Message for JKOA

Volume 6 | Issue 1 | Jan-April 2018 | Page 2 | Ajith Kumar Muthur


Authors: Ajith Kumar Muthur [1]

[1]Department of Orthopaedics, Tejasvini Hospital , Mangalore, India.

Address of Correspondence
Dr.M. Ajith Kumar
Senior Consultant, Department of Orthopaedics, Tejasvini Hospital , Mangalore, India
Email: ajithortho@yahoo.co.uk


Dear seniors and colleagues,
It gives me immense pleasure to bring to your attention that the KOA Journal has now become indexed.
This is entirely due to the efforts put in by the editor Dr Anil Bhat and his team and also his predecessors.
While this achievement is laudable, it brings with it greater responsibility to the editor and more so to us the members of KOA. It is now entirely up to us to constantly contribute quality scientific material so that we can enhance the standing of our journal amongst the Orthopaedic fraternity. The journal will provide an excellent platform to our young surgeons as an avenue to fulfill their academic requirements and satiate their desire for quality publication.
Along with publishing the Journal it is now also the responsibility of KOA to provide good research training and make our members aware of good publishing practices. To meet this need we have kept an hour-long research session in KOACON. The JKOA editorial team will be conducting this and KOA members can then interact with the faculty and resolve their queries. Hopefully these initiatives will improve our research and academic value as individuals and association as a whole

Congratulations once again to one and all.

Dr. M. Ajith Kumar
President, Karnataka Orthopaedic association


How to Cite this article:Muthur AK. Message for JKOA. J Kar Orth Assoc. Jan-April 2018; 6(1): 2

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Indexing of JKOA and what is means for KOA

Volume 6 | Issue 1 | Jan-April 2018 | Page 1 | Anil Bhat


Authors: Anil Bhat [1]

[1]Department of Orthopedics, Kasturba Medical College,Manipal, India.

Address of Correspondence
Dr Anil K. Bhat
Professor and Head, Department of Orthopedics, Kasturba Medical College, Manipal
Email: anilkbhat@yahoo.com


Dear Members of Karnataka Orthopaedic Association,
It is with great pleasure and pride I would like to convey to you all that our journal is now indexed in Index Copernicus for the year 2016 with an Index Copernicus value (ICV) of 63.17. The last two years of hard work has paid off finally and this is an inspiration for us to strive further in our efforts to index in agencies like Medline, PubMed Central, Science citation index, Embase / Excerpta Medica and Scopus
Publications in scientific journals from State level associations and organisations provides excellent platform to share clinical experience and opinions among peers. It also provides an opportunity for the Postgraduates to publish their dissertations and offer a primary insight into the exciting world of scientific publications.
Medical Council of India (MCI) has laid down guidelines for faculty appointments and promotions in medical colleges. One of the important parameters is publication of research in indexed journals. Accordingly, MCI recognises scientific publications included in Index Copernicus database. Thus, the Journal of Karnataka Orthopaedic Associations’ inclusion into Index Copernicus assumes paramount significance and offers new prospects for promotions to teachers in medical colleges across entire nation.
There are many ways of assessing the scientific value of a journal. One such method is indexation or inclusion is reputed databases.
Index Copernicus International is a specialized platform for promoting scientific achievements, as well as supporting national and international collaboration between scientists, publishers of scientific journals and scientific entities. The ICI Journals Master List is an international indexation database of scientific journals. To be indexed, the journal needs to successfully pass an evaluation process involving a multi-dimensional parametric evaluation based on more than 100 criteria. Successful journals are awarded the ICV (Index Copernicus Value) valid for one year only. ICV is a measure of the impact that the scientific journal has. It tells you how fast the journal will reach the goal, i.e. increase the citation rate of its scientific papers and is the sum of points awarded in the assessment of two components i.e., Quality and Impact of the scientific journal.
We have successfully gone through this rigorous evaluation process and I place my gratitude to the executive committee of Karnataka Orthopaedic association and all the association members for their support and faith. I also take this opportunity to thank the Indian Orthopaedic research group for helping us through the indexation process. We need to continue our efforts to publish at least two volumes a year and enhance the quality of research articles from now on to retain the Index Copernicus indexation as well as to apply for other indexing agencies.
Hence, I request all our members to contribute your research work which is immense in scientific content and high in ethical standards.
Wishing you all a very happy new year ahead


How to Cite this article: Bhat AK. Indexing of JKOA and what is means. J Kar Orth Assoc. Jan-April 2018; 6(1): 1

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“ Factors affecting demonstration of intra-operative Co-planar test in Total Hip Arthoplasty ”

Volume 6 | Issue 1 | Jan-April 2018 | Page 35-38 | Sharath Ramantha Kittanakere, Ramneesh Kohli, Harsha Mohan Shah, Naresh Shetty, Rahul P Bhonsle, Archadhaa Sivakanthan


Authors: Sharath Ramantha Kittanakere [1], Ramneesh Kohli [1], Harsha Mohan Shah [1], Naresh Shetty [1], Rahul P Bhonsle [1], Archadhaa Sivakanthan [1].

[1]Department Of orthopaedics, Ramaiah Medical college, Bangalore.

Address of Correspondence
Dr. Kittanakere Ramanatha Sharath
87,3A Cross , Annapurna Enclave, Katriguppe main Road , BSK 3 Stage, Bangalore -85
Email : dr.sharathkr@gmail.com


Abstract

Context: Coplanar test measures intraoperative value of combined anteversion of femoral and acetabular components .
Aim: Purpose of this study was to investigate factors affecting demonstration of Coplanar test when the combined anteversion (CA) was be kept within the safe zone in uncemented total hip arthroplasty (THA) in posterior approach .
Settings and Design: It’s a prospective study design conducted in a teritiary care health centre.
Methods and Material: We analysed 80 cases of primary uncemented THA between October 2015 to Dec 2016 . Pre-operatively, we measured height of all patients and mid –thigh circumference .Transverse acetabular ligament was used as a reference for acetabular anteversion and implantation . We were able to demonstrate the coplanar test in 58 patients . Analysis of correlation of coplanar test with thigh circumference , height of the patient , Neck shaft angle of femoral stem and abduction angle of acetabular component was done .
Statistical analysis used: Baseline Data were described in mean and Interquartile Ratio compared to non parametric test. Pearson chi square test for correlation of abduction angle and neck shaft angle with coplanar test. Levene test for correlation of thigh circumference and height of the patient. Multiple logistic regression analysis for all factors .
Results: Inclination of cup and thigh circumference were statistically significant independent factors which could affect the test demonstration .
Keywords: Co-planar test , Combined anteversion , uncemented total hip replacement , Ranawat coplanar test.


