Periprosthetic Fractures Around the Acetabulum.

Peri-Prosthetic acetabular fractures are rare but challenging Complications related to total hip arthroplasty (THA), especially during revision procedures. Factors contributing to these fractures include poor bone quality, prior implant placement, and increased mechanical stress. Several systems classify these fractures and management strategies differ based on whether the fracture occurs intraoperatively or postoperatively and whether the prosthesis is stable/unstable.

Impact on vitronectin and secreted protein acidic and rich in cysteine dynamics by estradiol to address rheumatoid arthritis pathogenesis.

Rheumatoid arthritis (RA) is an autoimmune disease caused by intricate signal transductions, where chronic inflammation is manifested in the joints and has a higher prevalence observed in females. To address RA pathogenesis, Estradiol (E2), a prominent form of estrogen, has been used in this study, identifying differentially expressed proteins in RA-Fibroblast-like synoviocytes by SWATH-MS, as well as exploring its mechanistic pathways. In-silico pathway enrichment analysis depicted the major involvement of the proteins in extracellular matrix organization, with Vitronectin (VTN) and Secreted protein acidic and rich in cysteine (SPARC) proteins as prominent protein targets.

Direct Anterior Approach for Total Hip Arthroplasty in bony ankylosis of hips - .

Introduction: We performed a retrospective study to assess the intraoperative course and postoperative outcome of Direct Anterior Approach (DAA) in supine position for Total Hip Arthroplasty (THA) in bony ankylosis of hips and compare with historical series of THA in bony ankylosis performed by posterior approach.

Methods: Inpatient details with intra and post operative data were retrieved from the service arthroplasty register and medical records. All patients were followed up till a minimum of 2 years post-surgery with x-rays and clinical score.

Simultaneous bilateral total knee arthroplasty may be safe in selected patients.

Background: Simultaneous bilateral total knee arthroplasty (TKA) provides advantages in the form of single anaesthesia, lower cost, and faster overall rehabilitation for patients suffering from bilateral knee pathologies. However, there are concerns regarding the safety of performing simultaneous bilateral TKA. The present study was aimed at comparing the perioperative outcomes of patients undergoing simultaneous and staged bilateral TKA.

Management of chronic pelvic discontinuity during revision hip arthroplasty using the 'acetabular distraction technique' : clinical and radiological outcomes from a two-centre study with a minimum two-year follow-up.

Aims: Chronic pelvic discontinuity (CPD) during revision hip arthroplasty is a challenging entity to address. The aim of this study was to evaluate the clinical and radiological outcomes and complications of the 'acetabular distraction technique' for the management of CPD during revision hip arthroplasty.

Methods: Patients with CPD, who underwent acetabular revision between January 2014 and April 2022 at two tertiary care centres, using an identical distraction technique, were evaluated.

Clinicoepidemiological profile of acute postoperative hyponatraemia in patients undergoing joint replacement surgery: A prospective observational study.

Background: Postoperative hyponatraemia is frequently misunderstood or undiagnosed after orthopaedic surgery, such as total knee and hip replacements, which is associated with increased morbidity. Limited and primarily retrospective literature exists on postoperative hyponatraemia in hip and knee arthroplasties. Key risk factors include preoperative hyponatraemia, older age, female sex, lower body weight, fluid imbalance, and surgical stress.

The Quadriceps Vector in the Lower Extremity of Indian Patients Is Similar in Caucasian and Japanese Patients.

Background: Correct alignment of knee components contributes to the longevity and function of total knee arthroplasty. The accuracy and reliability of calculating the three-dimensional quadriceps vector (QV) using computed tomography (CT) scans in Caucasian and Japanese study participants have been established in previous studies. In all cases, the QV was directed from the top of the patella to the middle of the femoral neck.

Osteonecrosis following Steroid Therapy in COVID-19 Patients: An Outlook on the Emerging Problem.

Steroids are used in management of coronavirus disease 2019 (COVID-19) patients with severe illness and their use has been demonstrated to decrease mortality. Although life-saving, steroids are well documented as risk factors for osteonecrosis. Osteonecrosis of the hip can be debilitating and surgery may be required to improve the quality of life.

Comparative assessment of 5-factor modified frailty index and American Society of Anesthesiologists classification for morbidity and mortality prediction in arthroplasty: A prospective observational study.

Background: Identifying early predictors of postoperative complications is paramount in frail patients. While the American Society of Anaesthesiologists classification is subjective, the 5-factor modified frailty index is simpler and associated with promising results in predicting morbidity and mortality in various surgical specialities.

Methods: This prospective observational study assessed the comparative utility of 5-factor modified frailty index and American Society of Anaesthesiologists classification in predicting intensive care unit admission and revision surgery in 220 patients following arthroplasty with standardised anaesthesia techniques under the same group of surgeons.

Osteonecrosis with Concomitant Septic Arthritis of Bilateral Hips following Severe COVID-19 Infection: A Case Report.

Introduction: Among the various musculoskeletal manifestations of post-acute Coronavirus disease 2019 (COVID-19) syndrome, osteonecrosis and pyogenic infections are of serious concern due to their potential for joint destruction and the need for major surgery, even among young patients. Spontaneous septic arthritis is rare among healthy adults. Very few cases of osteonecrosis of the femoral heads (ONFH) with concomitant septic arthritis of the hip following a COVID-19 infection are reported in the literature.

Characterizing acetabular defects and need of major reconstruction during total hip arthroplasty in patients with acetabular protrusion- a retrospective study.

