Search JRPMS

Volume 5, Issue 3, September 2021

Original Article JRPMS, Vol 5, No 3, September 2021, p.88-92
Incidence of surgical site infections and associated risk factors in clean orthopaedic surgeries
Rohit M. Sane, Prakash D. Samant
Keywords: Clean wound, micro-organisms, Orthopaedic, Risk factors, Surgical site infection
Objectives: The study aimed to estimate the incidence of SSI in clean orthopaedic surgeries, while identifies the associated risk factors and prevalent infective microorganisms. Methods: This was a prospective, observational study conducted in patients who underwent orthopaedic surgeries during the period between October-2019 to March-2020. Adult patients admitted in the in-patient wards of Orthopedics and underwent (category 1) clean wound type of orthopaedic surgeries (elective or emergency) were included in the study. Patients’ demographics details, clinical history, characteristics of disease, surgery-related variables, pre/ post management, hospital stay details and laboratory indexes were inquired and documented. We excluded other categories of surgical wounds (category 2, 3 and 4). Results: In this study, incidence of SSI in clean wound orthopaedic surgeries was 6.84 %. The male to female ratio was 1.8. In this study, SSI was associated significantly with age, comorbid condition, and pre-op hair removal technique. The most common infective organisms identified on culture were Klebsiella pneumonia and Methicillin-resistant Staphylococcus aureus. Conclusion: Incidence of SSI in clean orthopaedic surgeries was high. Proper identification and optimization of modifiable risk factors needs to be done prior to orthopaedic surgeries to reduce the risk of SSI.
Original Article JRPMS, Vol 5, No 3, September 2021, p.93-100
Patient-reported outcome measures after total knee arthroplasty using knee injury and osteoarthritis outcome score
Shota Higashihira, Riki Inasaka, Yuichi Iwamura, Motonori Kohno, Gosuke Akiyama, Yutaka Inaba
Keywords: Knee injury and Osteoarthritis Outcome Score, Knee osteoarthritis, Patient reported outcome, Total joint replacement, Total knee arthroplasty
Objectives: The purpose of this study was to evaluate outcomes after TKA using Knee injury and Osteoarthritis Outcome Score (KOOS). Methods: We retrospectively reviewed 60 knees. KOOS was conducted before surgery, 3 weeks, 3 months, 6 months, and 1 year after surgery. Each score was evaluated and compared using a multiple comparison test. Besides, we evaluated the correlation between KOOS and the patient’s objective factors. Results: Regarding the total score, the value was improved at any point of post-operation (p<0.001). Especially, pain score and quality of life score were improved between 6 months and 1 year after surgery (pain score: p=0.04, quality of life score: p=0.007). The correlation between patient’s factors and KOOS, concerning age, showed that there was a positive correlation with preoperative symptom/stiffness score (p=0.004) and the pain score (p=0.04). Also, the preoperative knee extension range was correlated with symptom/stiffness score and sports/recreation score at 3 weeks after surgery (p=0.03), and quality of life score at 6 months (p=0.04). The preoperative knee flexion range showed a significant correlation with the sports/recreation score at 1 year after surgery (p=0.006). Conclusions: In conclusion, it is necessary to follow the progress of 1 year or more even for cases with a seemingly poor outcome at 6 months after surgery.
Review Article JRPMS, Vol 5, No 3, September 2021, p.101-104
Low energy fractures in childhood: the association with an increased fracture risk in adulthood
Despoina Papadimitriou
Keywords: Childhood fractures, Fracture risk, Risk of osteoporosis
This study aimed to investigate whether childhood fractures are associated with future risk of osteoporosis and fracture occurrence in adult life. Bone is a dynamic organ which is modified by bone modeling and remodeling. Peak bone mass is obtained in early adulthood and it is affected by a variety of modifiable and non-modifiable factors. In the last decades, childhood fractures have been increased by 35-65% due to many variable factors. Pediatric fractures are 10-25% of all pediatric injuries, their most common site is distal forearm and they are most frequent during the prepubertal and pubertal period of life. According to some cohort studies, childhood fractures are considered a risk factor for osteoporosis and future bone fragility. Most of the available data from published studies suggest that pediatric low-energy fractures are linked to decreased bone mass. However, based on our literature search the prognostic value of positive pediatric fracture history in osteoporosis and skeletal fragility is still debated.
Review Article JRPMS, Vol 5, No 3, September 2021, p.105-109
Mesenchymal stem cells for articular cartilage repair treatment of the knee. A review of clinical studies
Christos P. Margiannis, Stylianos S. Pernientakis, Ioannis F. Mamais, Efstathios G. Ballas
Keywords: Articular cartilage, Knee, Mesenchymal stem cells
Knee cartilage lesions are a common source of pain and progressive debilitation affecting individuals in all age groups. Treatment of these lesions remains a challenge due to the poor healing capacity of the articular cartilage. Numerous techniques with various improvements in terms of pain and function have been published and only few of them have been proven to be valuable. Mesenchymal stem cells provide a new option for treatment due to their differentiation properties into several connective tissues. They can be isolated from several human tissues such as bone marrow, adipose tissue, synovial tissue, peripheral blood and periosteum. When applied in combination with proper biomaterials used as scaffolds as well as growth and other stimuli factors, they represent a promising treatment strategy. Aim of our study is to review the clinical trials which evaluate the current status of MSCs application for the management of knee cartilage lesions.
Review Article JRPMS, Vol 5, No 3, September 2021, p.110-115
The role of biophysical enhancement (LIPUS, ESWT and PEMF’s) in fracture healing
Ioannis D. Aifantis, Pantelis K. Mitsikostas
Keywords: ESWT, Fracture healing, LIPUS, Nonunion, PEMF
Fracture healing is a biological route that may not always lead to bone healing. Delayed union or even nonunion of a fracture is possible to have devastating socio-economic impact on patients and healthcare systems. Except of surgical treatment, other non-invasive methods have been proposed for the management of non-united fractures commonly known as biophysical enhancement. This includes low-intensity pulsed (LIPUS), extra-corporeal shockwave therapy (ESWT) and pulsed electromagnetic fields (PEMF) stimulation. The utility and efficacy of biophysical enhancement is a matter of question and no safe conclusion can be drawn especially because of great heterogeneity present in literature.