References

1. Shigeo Fukunishi , Shoji Nishio, Yuki Fujihara , Shohei Okahisa Yu Takeda Tomokazu: Accuracy of combined anteversion in image-free navigated total hip arthroplasty: stem-first or cup-first technique. Int Orthop. 2016 Jan;40(1):9-13
2. Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR. Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am. 1978 Mar;60(2):217-20 .
3. Wixson RL, MacDonald MA . Total hip arthroplasty through a minimal posterior approach using imageless computer-assisted hip navigation. J Arthroplasty. 2005 Oct;20(7 Suppl 3):51-6.
4. Biedermann R, Tonin A, Krismer M, Rachbauer F, Eibl G, Stöckl B. Reducing the risk of dislocation after total hip arthroplasty: the effect of orientation of the acetabular component. J Bone Joint Surg Br. 2005 Jun;87(6):762-9.
5. Leunig M, Beck M, Dora C, Ganz R. Femoroacetabular impingement: trigger for the development of coxarthrosis. Orthopade. 2006;35:77-84.
6. Krushell RJ, Burke DW, Harris WH. Range of motion in contemporary total hip arthroplasty. The impact of modular head-neck components. J Arthroplasty. 1991;6:97-101
7. D’Lima DD, Chen PC, Colwell CW Jr. Optimizing acetabular component position to minimize impingement and reduce contact stress. J Bone Joint Surg Am. 2001;83 Suppl 2:87-91
8. Kummer, Frederick J. et al.The effect of acetabular cup orientations on limiting hip rotation. The J of Arthroplasty. 1999 ;14(4):509 -13.
9. D’Lima DD, Urquhart AG, Buehler KO, Walker RH, Colwell CW Jr. The effect of the orientation of the acetabular and femoral components on the range of motion of the hip at different head-neck ratios. J Bone Joint Surg Am. 2000;82:315-21.
10. Ranawat CS, Maynard MJ. Modern techniques of cemented total hip arthroplasty. Tech Orthop. 1991;6:17-25.
11. Wines AP, McNicol D. Computed tomography measurement of the accuracy of component version in total hip arthroplasty. J Arthroplasty. 2006;21:696-701.
12. Pierchon F, Pasquier G, Cotten A, Fontaine C, Clarisse J, Duquennoy A. Causes of dislocation of total hip arthroplasty. CT study of component alignment. J Bone Joint Surg Br. 1994;76:45-8.
13. Murray DW The definition and measurement of acetabular orientation. J Bone Joint Surg .1993. Br 75(2):228–232
14. Dorr LD, Malik A, Dastane M, Wan Z .Combined anteversion technique for total hip arthroplasty. Clin Orthop Relat Res. 2009. 467(1):119–127.
15. Hiddema WB, van der Merwe JF, van der Merwe W. The Transverse Acetabular Ligament as an Intraoperative Guide to Cup Abduction. J Arthroplasty. 2016 Jul;31(7):1609-13.
16. Grammatopoulos G, Alvand A, Monk AP, Mellon S, Pandit H, Rees J et al . Surgeons’ Accuracy in Achieving Their Desired Acetabular Component Orientation. J Bone Joint Surg Am.2016; 7:98(17)
17. Idrissi ME, Elibrahimi A, Shimi M, Elmrini A . Acetabular component orientation in Total Hip Arthroplasty : The role of Acetabular Transverse . Acta Ortop Bras. 2016 ;24(5):267-269.
18. Imai H, Miyawaki J, Kamada T, Takeba J, Mashima, N, Miura H . Preoperative planning and postoperative evaluation of total hip arthroplasty that takes combined anteversion. European Journal of Orthopaedic Surgery & Traumatology . 2016; 26: 493–500.


How to Cite this article: Kittanakere SR, Kohli R, Shah HM, Shetty N, Bhonsle RP, Sivakanthan A. Factors affecting demonstration of intra-operative Co-planar test in Total Hip Arthoplasty. J Kar Orth Assoc. Jan-April 2018; 6(1): 35-38

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“Surgical management of spinal tuberculosis in children, our experience”

Volume 6 | Issue 1 | Jan-April 2018 | Page 28-34 | Srinivasalu S, Madan Mohan M, Anoop P, Thomas Issac, Mallikarjunaswamy B


Authors: Srinivasalu S [1], Madan Mohan M [1], Anoop P [1], Thomas Issac [1], Mallikarjunaswamy B [1].

[1]Department of Orthopaedics, St. John’s Medical College Hospital, Sarjapur Road, Bangalore 560034

Address of Correspondence
Dr. Madan Mohan M
Department of Orthopaedics, St. John’s Medical College Hospital,
Sarjapur Road, Bangalore 560 034
Email : drmadanmmohan@yahoo.co.in


Abstract

Study Design: Retrospective Descriptive study
Purpose: The goal of this study was to assess the outcome of surgical management of 10 pediatric Pott’s spine cases.
Overview of Literature: Spinal tuberculosis represents 50% of skeletal tuberculosis cases and 0.5-1% of all cases. Children are affected in 5-15% of cases. Antituberculous chemotherapy remains the mainstay of treatment of the tubercular spine with very good response in paediatric patients. However, children are more prone to kyphotic deformity of the spine.
Methods: All cases were followed-up for an average of 23.1 months (range 14–48 months). Ages ranged from 7 to 17 years. There were 8 male and 2 female children. All patients were treated with antituberculous chemotherapy which was continued after the surgical intervention also. The anatomical distribution was: Fifty per cent thoracic, 30% thoracolumbar, and 20% lumbar. Indications for surgery included: deformity (60%), neurological compromise (30%), and pain (10%). The majority of the fusions were anterior (7) the others were posterior (3).
Results: All patients were relieved of pain post operatively (evaluated by VAS, visual analog scale). Only 3 patients had neurological deficits, all of them improved post operatively (evaluated by Frankel classification grading system). The kyphotic angle improved from an average of 27.5° to 11.7° in the immediate post-operative period. Average kyphotic angle in the final follow up was 13.7° with an average 2° loss of correction.
Conclusions: Even though spinal tuberculosis is a curable medical condition, surgery in carefully selected patients by either anterior or posterior approach with instrumentation is a feasible and effective way of achieving and maintaining good correction of deformity and disease control.
Keywords : Pediatric spine; Tuberculous spondylitis; Surgical Management


