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Volume 5, Issue 2, June 2021

╬čriginal Article JRPMS, Vol 5, No 2, June 2021, p.48-58
Is subvastus approach better in bilateral TKA? Comparison of early functional outcomes of subvastus and medial para-patellar approach in Simultaneous Bilateral Total Knee Arthroplasty (SBTKA)
Chetan Sood, Thulasidharan Vengappally Panichedath, Emy Jo Titus
Keywords: KSS, Medial para-patellar, Subvastus, TKA, PROM
Objectives: Medial para-patellar is common approach for TKA; Subvastus approach is technically demanding and spares the quadriceps mechanism. Does the subvastus approach significantly improve outcomes compared to medial para-patellar approach in simultaneous bilateral total knee arthroplasty (SBTKA)? Methods: The study conducted on 100 patients between Jan 2018 to June 2019 matched in base demographics and clinical parameters divided in two equal groups; medial para-patellar approach and subvastus approach. VAS and PROM assessed in early post-operative period. Functional outcomes assessed using WOMAC scores and KSS postoperatively up to 01 year. Results: VAS at 3rd week was significantly higher in para-patellar group. At 3 weeks, 6 weeks and 3 months follow-up WOMAC score was higher and KSS was lower in para-patellar group. At 06 months and 01 year both WOMAC and KSS scores were similar. Measured functional outcomes were consistently better in subvastus group. Conclusion: Subvastus approach had less post-operative pain, faster recovery and better functional outcomes after surgery as compared to medial para-patellar approach in early post-operative period. There was no difference in outcomes at 01 year. The complication rates, transfusion rate, hospital stay, requirement of physiotherapy and rehabilitation was similar for both groups. We conclude the subvastus approach significantly improves early outcomes in SBTKA cases.
Review Article JRPMS, Vol 5, No 2, June 2021, p.59-64
Effects of aging on biomechanical gait parameters in the healthy elderly and the risk of falling
Pavlos Morfis, Maria Gkaraveli
Keywords: Falls, Gait disorders, Kinematics, Kinetics, Motion analysis
The biomechanics of walking seems to be affected in the elderly compared to young adults. These adjustments are likely to be associated with an increase in the risk of falling. This review aims to investigate the effect of age on walking ability specifically focusing on studies that have assessed spatiotemporal, kinematics and kinetics variables using three-dimensional (3D) analysis. A systematic review of the research literature was applied until January 2019 across Pubmed electronic database. A targeted search strategy traced full papers that fulfilled the inclusion and exclusion criteria. Eleven of 214 articles met the predetermined inclusion criteria and were included in the review. Differences between older and young adults were found in the most parameters which were evaluated. Changes in the lower-limb walking kinematics in elderly during walking may compromise the quality of gait. However, there is a bibliographic gap, as there are no articles that assess the risk of falling taking into account joint kinematic and kinetic parameters.
Review Article JRPMS, Vol 5, No 2, June 2021, p.65-70
Acid-base disorders and the impact on metabolic bone disease in hemodialysis patients
Eirini Evaggelou, George I. Lambrou
Keywords: Chronic Kidney Disease, Hemodialysis, Metabolic acidosis, Mineral Bone Disorder
Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) is a term that is used to describe a wider clinical syndrome that can be developed as a systemic metabolic mineral bone disturbance, due to the chronic kidney disease, and it manifests itself as metabolic mineral bone anomalies or extra-skeletal calcifications. Metabolic acidosis is considered to be the most widespread acid-base disorder that is found in the majority of CKD patients. Hemodialysis patients seem to be more prone to MBD due to acid base disorders. This article aims to review the available literature about the acid-base disorders and their impact on MBD in hemodialysis patients. We have conducted an electronic literature research, where titles and abstracts of relevant papers were validated by the authors for further inclusion in this work. Finally, full texts of the included articles were retrieved. The findings of our literature research have concluded that at the age of 55, the relative risk of hip fractures increases and in CKD patients is high; after 4 years of undergoing dialysis, the age-specific relative risk of suffering a hip fracture was 9.83 for males and 8.10 for females. The average relative risk of mortality associated with hip fracture was 1.99. Our review has highlighted that CKD and MBD are closely related and they consist of a phenomenon requiring further research.
Review Article JRPMS, Vol 5, No 2, June 2021, p.71-78
Physiotherapy management of obstetric brachial plexus palsy: A systematic review of the literature
Kyriaki Tsafa, Christos Zafeiris
Keywords: Conservative management, Obstetric brachial plexus palsy, Occupational therapy, Physiotherapy, Rehabilitation
Obstetric brachial plexus palsy (OBPP) is a pathological situation that is defined as a birth complication with the frequency of occurrence 1-3 per 1000 live births globally. The prime mechanism of injury is the complexion and/or traction of the brachial plexus and may occur in utero through the birth canal or during the process of delivery. This pathology can result in a variety of injuries with that affect the range of motion, the mobility and the use of the upper limb. Management alternatives for the treatment of OBPP consist of non-operative and operative treatment. There is a controversy regarding the selection of the appropriate rehabilitation method for the management of OBPP. The objective of the current research is the search of the literature for the current scientific evidence about the effectiveness of physiotherapy as a conservative method of treatment of infants with OBPP. According to current literature the physiotherapy methods that were used varied form passive exercise to splints and traction. There is little evidence regarding the use of physiotherapy as a primary method of conservative management of OBPP, there is need for more research to elucidate their role
Review Article JRPMS, Vol 5, No 2, June 2021, p.79-87
Choosing the site to estimate bone mineral density with DXA method
Tatiana Themeli, Ioannis K. Triantafyllopoulos
Keywords: Bone Mineral Density, Dual-Energy X-Ray Absorptiometry, Imaging, Osteoporosis
Osteoporosis is a chronic disease requiring prompt and accurate diagnosis. The most widely used quantitative bone imaging technique for estimating Bone Mineral Density (BMD) both for research purposes and in the clinical practice according to WHO, is DXA (dual-energy X-ray absorptiometry). DXA may be performed at the axial (lumbar spine, proximal femur) and appendicular skeleton (distal forearm) for the diagnosis of osteoporosis. In this review, we summarize basic considerations concerning the technique, as well as recommendations for scanning sites in different individuals.