IntroductionOsteoarthritis (OA) of the knee is a common degenerative disease, relatively more prevalent among middleaged people. It is one of the major reasons for walking-related disability. Recently, early knee OA has been seen as an imperative concern in many younger patients who struggle with the disabling effect of pain and management is extremely speckled. Degenerative changes such as loss of cartilage, subchondral bone changes, synovial inflammation, and meniscal degeneration are seen in OA. Symptoms are relieved by therapeutic strategies such as lifestyle behaviour changes, exercise, and oral and injectable medications. Intra-articular delivery of drugs acts as a direct effect on the target tissue, which grossly reduces side effects and is commonly preferred nowadays. The current study is a comparative assessment of the functional outcomes associated with various treatment modalities in osteoarthritis of the knee, i.e., arthroscopic debridement, arthroscopic debridement with microfracture, platelet-rich plasma (PRP) injection, and hyaluronic acid. MethodsA retrospective observational hospital-based study was conducted among 139 cases of osteoarthritis. Patients aged between 40-60 years with diagnosed Kellgren-Lawrence grade 1 and 2 OA knee, who underwent arthroscopic debridement, arthroscopic debridement with microfracture, PRP injection, or hyaluronic acid in our institute were included. ResultsThe mean age was 52.83 + 6.8 years. The mean BMI was 27.45 + 1.6 kg/m 2 . At the time of diagnosis of OA, the mean visual analogue scale for pain (VAS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores were 7.26 +0.7 and 55.30 + 2.21 respectively. Out of the total, 88 (63.3%) were females and 51 (36.7%) were males. Right-sided OA knee was seen in the majority of study participants. Of the total, 93 (66.9%) patients had grade 2 and only 46 (33.1%) had grade 1 OA. A statistically significant difference was found between the mean VAS and WOMAC score at the time of diagnosis, three weeks, three months, as well as at six months of therapy. In the hyaluronic acid treatment, no significant difference was found in mean VAS and WOMAC scores. ConclusionVarious treatments are available for early-diagnosed OA. According to the findings of this study, overall improvement was seen in VAS and WOMAC scores at the follow-up after six months of specific treatment. In a period over six months, arthroscopic debridement with micro-fracture was more effective and safe when compared with other modalities of treatment for early OA knee. Also, injection of PRP was superior to other methods for VAS pain reduction, and WOMAC-pain and WOMAC-stiffness scores improved at one month.
IntroductionThere is still a lot of controversy and ambiguity, and no single therapy regimen or strategy for proximal humerus fractures has been proved to be uniformly helpful. According to estimates, only about 20% of proximal humeral fractures require surgery. This study aims at evaluating the functional outcome of treatment of Proximal humerus fractures with PHILOS (Proximal Humerus Inter Locking System) plating using Constant score and assessing the duration for fracture union by follow-up x-rays. MethodologyThis is a retrospective study on patients admitted to the Department of Orthopaedics attached to a tertiary hospital in Kolar from January 2017 to January 2020. After meeting inclusion and exclusion criteria, 40 patients were included in this study. All the patients underwent PHILOS plating after the pre-anesthetic check-up. The patients were regularly followed up, the functional outcome was assessed using the Constant Murley score, and the fracture union was assessed radiologically by follow-up x-rays. ResultsThe mean age of our forty patients was 46.8 (20-70), with a male: female ratio of 2.3:1. Fractures united at an average of 13.75 weeks. The functional outcome was found to be excellent in 2 patients (5%), good in 22 patients (55%), fair in 7 patients (17.5%), and poor in 9 patients (22.5%). The Constant mean score achieved was 68.75±14.03. The mean time of fracture union was 13.75 weeks. The constant score was compared between variables like age groups, sex, fracture pattern, and mode of injury, but the values were statistically insignificant. ConclusionEven in individuals with osteopenic bones, we achieved excellent to good fracture repair in most cases. The locking plate provides adequate fracture stability and facilitates early shoulder mobilization without hindering fracture union.
BackgroundOsteoporosis is a chronic, progressive, systemic condition of the skeletal tissue that is characterized by reduced bone density, microarchitecture deterioration, and fragile bones, making osteoporotic fractures or fragility fractures more likely to occur. This condition often remains asymptomatic and undiagnosed until it presents with fragility fractures. The condition is associated with a significant socioeconomic burden with disability, morbidity, and mortality. Therefore, early diagnosis, as well as treatment, is needed to prevent fractures. Intravenous zoledronic is an effective bisphosphonate with high patient compliance due to onceyearly dosing. The present study aims to determine whether zoledronic acid effectively treats chronic back pain in people with osteoporosis. Materials and methodsSeventy patients above the age of 60 years presented with complaints of chronic low back aches to the outpatient department of orthopedics, R L Jalappa Hospital & Research Centre attached to Sri Devaraj Urs Medical College. The study was conducted between November 2016 and November 2018. ResultsAll the patients found excellent clinical improvement following zoledronic acid infusion in early and longterm follow-ups. Additionally, it was found that zoledronic acid's effectiveness was excellent, with significant improvement in bone mineral density (BMD), T-score, and Z-score. ConclusionEarly diagnosis and treatment of vertebral osteoporosis is the most important factor in preventing fragility fractures. Zoledronic acid, an antiresorptive drug with better compliance, is very effective in controlling low back pain, improving bone mineral density, and preventing the occurrence of atraumatic fragility fractures. With all the above factors, zoledronic acid is a preferable bisphosphonate for the treatment and prevention of osteoporosis compared to other modalities of treatment of osteoporosis.
Background: The femur is the primary weight demeanor bone of the lower limb and fracture of the femur leads to substantial morbidity and mortality in all age groups. Femoral shaft fracture occurs due to high-energy trauma which may be related to considerable soft tissue injury. Due to osteoporosis in the Geriatrics age group, they are more prone to fractures of the shaft even with low-energy trauma. So, the present study aimed to investigate the difference between both the groups- Greater trochanter (GT) versus Piriformis fossa (PF) entry portal group with respect to the operative and uoroscopic time required for intramedullary nail xation in femoral diaphysis fractures, complications and functional outcome (BASED ON HARRIS HIP SCORE). A Retrospective Hospital based study was conduc Methodology: ted in duration from AUGUST 2020 –AUGUST 2022 among total 42 patients of femoral diaphyseal fractures admitted at OPD or emergency department of orthopedics at R.L. JALAPPA HOSPITAL, TAMAKA, KOLAR and treated with piriformis fossa entry portal and greater trochanter fossa entry portal are selected for ante grade nailing. Mean age of study participants were 44.19 + 11.15 years in Group 1 a Results: nd 46.14 + 11.24 years in Group 2. Females were more affected. No association was found between Class of fracture and Type of nailing entry portals. There was statistically signicant difference was found between Harris Hip score and Type of nail entrance in follow up visit at 3, 6 and 12 months. There was signicant Conclusion: improvement were seen at 12 month follow up visit in patients who had given greater trochanteric nail entry. As we considered outcome measures, which is better in Greater trochanteric nailing entry as compared to pisiform fossa nailing entrance.
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