References

1. Lönnroth K, Raviglione M. Global epidemiology of tuberculosis: prospects for control. Semin Respir Crit Care Med. 2008; 29:481–491.
2. Rasouli MR, Mirkoohi M, Vaccaro AR, Yarandi KK, Rahimi-Movaghar V. Spinal Tuberculosis: Diagnosis and Management. Asian Spine J.2012;6(4):294-308.
3. Huang Q-S, Zheng C, Hu Y, et al. One-stage surgical management for children with spinal tuberculosis by anterior decompression and posterior instrumentation. International Orthopaedics. 2009;33(5):1385-1390.
4. Kumar R, Srivastava AK, Tiwari RK. Surgical management of Pott’s disease of the spine in pediatric patients: A single surgeon’s experience of 8 years in a tertiary care center. J Pediatr Neurosci. 2011;6(Suppl1): S101-S108.
5. Jain AK, Sreenivasan R, Mukunth R, Dhammi IK. Tubercular spondylitis in children. Indian J Orthop. 2014;48(2):136-144.
6. Frankel HL, Hancock DO, Hyslop G, et al. The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia. Paraplegia. 1969; 7:179–192.
7. Rajasekaran S, Shanmugasundaram TK (1987) Prediction of the angle of gibbus deformity in tuberculosis of the spine, J Bone Joint Surg [Am] 69:503–508
8. Garg RK, Somvanshi DS. Spinal tuberculosis: A review. J Spinal Cord Med. 2011;34(5):440-454.
9. Jain AK. Tuberculosis of the spine. Clin Orthop Relat Res. 2007; 460:2–3.
10. Moon MS, Moon YW, Moon JL, et al. Conservative treatment of tuberculosis of the lumbar and lumbosacral spine. Clin Orthop Relat Res. 2002; 398:40–49.
11. Jutte PC, Van Loenhout-Rooyackers JH. Routine surgery in addition to chemotherapy for treating spinal tuberculosis. Cochrane Database Syst Rev 2006
12. Jain AK, Kumar J. Tuberculosis of spine: neurological deficit. Eur Spine J. 2013;22(Suppl 4):624-633.
13. Jain AK. Tuberculosis of the spine: a fresh look at an old disease. J Bone Joint Surg Br. 2010; 92:905–913.
14. Sai Kiran NA, Vaishya S, Kale SS. Surgical results in patients with tuberculosis of the spine and severe lower-extremity motor deficits: a retrospective study of 48 patients. J Neurosurg Spine 2007; 6: 320–326.
15. Dalal S, Modi J, Soman S, Patel H, Dhanani S. Results of Single-Staged Posterior Decompression and Circumferential Fusion Using a Transpedicular Approach to Correct a Kyphotic Deformity due to Thoracolumbar Spinal Tuberculosis. Asian Spine J. 2016;10(6):1106-1114.
16. Moon MS. Tuberculosis of the spine. Controversies and a new challenge. Spine. 1997; 22:1791–1797.
17. Ferrer MF, Torres LG, Ramírez OA, Zarzuelo MR, Del Prado González N. Tuberculosis of the spine. A systematic review of case series. Int Orthop. 2012 Feb;36(2):221-31.
18. Guerado E, Cer ván AM. Surgical treatment of spondylodiscitis. An update. Int Orthop. 2012;36(2):413–20.
19. Wang X, Li J, Lu G, Wang B, Lu C, Kang Y. Singlestage posterior instrumentation and anterior debridement for active tuberculosis of the thoracic and lumbar spine with kyphotic deformity. Int Orthop. 2012;36(2):373–80.
20. Ma YZ, Cui X, li HW, Chen X, Cai XJ, Bai YB. Outcomes of anterior and posterior instrumentation under different surgical procedures for treating thoracic and lumbar spinal tuberculosis in adults. Int Orthop. 2012;36(2):299–305.
21. Moon M-S, Kim S-S, Lee B-J, Moon J-L. Spinal tuberculosis in children: Retrospective analysis of 124 patients. Indian J Orthop. 2012;46(2):150-158.
22. Sun L, Song Y, Liu L, Gong Q, Zhou C. One-stage posterior surgical treatment for lumbosacral tuberculosis with major vertebral body loss and kyphosis. Orthopedics. 2013;36: e1082–90.
23. Jain AK. Treatment of tuberculosis of the spine with neurologic complications. Clin Orthop Relat Res. 2002; 398:75–84.
24. Reid C, Dunn RN. The surgical management of spinal tuberculosis in children and adolescents. SA Orthop. J. 2009; 8(4): 56-62.
25. Chen WJ, Chen CH, Shih CH. Surgical treatment of tuberculous spondylitis: 50 patients followed for 2-8 years, Acta Orthop Scand. 1995; 66:2, 137-142.
26. Mushkin AY, Kovalenko KN. Neurological complications of spinal tuberculosis in children. Int Orthop. 1999; 23:210–2.
27. Rajasekaran S. The natural history of post-tubercular kyphosis in children. J Bone Joint Surg Br. 2001; 83:954–962.
28. Rajasekaran S. The problem of deformity in spinal tuberculosis. Clin Orthop Relat Res. 2002; 398:85–92.
29. Jain AK, Aggarwal PK, Arora A, et al. Behaviour of the kyphotic angle in spinal tuberculosis. Int Orthop. 2004; 28:110–114.
30. Upadhyay SS, Saji MJ, Sell B, Hsu LC. Spinal deformity after childhood surgery for tuberculosis of the spine: A comparison of radical surgery and debridement. J Bone Joint Surg. 1994; 76:91–8.
31. Upadhyay SS, Sell P, Saji MJ, Sell B, Yau AC, Leong JCY. 17-year prospective study of surgical management of spinal tuberculosis in children.Hong Kong operation compared with debridement surgery for short-and long-term outcome of deformity. Spine (Phila Pa 1976) 1993; 18:1704–11.
32. Rajasekaran S. The natural history of post-tubercular kyphosis in children. Radiological signs which predict late increase in deformity. J Bone Joint Surg Br. 2001; 83:954–962.
33. Tuli SM (1995) Severe kyphotic deformity in tuberculosis of the spine. Int Orthop 19(5):327–331.
34. Issack PS, Boachie-Adjei O. Surgical correction of kyphotic deformity in spinal tuberculosis. Int Orthop. 2012;36(2):353-357.
35. Yau ACMC, Hsu LCS, O’Brien JP, Hodgson AR. Tuberculosis kyphosis-correction with spinal osteotomy, halo-pelvic distraction and anterior and posterior fusion. J Bone Joint Surg. 1974;56A:1419–1434.
36. Rajasekaran S, Soundarapandian S. Progression of kyphosis in tuberculosis of the spine treated by anterior arthrodesis. J Bone Joint Surg [Am] 1989;71-A:1314-23.
37. Pu X, Zhou Q, He Q, et al. A posterior versus anterior surgical approach in combination with debridement, interbody autografting and instrumentation for thoracic and lumbar tuberculosis. Int Orthop. 2012;36(2):307-313
38. Zhang HQ, Wang YX, Guo CF, et al. One-stage posterior approach and combined interbody and posterior fusion for thoracolumbar spinal tuberculosis with kyphosis in children. Orthopedics. 2010; 33:808.


