Nitin Wagh ¹, Adit Maniar ¹, Akshay Fuse ¹, Aditya Apte ¹, Shantanu Bharadwaj ¹

Affiliations
1 Department of Orthopaedics, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN

Abstract

Introduction: Rotator cuff tears is a severely debilitating condition widely prevelant amongst the elderly age group. Timely adequate repair is of utmost importance. Aims and Objectives: To study the functional outcome of arthroscopic single row repair for rotator cuff tears. Materials and Methodology: We enrolled 30 patients of rotator cuff tears. Each patient underwent arthrosocpic single row repair in the lateral position with concomitant sub acromial decompression. Post operative protocol included immobilisation for 6 weeks followed by active assisted range of motion at 6 weeks and strengthening exercises at 3 months. We assessed the patient pre operatively and post operatively at 6 weeks, 3 months and 6 months using Constant Score and Visual analog scale for pain. Results: There was significant improvement at every follow up with mean Constant Score increasing from pre operative to post operative stage at 6 months. According to individual relative Constant Score patients went from a mean of poor to good outcome. Visual analog scale for pain changed from a meanscore of severe to mild at 6 months post operatively. Conclusion: Arthroscopic single row repair is a simple, minimally invasive, cost effective procedure with good functional outcomes and pain relief.

Keywords

Arthroscopic, Outcome, Rotator Cuff, Single Row

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Aditya P. Apte ¹, Sandeep Aware ², Adit Maniar ¹, Shantanu Bharadwaj ¹, Akshay Fuse ¹

Affiliations
1 PG Resident, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN
2 Assistant Professor, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422003, Maharashtra, IN

Abstract

Introduction: Cervical spondylosis means osteoarthritis of cervical spinal column. The degenerative process mainly affects the vertebrae, neural foramina and the facet joints. It leads to compression of the spinal cord resulting in progressive neural cell loss and neurological deterioration in 40 to 60 % of patients. Cervical myelopathy is a constellation of symptoms and physical findings including motor and sensory abnormalities. Spasticity and paresis are frequently seen. The patient often complaints of gait disturbance due to abnormalities incorticospinal tract and spinal spinocerebellar tracts. There is also associated loss of grip strength and finger movements. Anterior cervical discectomy and fusion (ACDF) is a commonly performed procedure to remove a herniated or degenerative disc. An incision is made in the anterior cervical region and the disc is then removed. A graft is then placed to fuse the vertebrae above and below the disc. ACDF was first described by Cloward, Smith and Robinson in 1958 and shortly later by Hirsch in 1960 who described anterior cervical decompression and debated the necessity for inter body fusion. Anterior cervical discectomy and fusion has been widely performed since the late 1950s and is currently recommended in patients in whom the nonoperative modalities for single level or multilevel disease have failed. Objectives: To study the functional outcome of cervical discectomy and fusion with anterior cervical plating among patients of cervical disc disease. Materials and Methods: 46 patients treated with ACDF with anterior cervical plating were considered in this study. Results and Conclusion: All the patients showed significant post-operative improvement in their symptoms and diagnostic scores. Thus, we can conclude that ACDF with anterior cervical plating is an efficient procedure in patients with cervical myelopathic symptoms not responding to conservative treatment.

Keywords

Anterior Cervical Plates, Cervical Myelopathy, Fusion, Kirkaldy Willis, MJOA Score, NURICK

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Shantanu Hari Bhardwaj ¹, Sandeep Aware ², Sandeep Pangavane ³, Aditya Apte ¹, Adit Maniar ¹, Akshay Fuse ¹

Affiliations
1 Former PG Resident, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN
2 Assistant Professor, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN
3 Professor and Head, Department of Orthopedics, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, IN

Abstract

Background: Meniscal repair is performed in an attempt to prevent post-traumatic arthritis resulting from meniscal dysfunction after meniscal tears. The socio-economic implications of premature arthritis are significant in the young patient population. Investigations and techniques focusing on meniscus preservation and healing are now at the forefront of orthopaedic sports medicine. Methods: All unilateral primary ACL reconstructions in a prospective cohort who had meniscal repair at the time of ACLR were evaluated. Validated patient oriented outcome instruments were completed preoperatively and then again at follow up. Results: 65 unilateral primary ACL reconstructions were performed concomitant meniscal repairs during the study period. Patient follow-up was obtained, allowing confirmation of meniscal repair success (defined as no repeat arthroscopic procedure) or failure. Conclusions: Meniscal repair is a successful procedure in conjunction with ACL reconstruction. When confronted with a “repairable” meniscal tear at the time of ACL reconstruction, orthopaedic surgeons can expect an estimated >90% clinical success rate using a variety of methods as shown in our study.

Keywords

Anterior Cruciate Ligament, Meniscal Repair, Reconstruction, Meniscal Tear

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