Background: Osteoarthritis of the knee is a common clinical problem that affects elderly and few young individuals. It is associated with symptoms like pain, stiffness and limitation of activity. Total Knee Arthroplasty is an effective surgical modality that reduces pain, improves patients' quality of life, and increases functional capability in patients with severe osteoarthritis of knee. Role of Posterior Condylar Offset on Range of movements has always been a controversial topic. The present study has been taken up by us because studies conducted by western authors reported conflicting outcomes. Materials and Methods:This was a prospective study in which Patients with diagnosis of osteoarthritis knee presenting in Department of Orthopaedics at a tertiary care hospital and willing to undergo surgery were included depending upon inclusion and exclusion criteria. Assessment of knee was done preoperatively and postoperatively to obtain functional outcome of TKA clinically by using knee society score and oxford knee score and radiologically to obtain PCO and PCOR. Results: We found no significant correlation between post-operative Posterior Condylar Offset (mean 25.94+/-1.89), Posterior Condylar Offset Ratio (mean 0.45+/-0.02) with Maximum Flexion Angle (mean115.93+/-9.59) with p value 0.136 and 0.995 respectively. Conclusion: Maximum flexion angle after Total Knee Arthroplasty is a multivariate hence Posterior Condylar Offset and Posterior Condylar Offset Ratio cannot be used as an independent variable for the quantification of functional outcome of Total Knee Arthroplasty. Moreover, accurate radiographic measurement of pre-operative Posterior Condylar Offset is not possible as the cartilage thickness remained was not accounted for and also there is an inherent error in the measurement techniques that accounts for inconsistent findings.
Background and Objectives: Ankle sprain is one of the most common injuries in general population. Lateral ankle sprain make up a majority of these injuries and literature describes a high degree of success with quick return to function. Injury to Syndesmotic ligament occurs in 10-18 percent of all ankle sprains. Its incidence is higher in individuals participating in sports activities like football, downhill skiing and hockey. These injuries are associated with high incidence of chronic pain, significant long term complication as compared to lateral ankle sprain. Recognizing these injuries and intervening at an appropriate time is crucial to prevent long-term morbidity. The workup of these patients involve complete history, weight bearing radiographs, external rotation stress testing and in some cases MRI. In stable injuries non-operative treatment and physiotherapy may work while in unstable injuries tendon repair and other operative interventions may be required. We attempted to study the incidence of Syndesmotic injury in patients of ankle sprain by combining clinical, radiographic and ultrasound examinations. Follow up of all patients was done for 6 months to evaluate their functional outcome. Materials and Methods:This was a prospective cohort study conducted in the orthopedics department of a tertiary care hospital situated in an urban area to find out the incidence of Syndesmotic injuries in patients with ankle sprain by combining clinical and radiological methods and to know the utility of ultrasound examination in these patients. 66 patients with history of ankle sprain were included in this study after taking into consideration inclusion and exclusion criteria. The patients were assessed on the basis of history, clinical examination, squeeze test, external rotation stress test, anterior drawer test and imaging (X-Ray and Musculoskeletal Ultrasound using high frequency probe). The incidence of Syndesmotic injuries, their mechanism, clinical and imaging evaluation and outcome was studied. The results were studied using various statistical methods. P <0.05 was taken as statistically significant. Data analysis was carried out SPSS 16.0 version software. Results: 66 patients, 38 male and 28 female were included in the study. Most common mechanism of injury seen in this patient was found to be inversion followed by eversion type injuries which were seen
Objectives: The objectives of this study was to test the primary hypothesis that “retrolisthesis causes supine lying low back pain (LBP).” Methods: Patients with history of chronic back pain (>12 weeks) who presented to the hospital outpatient department were evaluated. Patients with history of supine lying exaggeration of symptoms were specifically asked for duration, for which they can comfortably lie in supine position. Retrolisthesis in this study was measured on MRI mid sagittal image by measuring the slip percent. Slip percent of more than 8% was labeled as retrolisthesis. Statistical analysis was done using SPSS software. Results: Average age of the study population was 41.46 ± 10.82 years. All the study participants had the history of supine lying LBP for 50 ± 54.51 weeks. About 94.78% (n = 115) of the study subjects had retrolisthesis on MRI. About 46.08% (n = 115) were house wives. L5-S1 was the most commonly involved level, three patients had no instability, and three patients had anterolisthesis. Duration of time up to which the patients can lie down in supine position was not statistically significant when analyzed with the VAS values for supine lying LBP and the slip percent. Conclusion: The presence of supine lying LBP in an individual should be strongly considered for the underlying subtle instability at the lumbar intervertebral segments and diagnostic evaluation should be performed to rule out retrolisthesis. Keywords: Retrolisthesis, Low back pain, supine lying, Lumbar instability, Vertebral slippage, Lateral stenosis, Dynamic radiograph.
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