How to Cite this article: Srinivasalu S, Madan M M, Anoop P, Issac T, Mallikarjunaswamy B. Surgical Management of Spinal Tuberculosis in Children, our Experience. J Kar Orth Assoc. Jan-April 2018; 6(1): 28-34

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Management of Infection Following Arthroscopic Anterior Cruciate Ligament Reconstruction

Volume 6 | Issue 1 | Jan-April 2018 | Page 23-27 |  P Anoop, Mathew David, M. Madan Mohan, Rajkumar S Amaravati


Authors: P Anoop [1], Mathew David [1], M. Madan Mohan [1], Rajkumar S Amaravati [1]

[1]Department of Orthopaedics, Division of Arthroscopy & Sports Surgery, St. John’s Medical College, Bengaluru, Karnataka, India.

Address of Correspondence
Dr. P Anoop
Department of Orthopaedics, St. John’s Medical College,
Bengaluru – 560 034, Karnataka, India.
E-mail: dranoopp07@gmail.com


Abstract

Aim: The purpose of this case series is to summarize our experience in the diagnosis and management of septic arthritis after anterior cruciate ligament (ACL) reconstruction. Infection after arthroscopic ACL reconstruction (AACLR) is a relatively rare but potentially a serious complication.
Settings and Design: Case series, prospective study.
Materials and Methods: We present a series of four cases who presented with septic arthritis following AACLR. After initial evaluation and intravenous antibiotics, the patients were subjected to early arthroscopic wash, debridement and graft retention, and antibiotics for 6 weeks. Postoperative rehabilitation protocol was followed and the patients were reviewed for a period of 2 years. Functional evaluation was done and the patients were found to have good to satisfactory results with no complaints of instability.
Statistical Analysis Used: Functional outcome measured with Tegner and Lyshlom scores, IKDC, KOOS score, and X-ray.
Results: At 2-year follow-up, patients had good functional outcome measured with Tegner and Lyshlom scores, KOOS, IKDC scores, and with no evidence of instability.
Conclusion: Infection post-arthroscopic anterior cruciate ligament reconstruction (AACLR) is a relatively rare but potentially devastating complication, early diagnosis in infection following AACLR and prompt treatment is necessary. Diagnosis relies on clinical evaluation, laboratory tests, synovial fluid analysis, and bacterial culture. Our proposed treatment protocol is arthroscopic debridement and irrigation as early as possible with retention of the graft.
Keywords: Septic Arthritis, Knee Arthroscopy, ACL, Management


References

1. Wang C, Lee YH, Siebold R. Recommendations for the management of septic arthritis after ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 2014;22(9):2136-2144.
2. Matava MJ, Evans TA, Wright RW, Shively RA. Septic arthritis of the knee following anterior cruciate ligament reconstruction: Results of a survey of sports medicine fellowship directors. Arthroscopy 1998;14(7):717-725.
3. Scully WF, Fisher SG, Parada SA, Arrington ED. Septic arthritis following anterior cruciate ligament reconstruction: A comprehensive review of the literature. J Surg Orthop Adv 2013;22(2):127-133.
4. Indelli PF, Dillingham M, Fanton G, Schurman DJ. Septic arthritis in postoperative anterior cruciate ligament reconstruction. Clin Orthop Relat Res 2002;398:182-188.
5. Schollin-Borg M, Michaëlsson K, Rahme H. Presentation, outcome, and cause of septic arthritis after anterior cruciate ligament reconstruction: A case control study. Arthroscopy 2003;19(9):941-947.
6. Demirag B, Unal OK, Ozakin C. Graft retaining debridement in patients with septic arthritis after anterior cruciate ligament reconstruction. Acta Orthop Traumatol Turc 2011;45(5):342-347.
7. Fong SY, Tan JL. Septic arthritis after arthroscopic anterior cruciate ligament reconstruction. Ann Acad Med Singapore 2004;33:228-234.
8. Judd D, Bottoni C, Kim D, Burke M, Hooker S. Infections following arthroscopic anterior cruciate ligament reconstruction. Arthroscopy 2006;22(4):375-384.
9. McAllister DR, Parker RD, Cooper AE, Recht MP, Abate J. Outcomes of postoperative septic arthritis after anterior cruciate ligament reconstruction. Am J Sports Med 1999;27(5):562-570.
10. Nag HL, Neogi DS, Nataraj AR, Kumar VA, Yadav CS, Singh U. Tubercular infection after arthroscopic anterior cruciate ligament reconstruction. Arthroscopy 2009;25(2):131-136.
11. Van Tongel A, Stuyck J, Bellemans J, Vandenneucker H. Septic arthritis after arthroscopic anterior cruciate ligament reconstruction: A retrospective analysis of incidence, management and outcome. Am J Sports Med 2007;35(7):1059-1063.
12. Wang C, Ao Y, Wang J, Hu Y, Cui G, Yu J. Septic arthritis after arthroscopic anterior cruciate ligament reconstruction: A retrospective analysis of incidence, presentation, treatment, and cause. Arthroscopy 2009;25(3):243-249.
13. Williams RJ 3rd, Laurencin CT, Warren RF, Speciale AC, Brause BD, O’Brien S. Septic arthritis after arthroscopic anterior cruciate ligament reconstruction. Diagnosis and management. Am J Sports Med 1997;25(2):261-267.
14. Zalavras CG, Patzakis MJ, Tibone J, Weisman N, Holtom P. Treatment of persistent infection after anterior cruciate ligament surgery. Clin Orthop Relat Res 2005;439:52-55.
15. Schub DL, Schmitz LM, Sakamoto FA, Winalski CS, Parker RD. Long-term outcomes of postoperative septic arthritis after anterior cruciate ligament reconstruction. Am J Sports Med 2012;40(12):2764-2770.
16. Cadet ER, Makhni EC, Mehran N, Schulz BM. Management of septic arthritis following anterior cruciate ligament reconstruction: A review of current practices and recommendations. J Am Acad Orthop Surg 2013;21(11):647-656.
17. Saper M, Shneider DA. Lateral patellofemoral ligament reconstruction using a quadriceps tendon graft. Arthroscopic Tech 2014;3(4):e445-e448.
18. Saper M, Stephenson K, Heisey M. Arthroscopic irrigation and debridement in the treatment of septic arthritis after anterior cruciate ligament reconstruction. Arthroscopy 2014;30(6):747-754.
19. Maletis GB, Inacio MC, Reynolds S, Desmond Jl, Maletis MM, Funahashi TT. Incidence of postoperative anterior Cruciate ligament reconstruction infections: graft choice makes a difference. Am J Sports Med. 2013;41:1780-1785
20. Katz LM, Battaglia TC, Patino P, Reichmann W,Hunter DJ, Richmond JC. A Retrospective comparison of the incidence of bacterial infection following anterior cruciate ligament reconstruction with autograft versus allograft. Arthroscopy. 2008:24:1330-1335.