Purpose: Total hip arthroplasty (THA) in patients with acetabular protrusion can be challenging due to the lack of acetabular bone support. Some patients may require a major reconstructive procedure to aid in the fixation of the acetabular components. The purpose of the study was to characterize the type of acetabular defects in patients with protrusion and to assess the need for major reconstruction.

Surveillance for surgical site infections developed during hospital stay & after discharge: A multicentric study.

Background & objectives Surgical site infections (SSIs) are among the most prevalent healthcare-associated infections (HCAIs). They cause significant morbidity, leading to excess health expenditures and increased length of hospital stay. Despite a high population burden, data on post-discharge SSIs is lacking from low-and middle-income countries (LMICs).

Difference of Neck Shortening in Femoral Neck Fracture between Femoral Neck System and Multiple Cannulated Cancellous Screws: Single Center, Prospective Randomized Controlled Trial.

Purpose: Fracture union after osteosynthesis of a fracture neck femur (FNF) occurs by compression of the fracture ends and potential neck shortening. Selection of an implant for fixation of a femoral fracture of the neck can be challenging when making management decisions. Femoral neck shortening after internal fixation of FNFs using a femoral neck system (FNS) or multiple cannulated cancellous screws (MCS) was compared.

Design and development of a mobile health intervention for rehabilitation support after knee arthroplasty: TeleRehabilitation after knee ArThroplasty (TReAT) project.

Background: The steep increase in knee arthroplasties in lower- and middle-income countries has increased demand for personalised rehabilitation care. Technology-based rehabilitation programs offer potential to replace or augment conventional face-to-face rehabilitation for providing continuum of care. We aimed to systematically develop a theory, evidence-driven, contextualised, and user-centred mobile health platform for people undergoing knee arthroplasty to facilitate monitoring progress during rehabilitation.

Microbiological Profile of Periprosthetic Joint Infections: A Retrospective Analysis from North India.

With the rise in total joint arthroplasties, prosthetic joint infections (PJIs) have become a significant complication, leading to high morbidity. The causative organisms of PJIs vary by region, and the rates of drug-resistant organisms are growing, thus complicating the initial empiric choice of antibiotics. This retrospective study analyzed records of patients with orthopedic implants and intraoperative tissue samples sent for sonication and culture at a tertiary care hospital in India.

Direct Anterior Approach in Total Hip Arthroplasty: A Single Center Experience.

Purpose: The direct anterior approach (DAA) for conducting total hip arthroplasty (THA) is gaining popularity worldwide. However, careful selection of patients and surgeon experience are important. Although promising outcomes have been reported in international studies, research on DAA in Southern and Southeast Asia has been limited.

Clo-miR-14: a medicinally valued spice-derived miRNA with therapeutic implications in rheumatoid arthritis.

Plant microRNAs (miRNA) are regularly consumed orally along with diet, gaining attention for their RNA-based drug potential because of their ability to regulate mammalian gene expression specifically at the post-transcriptional level. Medicinally valued plants are well known for their anti-inflammatory property; however, the contribution of their miRNA in managing inflammation has been less studied. We investigated miRNA from four medicinally valued regularly consumed spices, and validated one of the most potential miRNA 'Clo-miR-14' for its thermal stability, and absorption in the plasma samples of RA patient's by RT-PCR.

Transfusion Practices in Severely Injured Patients at a Level 1 Trauma Center.

Introduction: Acute trauma resuscitation is challenging and disorganized in low- and middle-income countries as there is lack of evidence-based transfusion practices with respect to ratio, volume, trigger, cutoff points for various triggers. This study aims to study the patterns of blood use in various mechanisms of injury, by interfacility transfer status and define triggers for transfusion of various blood components. Prospective observational study, emergency department of level 1 trauma center (August 2017-August 2018).

Pre-operative Anemia and Hyponatremia Increase the Risk of Mortality in Elderly Hip Fractures.

Objectives: Pre-operative assessment is routinely performed for all hip fractures, and include a thorough clinical examination and multiple pre-operative tests. While abnormalities are often detected in many tests, they have varied effect on mortality. The purpose of the study was to assess the prevalence and impact of these abnormal tests and comorbidities.

Kodamaea ohmeri: A rare yeast causing invasive infections in immunocompromised patients.

Introduction: Kodamaea ohmeri is a rare, recognized pathogen that has previously been isolated from environmental sources. The patients commonly affected by this yeast include immunocompromised as well as immunocompetent patients having several associated risk factors.

Methodology: We report three cases in which K.

Functional Significance of miR-4693-5p in Targeting HIF1α and Its Link to Rheumatoid Arthritis Pathogenesis.

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that causes joint inflammation and destruction with an unknown origin. Our study aims to elucidate the molecular mechanism behind HIF1α overexpression in RA. Dysregulated miRNA expressions are known to influence gene behavior, thereby enhancing cell proliferation, inflammation, and resistance to apoptosis, contributing to RA development.

Survey of awareness and attitudes to the management of fragility fractures among the membership of the Asia Pacific Orthopaedic Association.

Unlabelled: A survey of awareness and attitudes to the management of fragility fractures among the membership of the Asia Pacific Orthopaedic Association conducted in 2022 found considerable variation in care across the region. A Call to Action is proposed to improve acute care, rehabilitation and secondary fracture prevention across Asia Pacific.

Purpose: Fragility fractures impose a substantial burden on older people and their families, healthcare systems and national economies.