Publications by authors named "Muhammad Adeel Akhtar"

Background: Scotland has one of the highest rates of obesity in the developed world which increases risk of lower limb osteoarthritis resulting in total joint arthroplasty (TJA). This paper aimed to investigate (1) current practice of orthopaedic consultants in Scotland in managing end-stage hip and knee osteoarthritis in obese patients, (2) adherence to National guidelines, and (3) understanding of complication risks in lower limb TJA for BMI≥40.

Methods: A 15-question online survey was sent to all active members of Scottish Committee for Orthopaedics and Trauma (SCOT) between February and March 2023 to understand the current practices for managing obese patients with lower limb arthritis requiring joint replacement surgery.

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Article Synopsis
  • Patients using traditional socket prostheses after transtibial amputation face frequent repairs, high skin ulceration rates, and limited mobility, leading to the exploration of Trans-Tibial Osseointegration (TTOI) as a potential solution.
  • This study analyzes mobility, quality of life, and safety in the largest cohort of patients (21 adults) who underwent TTOI after socket prosthesis failure, with follow-ups of at least two years.
  • Results showed significant improvements in mobility outcomes, suggesting that TTOI could enhance patient experiences and reduce issues associated with traditional prosthetics.
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Background: Femoral stem fracture following total hip arthroplasty (THA) is an infrequent but nevertheless devastating complication, with an increasing worldwide prevalence as demand for primary THA continues to increase. The aim of this study was to perform a systematic review and meta-analysis of risk factors for femoral stem fracture to help identify at risk patients.

Methods: A systematic search was conducted on EMBASE, MEDLINE and AMED to identify relevant studies.

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Article Synopsis
  • The systematic review examined outcomes of two salvage options for failed total knee replacements: transfemoral amputation (TFA) and knee arthrodesis (KA), focusing on factors like ambulatory status, infections, and quality of life.
  • A total of 44 studies were analyzed, revealing that TFA patients had lower ambulatory capacity and higher infection rates compared to KA patients, but similar rates of needing revision surgery.
  • The lack of randomized controlled trials highlights possible selection bias in the data, suggesting that KA patients generally have better outcomes in terms of mobility compared to those undergoing TFA.
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Introduction: Periprosthetic fractures (PPFs) around the hip joint are increasing in prevalence. In this collaborative study, we aimed to investigate the impact of patient demographics, fracture characteristics, and modes of management on in-hospital mortality of PPFs involving the hip.

Methods: Using a multi-centre cohort study design, we retrospectively identified adults presenting with a PPF around the hip over a 10-year period.

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Importance: Transcutaneous osseointegration post amputation (TOPA) creates a direct linkage between residual bone and an external prosthetic limb, providing superior mobility and quality of life compared with a socket prosthesis. The causes and potential risks of mortality after TOPA have not been investigated.

Objective: To investigate the association between TOPA and mortality and assess the potential risk factors.

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Background: Management of total knee replacement (TKR) infection may sometimes prompt knee fusion (KF) or transfemoral amputation (TFA), both associated with low mobility and quality of life (QOL). Transcutaneous osseointegration for amputees provides superior mobility and QOL vs traditional socket prostheses but has not been studied for patients with a history of infected TKR. This study investigates the following hypothesis: Patients who have had TFA or KF following infected TKR achieve better mobility and QOL following transfemoral osseointegration.

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Article Synopsis
  • Transcutaneous osseointegration for amputees (TOFA) involves a metal endoprosthesis that connects a limb to an exoprosthesis and has evolved since the 1940s.* -
  • Despite significant advancements in TOFA, current literature often overlooks foundational research, which may lead to repeating past mistakes.* -
  • This review aims to compile early research and advancements in TOFA to help clinicians and researchers understand its origins and support future innovations in the field.*
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We reviewed the literature to investigate the relationship between depression and metabolic syndrome. Major depressive disorder is characterized by a low mood or a loss of interest for longer than two weeks. Metabolic syndrome describes multiple metabolic risk factors including obesity, insulin resistance, dyslipidemia, and hypertension.

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In this case report, we present the case of a 19-year-old male who presented to the emergency department with bilateral shoulder pain and significantly decreased range of motion. His X-rays showed a bilateral dislocation of the glenohumeral joints, along with a proximal humeral fracture. Shoulder dislocations were manipulated, while the proximal humeral fracture was conservatively managed.

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Unlabelled: The management of peripheral vascular disease (PVD) can require amputation. Osseointegration surgery is an emerging rehabilitation strategy for amputees. In this study, we report on 6 patients who had PVD requiring transtibial amputation (PVD-TTA) and either simultaneous or subsequent osseointegration (PVD-TTOI).

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Introduction: Lower extremity amputation uniformly impairs a person's vocational, social and recreational capacity. Rehabilitation in traditional socket prostheses (TSP) is associated with a spectrum of complications involving the socket-residuum interface which lead to reduced prosthetic use and quality of life. Osseointegration has recently emerged as a novel concept to overcome these complications by eliminating this interface and anchoring the prosthesis directly to bone.

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Distal biceps femoris tendon is an unusual site of calcific tendinitis and a rare cause of knee pain. We present a case of 72-year-old lady who presented with a six-month history of pain over the lateral aspect of knee. Subsequent imaging demonstrated calcific deposits within the biceps femoris tendon substance.

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Spontaneous biloma is an uncommon entity. We report a case of subcapsular biloma in an elderly patient with a nonobstructed biliary channel, without prior history of surgery, instrumentation, or trauma. Computed tomography (CT) and magnetic resonance imaging are described.

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