How to Cite this article: Anoop P, Mathew D, Mohan MM, Amaravati RS. Management of Infection Following Arthroscopic Anterior Cruciate Ligament Reconstruction. J Kar Orth Assoc. Jan-April 2018; 6(1): 23-27.

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“Intra-articular Fracture of Distal End of Radius Treated by Open Reduction and Internal Fixation with Buttress Plate:” A Clinical Study

Volume 6 | Issue 1 | Jan-April 2018 | Page 18-22 | Pavankumar H Patil,Chidanand Metri, Umesha C , V V Mundevadi


Authors: Pavankumar H Patil [1],Chidanand Metri [2], Umesha C [3] , V V Mundevadi [4]

[1]Vydehi Institute of medical science & research institute, Bangalore
[2] Metri hospital, Athani, Belgaum, Karnataka
[3] Mandya Institute of Medical Sciences,Mandya, Karnataka
[4]Al ameen medical college , Bijapur, Karnataka

Address of Correspondence

Dr. Umesha C
Chowdeshwari nilaya, G madegouda layout, K M Doddi post,
Maddur Thalluk, Mandya district. PIN- 571422
Email Id : umeshmmc@gmail.com


Abstract

Background: Fracture of the distal radius is one of the most common skeletal injuries treated by orthopedic surgeons restoration of radial length, radial tilt angle and congruity of the articular surface is important for good functional result. Devices like buttress plates allow improved fracture fixation without leading to soft tissue and vascular complications. They have been shown to provide excellent stability for an unstable fracture with either dorsal or volar metaphyseal comminution. The objective of the study was to evaluate the functional outcome of intra-articular fracture of distal end of radius treated by open reduction and internal fixation by buttress plate using Criteria of Gartland and Werley Point System.
Materials and Methods: Twenty patients with intra-articular fracture of the distal end radius were treated by open reduction and internal fixation using buttress plate.
Results: The study included 20 patients, 11 male and 9 females aged from 21 to 69 years with a mean of 40.2 years. The average duration of follow-up was 7 months ranged from 6 to 10 months. Using the demerit scoring system of Gartland and Werley, we had 20% excellent results, 45% good results, 20% fair results, and 15% poor result. As per our results, excellent to good results were found in 65% of patients.
Conclusion: Open reduction and internal fixation by buttress plate provide a better functional outcome in treating the intra-articular fracture of distal end radius. Excellent to good results are produced using buttress plate for fixation of intra-articular fractures of distal end radius.
Keywords: Distal end radius, intra-articular fracture, open reduction internal fixation, buttress plate.


References

1. Cooney WP. Fractures of the distal radius. A modern treatment-based classification. Orthop Clin North Am 1993;24(2):211-216.
2. Jakim I, Pieter HS, Sweet MB. External fixation for intraarticular fractures of distal radius. J Bone Joint Surg (Br) 1991;73:302-306.
3. Jupiter JB. Current concepts review fracture of distal end of radius. J Bone Joint Surg (Am) 1991;292:48-61.
4. Richrd A, Gachferky MD, Lipson SR. Treatment of severely comminuted intraarticular fracture of distal end of radius by open reduction combined internal and external fixation. J Bone Joint Surg (Br) 2001;83:215-226.
5. Cooney WP, Linscheid RL, Dobyn JH. External pin fixation for unstable Colle’s fracture. J Bone Joint Surg (A) 1979;61:840-846.
6. Nicolaos G, Alkiviadis K, Emmanouil F, Stylianos G. Trimed fixation system for displaced fractures of the distal radius. J Trauma 2007;62(4):913-918.
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8. Gartland JJ Jr, Werley CW. Evaluation of healed Colles’ fractures. J Bone Joint Surg Am 1951;33-A(4):895-907.
9. Chen NC, Jupiter JB. Current concepts review, management of distal radial fractures. J Bone Joint Surg Am 2007;89:2051-2062.
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11. Bholer L. Treatment of Fractures. 4th ed. Baltmore: William Wood; 1929.
12. Anderson R, O’Neil G. Comminuted fractures of distal end of radius. Surg Gynecol Obstet 1944;78:434-440.
13. Ellis J. Smith’s and Barton’s: A method of treatment. J Bone Joint Surg 1965;47B:724-727.
14. Melone CP Jr. Open treatment for displaced articular fractures of the distal radius. Clin Orthop Relat Res 1986;202:103-111.
15. Bradway JK, Amadio PC, Cooney WP. Open reduction and internal fixation of displaced, comminuted intra-articular fractures of the distal end of the radius. J Bone Joint Surg Am 1989;71(6):839-847.
16. Fitoussi F, Chow SP. Treatment of displaced Intra articular fractures of the distal end of radius with plates. J Bone Joint Surg Am 1997;79-A(9):1303-1311.
17. Swan K, Capo JT, Tan V. Distal radius plating options. Curr Opin Orthop 2003;14(4):238-244.
18. Ring D, Prommersberger K, Jupiter JB. Combined dorsal and volar plate fixation of complex fractures of the distal part of the radius. J Bone Joint Surg Am 2005;87:195-212.
19. Gruber G, Bernhardt GA, Köhler G, Gruber K. Surgical treatment of distal radius fractures with an angle fixed bar palmar plating system: A single center study of 102 patients over a 2-year period. Arch Orthop Trauma Surg 2006;126(10):680-685.
20. Rozental TD, Blazar PE. Functional outcome and complications after volar plating for dorsally displaced, unstable fractures of the distal radius. J Hand Surg Am 2006;31(3):359-365.
21. Kamath AF, Zurakowski D, Day CS. Low-profile dorsal plating for dorsally angulated distal radius fractures: An outcomes study. J Hand Surg Am 2006;31(7):1061-1067.
22. Simic PM, Robison J, Gardner MJ, Gelberman RH, Weiland AJ, Boyer MI. Treatment of distal radius fractures with a low-profile dorsal plating system: An outcomes assessment. J Hand Surg Am 2006;31(3):382-386.
23. Ruch DS, Papadonikolakis A. Volar versus dorsal plating in the management of intra-articular distal radius fractures. J Hand Surg Am 2006;31(1):9-16.
24. Gruber G, Zacherl M, Giessauf C, Glehr M, Fuerst F, Liebmann W, et al. Quality of life after volar plate fixation of articular fractures of distal part of the radius. J Bone Joint Surg Am 2010;92:1170-1178.
25. Richard LD, Volg W, Adam WM. Gray’s Anatomy for Students: With Student Consult Online Access. Philadelphia, PA: Churchill Livingstone; 2014. p. 686-689.


