Department Orthopaedics, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, IN
4 Associate Professor, Deptt. Anatomy, Government Medical College and Hospital, Patiala, IN

Abstract

Introduction: Proximal Fibular Osteotomy (PFO) is removing 1-1.5 cm of FIBULA, 7 to 10 cm below its head, which provides symptomatic relief from pain of medial compartment Osteoarthritis (OA) knee. It is a procedure wherein we remove Proximal part of fibula to stop mechanical axis of knee going into further varus and hence putting a stop to progression of disease. The aim of the study was to observe and study the resultsin patients of isolated medial compartment Osteoarthritis of Knee,treated by Proximal Fibular Osteotomy. Material and Method: The study was conducted on 36 patients amounting to 50 knee joints (male and female between the age of 50-70 years) with medial compartment OA Knee. Patients were followed up till 6 months. Medial and lateral joint space along-with visual analogue score for pain were recorded preoperative, immediate post-operative and at final follow up. Result: Significant improvement in mean visual analogue pain score (VAS), from 7.32 + 0.98 preoperative to 2.72 + 1.20 at the final follow up was observed (p-value <0.001). Medial joint space opening from 1.17 + 0.29 to 4.07 + 0.69 at final follow up was observed. American knee society score was divided into 2 subsets, knee score and functional score. Both of them showed significant improvements from 39.72 + 3.47 and 44.20 + 8.47 (pre-operative) to 86.58 + 10.79 and 84.60 + 8.38 respectively, at final follow up (p-value < 0.001). Conclusion: The objective as well as functional outcome after proximal fibular osteotomy were satisfactory. With correct patient selection and meticulous adherence to basics, Proximal fibular osteotomy offers an excellent alternative to tedious and extensive procedures like High tibial osteotomy (HTO) and Unicompartmental Knee Arthroplasty (UKA). It is specially enthralling in country like ours where everyone cannot afford expensive surgeries and are forced to live a life of misery and morbidity.

Keywords

Medial compartment Osteoarthritis Knee, PFO, American Knee Society Score, Fibular osteotomy.

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Rajdeep Singh Bajwa ¹, Rakesh Gautam ², Subodh K. Pathak ³, Aryan Sharma ¹, Vineet Pruthi ¹, Vishesh Verma ¹

Affiliations
1 PG Resident M/S Orthopaedics, Department Orthopaedics, Maharishi Markandeshwar Deemed to be University, Mullana, Ambala, IN
2 Associate Professor,Department Orthopaedics, Maharishi Markandeshwar Deemed to be University, Mullana, Ambala, IN
3 Assistant Professor, Department Orthopaedics, Maharishi Markandeshwar Deemed to be University, Mullana, Ambala, IN

Abstract

The present study was conducted to identify the link between increased uric acid and osteoarthritis and to find out the prevalence of hyperuricemia in population suffering from osteoarthritis of knee. Material and Method: The study was conducted on 100 patients (male and female between the age of 40- 70 years) with knee pain for more than 6 weeks to establish a correlation between knee osteoarthritis and hyperuricemia. Result: In the current study female preponderance was seen. Mean age of the patients was 50.10 years and maximum patients were in the age group of 40-50 years. KOA patients had higher values of uric acid as compared to patients without KOA however no stastically significant relation was found between increasing uric acid levels and severity of KOA with p-value .668 being insignificant. The mean BMI of patients with KOA was higher than the patients without KOA but no statistical significant relation was found between increased incidence of KOA in females as compared to males with increasing BMI p-value 0.777 being insignificant. There was no statistically significant correlation between hyperuricemia and either gender with p-value being >.0.05 (0.119). VAS and WOMAC scoring was done at 0 and 16 weeks however no significant improvement was seen except for the pain component which improved in KOA patients. Conclusion: In this present study we observed increased prevalence of OA knee in females and in patients with hyperuricemia and also with patients with higher BMI. Serum levels of CRP and ESR also show positive prevalence in patients with KOA in this study. However, no s statistically significant correlation was observed between levels of hyperuricemia and severity of KOA. Hence in conclusion our study points towards positive correlation between hyperuricemia and KOA. Limitations of our study included inability to homogenise groups in terms of BMI, age, activity level, smoking, alcohol etc.

Keywords

Knee osteoarthritis, Hyperuricemia, WOMAC Score

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