To compare the relative effectiveness of intralesional Steroid versus Platelet-Rich Plasma injection among 80 patients in plantar fasciitis. Methods: A total number of 80 patients with plantar fasciitis were divided into 2 groups (Group A and B). Group A with 30 patients received intralesional Platelet Rich Plasma (PRP) and Group B received intralesional methyl prednisolone acetate injection. Pre and post intervention Visual Analogue Score (VAS), Foot and Ankle Ability Measure (FAAM) score and PF (plantar fascia) thickness for assessment of pain relief in two groups were recorded at 6 months. Results: The mean VAS scores for heel pain measured after 6 months of treatment were 1.460+0.6911in PRP group and 3.024+0.9572in steroid group. The decrease in mean VAS score in both the groups was statistically significant when compared with pre-treatment values (8.38+0.6820in PRP group and 8.44+0.6021in steroid group). The mean FAAM score measured after 6 months of treatment increased in both the groups (83.43±5.661in PRP group and 69.12±5.795 in steroid group)when compared with pretreatment value (29.97±5.997in PRP group and 31.68±6.297 in steroid group)and it was statistically significant. There was 35.90% reduction in mean plantar fascia thickness in PRP group and 28.67% reduction in Steroid groupas compared to baseline values after 6 month of injection. Conclusion: Intralesional injection of both the PRP and steroid are effective and safe modalities of treatment for plantar fasciitis. Steroid is better for short term treatment of plantar fasciitis but in long term follow up platelet rich plasma therapy is better than steroid. Both the treatment methods have caused significant reduction in PF(Plantar fascia) thickness.
Objectives: There is no consensus about the optimal graft choice for anterior cruciate ligament (ACL) reconstruction. The present study was aimed to compare the clinical and functional results of reconstruction of ACL by using an autologous four strand semitendinosus tendon versus semitendinosus and gracilis graft. Design: Prospective Randomized control trial.
The aim of the study was to evaluate the functional outcome of transportal single bundle ACL reconstruction with Quadruple Hamstring Graft using suspensory femoral and hybrid tibial fixation for restoration of joint stability, patient satisfaction and for any complications. Design: Prospective Study Design. Methods: Patients admitted to the department of Orthopaedics, Bhagat Phool Singh Government medical college, Khanpur Kalan, Sonipat and fulfilling the inclusion criteria of age group 20-45 years without pre-existing arthritis and clinical and radiological evidence of anterior cruciate ligament tear were included in the study who were followed upto six months. Preoperatively Lysholm score and IKDC score was evaluated of each patient and post operatively Lysholm score and IKDC score were calculated at 2 weeks, 8 weeks, 12 weeks and 24 weeks. Results and conclusion: All patients were taken for single bundle ACL reconstruction using suspensory femoral and hybrid tibial fixation. The Lysholm and Knee Scoring Scale consists of eight parameters for evaluation. The individual parameters were allotted specific scores depending on the patient's functional ability. The maximum possible knee score was 100. Based on the outcome scores they were divided into Excellent, Good, Fair and Poor. The Subjective IKDC scale was evaluated by summing the scores for the individual items and then transforming the score to a scale that ranges from 0 to 100. The patients were followed up in OPD and their functional outcomes were measured by Lysholm scoring and IKDC scoring at 2 weeks, 8 weeks, 12 weeks, 24 weeks. There were 20 (83.3%) male patients and 4 (16.7%) female patients. The right side was more commonly injured (54.2%) than the left side (45.8%). The most common mode of injury in our study was Road Traffic Accidents (58.3%) followed by sports (20.8%). Most of the patients (41.7%) presented 4 to 6 months after injury. The most common symptom at presentation was knee pain (37.5%) followed by instability (29.2%). Both knee pain and instability were present in 16.7% of patients. There was associated meniscal injury in 75.0% of patients. The most commonly injured was medial meniscus (50%) followed by injury to both medial and lateral menisci (16.7%). Isolated ACL tear was present in 25% of the patients. In our study, 83.3% had excellent functional outcome while 16.7% patients had good outcome on the basis of Lysholm Scoring. In our study the mean pre-operative IKDC score was 55.60 whereas the post-operative score after 24 weeks was 86.13. There was significant improvement in post-operative IKDC score when compared with preoperative score. In young active adults, anatomic single bundle reconstruction with quadrupled hamstring graft gives good functional results. Endobutton on the femoral side and Bioabsorbable interference screw and suture disc on the tibial end is a good mechanical and strong suspensory type of fixation device for ACL reconstruction. This technique offers an excellent knee function, knee stability and restoration of pr...
Introduction: The present study was conducted to assess the clinical, functional and quality of life related outcome of rotator cuff repair performed using an arthroscopic assisted mini-open repair technique. Methodology: A prospective study was conducted in Department of Orthopaedics, BPS Government Medical College and Hospital, in which patients, aged 30 to 70 years, who had an isolated tear in the rotator cuff tendon diagnosed by clinical examination & confirmed by MRI and had cuff repair performed solely with the use of arthroscopic assisted mini-open technique were included. Shoulder function assessments were made with University of California at Los Angeles (UCLA) rating scale and Short Form Health Survey questionnaire (SF-36).Results: Mean age of the 26 patients included was 47.12 ± 10.72 years. Most common mode of injury in our patient population was domestic fall, reported by 84.6% of the patients. Road side accident was reported by three patients and sports injury by one. Partial thickness tear was observed in 57.7% of the patients and rest had a full thickness tear. We found the UCLA score reduced significantly from 12.42 ± 3.7 preoperatively to 29.46 ± 3.01 at the end of 6 months. There is significant improvement in range of motion at the last follow up. Forward flexion averaged 84° (SD 32°, 95% CI 73-96°) preoperatively and 120° (SD 21°, 95% CI 112-127°) at the last follow-up(P<.0.001). External rotation improved from a mean of 81°(SD 7.8°, 95% CI 79-84°) preoperatively to a mean of 99°(SD 15, 95% CI 94-105°) at the latest follow-up(P<.0.001). The mean internal rotation improved from 28° (SD 2°, 95% CI 28-29°) at baseline to 33° (SD 3, 95% CI 31-34°) at the latest follow-up (P<.0.001).SF36 scores showed a significant improvement in all the subscales as well. Conclusions: There is significant improvement in the quality of life both physically and mentally, as measured using the SF-36 self administered questionnaire and there is significant improvement in range of motion and functional status as measured by UCLA score after performing an arthroscopic assisted mini-open rotator cuff repair.
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