How to Cite this article: Patil P H, Metri C, Umesha C, V V Mundevadi . Intra-articular Fracture of Distal End of Radius Treated by Open Reduction and Internal Fixation with Buttress Plate: A Clinical Study. J Kar Orth Assoc. Jan-Apr 2018; 6(1): 18-22.

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Ankle Arthroscopy the Present and the Future

Volume 6 | Issue 1 | Jan-April 2018 | Page 8-13  | Krishnaprasad P R, Acharaya K


Authors: Krishnaprasad P.R [1], Acharaya K [1].

[1] Department of Orthopaedic surgery, Kasturba Medical College, Manipal University,

Address of Correspondence

Dr.KrishnaPrasad P.R
Department of Orthopaedics Kasturba Medical College,Manipal
Email: orthokrish@gmail.com


Abstract

Ankle arthroscopy evolved from 1939 Tagaki of tokyo, but it was after 1980’s there was a surge in understanding of Ankle arthroscopy with extensions of indications commenced. Surgical instruments and techniques evolved over period and still evolving. The 2.7mm and 1.9 mm arthroscope with 30 degrees obliquity become standard. supine, lateral and prone positions are used with distraction of the joint achieved by invasive or non-invasive methods depending on the indications. Arthroscopy pumps are now mandatory in arthroscopy assisted fusions in order to maintain the hemostasis and better visualization. The general anesthesia and regional anesthesia in combination helps the patient for better post-operative pain control and early rehabilitation. Off late understanding of arthroscopy of smaller joints like subtalar joints, endoscopy of Tarsal tunnel and plantar fascia for the release respectively as well tendoscopy of tendons like Achilles, posteriortibial, flexor halluces longus and peronei are gaining popularity which are aimed at minimizing the morbidity and enhancing the rehabilitation. Steep learning curve and experience in the technique by the surgeon are challenges for wider practice of this technique.
Keywords : Ankle distractors, Ankle arthroscopic portals, subtalar arthroscopy, tendoscopy, endoscopy around Ankle


References

1. O’Connor RL. Arthroscopy. Kalamazoo: Mich, Upjohn; 1977. p. 12-6.
2. Watanabe M. Selfoc-Arthroscope, Watanabe No. 24 Arthroscope, Monograph. Tokyo: Teishin Hospital; 1972.
3. Ferkel RD. Arthroscopic Surgery: The Foot and Ankle. Philadelphia PA: Lippincott-Raven; 1996.
4. Dowdy PA, Watson BV, Amendola A, Brown JD. Non-invasive ankle distraction: Relationship between force, magnitude of distraction, and nerve conduction abnormalities. Arthroscopy 1996;12:64-69.
5. Andrews JR, Previte WJ, Carson WG. Arthroscopy of the ankle: Technique and normal anatomy. Foot Ankle 1985;6(1):29-33.
6. Gepstein R, Conforty B, Weiss RE, Hallel T. Closed percutaneous drilling for osteochondritis dissecans of the talus. A report of two cases. Clin Orthop Relat Res 1986;213:197-200.
7. Ferkel RD. Arthroscopic Surgery: The Foot and Ankle. Philadelphia PA: Lippincott-Raven; 1996.
8. Chen YC. Clinical and cadaver studies on the ankle joint arthroscopy. J JpnOrthopAssoc1976;50:631-651.
9. Parisien JS. Arthroscopy of the posterior subtalar joint: A preliminary report. Foot Ankle 1986;6(5):219-224.
10. Parisien JS. Arthroscopy of the ankle: State of the art. ContempOrthop1982;5:21-27.
11. Watanabe M. Selfoc-Arthroscope, Watanabe No. 24 Arthroscope, Monograph. Tokyo: Teishin Hospital; 1972.
12. van Dijk CN, Scholten PE, Krips R. A 2-portal endoscopic approach for diagnosis and treatment of posterior ankle pathology. Arthroscopy 2000;16(8):871-876.
13. Ferkel RD, Guhl J. Complications in 612 ankle arthroscopies. Presented at the Annual Meeting of the American Academy of Orthopaedic Surgeons. Washington, DC: WVOC; 1992.
14. Coughlin MJ, Saltzman CL, Roger A. Manns Surgery of Foot and Ankle. 9th ed., Vol. 2. Philadelphia, PA: Elsevier Saunders; 2014.


How to Cite this article: Krishna Prasad PR, Acharaya K. Ankle Arthroscopy the Present and the Future. J Kar Orth Assoc. Jan-April 2018; 6(1): 8-13.

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Radial tunnel syndrome: Diagnostic and treatment algorithm

Volume 6 | Issue 1 | Jan-April 2018 | Page 14-17 | Monish Malhotra, Anil K Bhat, Ashwath Acharya


Authors: Monish Malhotra [1], Anil K Bhat [1], Ashwath Acharya [1].

[1]Department of Orthopedics, Kasturba Medical College, Manipal, India.

Address of Correspondence

Dr. Anil K. Bhat
Professor and Head, Department of Orthopedics, Kasturba Medical College, Manipal
Email: anilkbhat@yahoo.com


Abstract

Radial tunnel syndrome is a compressive neuropathy of Posterior interossei nerve(PIN) in the radial tunnel. Radial tunnel is commonly misdiagnosed and often treated as lateral epicondylitis. The difficulty in diagnoses is due to overlapping features among both the conditions. Understanding the anatomy of radial tunnel and possible sites of compression of PIN in the tunnel guides the surgical planning and management of radial tunnel syndrome. Dynamic ultrasonography helps in early diagnosis by assessing compression of the nerve during supination and pronation. Rule of 9 test and maudsley’s test are sensitive for detection of radial tunnel syndrome. Conservative treatment is less successful and surgical decompression is the treatment of choice. Complete release of possible sites of compression prevents recurrence.
Keywords: Radial Tunnel Syndrome, Conservative management, diagnosis


References

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3. Barnum M, Mastey RD, Weiss AP, Akelman E. Radial tunnel syndrome. Hand Clin. 1996;12(4):679-89.
4. Loh YC, Lam WL, Stanley JK, Soames RW. A new clinical test for radial tunnel syndrome-the Rule of- Nine test: a cadaveric study. J Orthop Surg (Hong Kong). 2004;12(1):83-86.
5. Bolster MA, Bakker XR. Radial tunnel syndrome: emphasis on the superficial branch of the radial nerve. J Hand Surg Eur. 2009; 34(3):343-47.
6. Werner CO. Lateral elbow pain and posterior interosseous nerve entrapment. Acta Orthop Scand Suppl 1979;174:1–62.
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8. Kupfer DM, Bronson J, Lee GW, Beck J et al. Differential latency testing: a more sensitive test for radial tunnel syndrome. J Hand Surg Am. 1998;23(5):859-64.
9. Verhaar J, Spaans F. Radial tunnel syndrome. An investigation of compression neuropathy as a possible cause. J Bone Joint Surg Am. 1991;73(4):539-44.
10. Ferdinand BD, Rosenberg ZS, Schweitzer ME, Stuchin SA et al. MR Imaging Features of radial tunnel syndrome: Initial Experience. Radiology. 2006;240(1):161-8.
11. Cleary CK. Management of radial tunnel syndrome: a therapist’s clinical perspective. J Hand Ther. 2006; 19(2):186-91.
12. Moss SH, Switzer HE. Radial tunnel syndrome: A spectrum of clinical presentations. J Hand Surg Am. 1983;8(4):414-20.
13. Sarhadi NS, Korday SN, Bainbridge LC. Radial tunnel syndrome: diagnosis and management. J Hand Surg Br. 1998;23(5):617-19.
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15. Clavert P, Lutz JC, Adam P, Wolfram-Gabel R et al. Frohse’s arcade is not the exclusive compression site of the radial nerve in its tunnel. Orthop Traumatol Surg Res. 2009; 95(2):114-18.
16. Sotereanos DG, Varitimidis SE, Giannakopoulos PN, Westkaemper JG. Results of surgical treatment for radial tunnel syndrome. J Hand Surg Am. 1999; 24(3):566-70.
17. Atroshi I, Johnsson R, Ornstein E. Radial tunnel release. Unpredictable outcome in 37 consecutive cases with a 1-5 year follow-up. Acta Orthop Scand. 1995;66(3):255-7.


How to Cite this article: Malhotra M, Bhat AK, Acharya A. Radial tunnel syndrome: Diagnostic and treatment algorithm. J Kar Orth Assoc. July-Dec 2017; 5(2): 14-17

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A prospective study of surgical mamnagment of intertrochanteric fractures of femur treated with trochanteric femoral nail

Volume 6 | Issue 1 | Jan-April 2018 | Page 39-42 | Vinay Patil, Nishant Panegaon, Lalit kumar Joon


Authors: Vinay Patil [1], Nishant Panegaon [1], Lalit kumar Joon [1].

[1]Department of Orthopaedics, M R Medical college, Kalaburgi, 585105, Karnataka, India

Address of Correspondence
Dr. Lalit Kumar Joon,
Department of Orthopaedics, M R Medical college,
Kalaburgi, 585105, Karnataka, India
Email: drlalitjoon@gmail.com


Abstract

Background: Intertrochanteric fractures are the most frequent fractures of the proximal femur and occur predominantly in geriatric patients and are among the most devastating injuries in the elderly. Since the general life expectancy of the population has increased significantly during past few decades leads to increase in incidence of these fractures and subsequently development of newer designs of implants for fixation of these fractures. Trochanteric femoral nail is a newly introduced nail for internal fixation, compared to single lag screw , the TFN with two screws yielding superior life to cut out and uncontrolled collapse at fracture site. In this prospective study operative time, blood loss, functional outcome and complications are studied.
Materials and Methods: 50 patients diagnosed with Intertrochanteric femur fracture were treated in our hospital. Classification used is Boyd and griffin, Excluding type 4 .Surgery performed after getting the medical fitness. Patient on traction table in supine position through lateral approach. Clinical outcome assessed with Harris hip score at the end of 6 months .
Results: This prospective study shows that Harris Hip score at 6 months was 85% in type I, 61%in type II, and 68% in type III frac-tures.
Conclusions: TFN gave good results clinically and functionally with early return to pre fracture activities to the patients.
Keywords: TFN, Intertrochanteric fracture, Harris hip score.


References

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5. M. Saudan, A. Lubbeke, C. Sadowskil, N. Riand, R. Stern and P. Hoffmeyer, “Pertrochanteric Fractures: Is There an Advantage to an Intramedullary Nail? A Randomized Pro- spective Study of 206 Patients Comparing the Dynamic Hip Screw and Proximal Femoral Nail,” Journal of Or-thopaedic Trauma, Vol. 16, No. 6, 2002, pp. 386- 393
6. J. Pajarinen, J. Lindahl, 0. Michelsson, V. Savolainen and E. Hirvensalo, “Pertrochanteric Femoral Fractures Treated with a Dy-namic Hip Screw or a Proximal Femo-ral Nail. A Randomized Study Comparing Post-Operative Rehabilitation, Journal of Bone and Joint Surgery Vol. 87No. 1.
7. Morris AH, Zuckerman JD, American Academy of Orthopaedic Surgeons Council of Health Policy and Practice. National Con-sensus Conference on Improving the Continuum of Care for Patients with Hip Fracture. J Bone Joint Surgery Am 2002; 84: 670-4.
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12. Simmermacher RKJ, Bosch AM, Van der Werken C. The AO/ASIF — Proximal femoral nail: A new device for the treatment of unstable proximal femoral fractures. Injury 1999; 30: 327-32.
13. Schipper IB, Marti RK, van der Werken C. Unstable trochantericfemoral fractures: extramedullary or intramedullary fixation .Review of literature. injury.2004;35(2): 142-51.
14. Dr. Punit J. Tank et al Results of Proximal Eemoral Nail in lntertrochanteric Fracture of Femur; IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) Volume 15, Issue 4 Ver. X, PP 17-24.
15. Dean GL, David S-Jason HN (2004 Osteoporotic pertrochateric fractures; Management and concurrent controversies. J Bone Jt Surg (Am) 72-B:737-752.
16. Pitfalls and complications in the use of the proximal femoral nail Journal Langenbeck‟s archives of surgery Publisher Springer Berlin I Heidelberg ISSN 1435-2443 (Print) 1435- 2451 (Online) Issue Volume 390, Number 1 I February, 2005 Category Original Article‟ DOl 10.1 007/s00423–004-0466-y Pages 59-65 Subject Collection Medicine.
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19. Leung KS, Chen CM, So WS, Sato K, Lai CH, Machaisavariya B, et al. Multicenter trial of modified gamma nail in East Asia. Clin Orthop Relat Res 1996; 323:146-54.
20. Dr. Punit J. Tank et al Results of Proximal Eemoral Nail in lntertrochanteric Fracture of Femur; IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) Volume 15, Issue 4 Ver. X, PP 17-24.


How to Cite this article: Patil V, Panegaon N, Joon L K. A prospective study of surgical mamnagment of intertrochanteric fractures of femur treated with trochanteric femoral nail. J Kar Orth Assoc. Jan-Apr 2018; 6(1): 39-42

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Posterolateral Corner Injuries of the Knee – Not to be Missed!

Volume 6 | Issue 1 | Jan-April 2018 | Page 3-7 | Sandeep Vijayan, Mahesh Kulkarni, Sourab Shetty, Monappa Naik, Sharath K Rao


Authors: Sandeep Vijayan [1], Mahesh Kulkarni [1], Sourab Shetty [1], Monappa Naik [1], Sharath K Rao [1].

[1]Department of Orthopaedics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India.

Address of Correspondence
Dr. Sandeep Vijayan
Department of Orthopaedics, Kasturba Medical College,
Manipal Academy of Higher Education, Manipal 576104, Karnataka, India.
Email: sandeep_vijayan@yahoo.co.in


Abstract

Injuries of the posterolateral corner (PLC) usually occur in combination with other ligamentous injuries of the knee. Failure to recognize and address the PLC injury can lead to significant disability. Here, we give an overview about the clinical features and the principles involved in treating PLC injuries.
Keywords: Multiligament injury, posterior cruciate, dial test, posterolateral, collateral.


References

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2. Crespo B, James EW, Metsavaht L, LaPrade RF. Injuries to poster lateral corner of the knee: A comprehensive review from anatomy to surgical treatment. Rev Bras Ortop 2014;50(4):363-370.
3. Stannard JP, Brown SL, Robinson JT, McGwin G Jr, Volgas DA. Reconstruction of the poster lateral corner of the knee. Arthroscopy 2005;21(9):1051-1059.
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5. Pacheco RJ, Ayre CA, Bollen SR. Poster lateral corner injuries of the knee: A serious injury commonly missed. J Bone Joint Surg Br 2011;93(2):194-197.
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10. Geiger D, Chang E, Pathria M, Chung CB. Posterolateral and posteromedial corner injuries of the knee. Radiol Clin North Am 2013;51(13):413-432.
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12. Huang GS, Yu JS, Munshi M, Chan WP, Lee CH, Chen CY, et al. Avulsion fracture of the head of the fibula (the “arcuate” sign): MR imaging findings predictive of injuries to the poster lateral ligaments and posterior cruciate ligament. AJR Am J Roentgenol 2003;180(2):381-387.
13. Yoo JH, Lee JH, Chang CB. Pure varus injury to the knee joint. Clin Orthop Surg 2015;7(2):269-274.
14. Hughston JC, Andrews JR, Cross MJ, Moschi A. Classification of knee ligament instabilities. Part II. The lateral compartment. J Bone Joint Surg Am 1976;58(2):173-179.
15. Pacholke DA, Helms CA. MRI of the poster lateral corner injury: A concise review. J Magn Reson Imaging 2007;26(2):250-255.
16. Yoon KH, Bae DK, Ha JH, Park SW. Anatomic reconstructive surgery for poster lateral instability of the knee. Arthroscopy 2006;22(2):159-165.
17. Shelbourne KD, Haro MS, Gray T. Knee dislocation with lateral side injury: Results of an en masse surgical repair technique of the lateral side. Am J Sports Med 2007;35(7):1105-1116.
18. McCarthy M, Camarda L, Wijdicks CA, Johansen S, Engebretsen L, LaPrade RF. Anatomic posterolateral knee reconstruction requires a popliteofibular ligament reconstruction through a tibia tunnel. Am J Sports Med 2010;38:1674-1681.
19. Larson RV. Isometry of the lateral collateral and popliteofibular ligaments and techniques for reconstruction using a free semitendinosus tendon graft. Oper Tech Sports Med 2001;9(2):84-90.
20. Fanelli GC, Larson RV. Practical management of poster lateral instability of the knee. Arthroscopy 2002;18 2 Suppl 1:1-8.
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22. Oliveira MG, Severino NR, Kawano CT. Reconstruction of chronic lesions in the posterolateral corner of the knee with autologous biceps femoralis and fascia late grafts. Clinics (Sao Paulo) 2012;67(2):597-602.
23. Moatshe G, Dean CS, Chahla J, Serra Cruz R, LaPrade RF. Anatomic fibular collateral ligament reconstruction. Arthrosc Tech 2016;5:e309-e314.
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27. Bottomley N, Williams A, Birch R, Noorani A, Lewis A, Lavelle J. Displacement of the common personal nerve in poster lateral corner injuries of the knee. J Bone Joint Surg Br 2005;87(9):1225-1226.


How to Cite this article: Vijayan S, Kulkarni M, Shetty S, Naik M, Rao SK. Posterolateral Corner Injuries of the Knee – Not to be Missed! J Kar Orth Assoc. Jan-April 2018; 6(1): 3-7.

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