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Clinical effectiveness and tolerability of UC-II, sodium hyaluronate, and curcumin in osteoarthritis of the knee – CAPE Study: A multicentre, Prospective, real-world evidence study UC-II、透明质酸钠和姜黄素在膝关节骨性关节炎中的临床疗效和耐受性——CAPE研究:一项多中心、前瞻性、真实世界证据研究
Pub Date : 2023-05-01 DOI: 10.22271/ortho.2023.v9.i2b.3358
Amitava N Mukherjee, S. Joshi, Ips Oberoi, Bhaskar Das, P. Bhushan, Sanjai Kumar Srivastava, KD Tripathi, A. Desai
Background: Osteoarthritis (OA) is a degenerative joint disease that results in the breakdown of cartilage, causing pain, stiffness, and decreased range of motion in the affected joints. It is a common form of arthritis, particularly in older adults. Undenatured type II collagen (UC-II) is a nutritional supplement which has been found to be effective in treating OA. Objective: To determine the efficacy and safety of UC-II, sodium hyaluronate, and curcumin in treating knee OA. Materials and Methods: 813 patients with knee OA were enrolled in the study. Subjects received a capsule containing 40 mg UC-II, 80 mg sodium hyaluronate and 200 mg curcumin once daily for three months. The Western Ontario and McMaster Osteoarthritis Index (WOMAC) evaluated pain, joint stiffness, and physical functions. A Visual Analog Scale (VAS) was used to assess the severity of the initial pain. Moreover, clinical symptom scores and patient and physician global assessments were evaluated. The patients were assessed before the treatment and three months after the initiation of the treatment. Results: The WOMAC scores for pain, stiffness, and function, as well as the VAS score, were significantly improved (P< 0.05) in subjects after three months compared to the baseline. There was a 73.51% improvement in the total WOMAC scores and a 69.92% improvement in the VAS scores. There was a significant reduction in clinical symptoms, and global assessments of treatment by patients and physicians based on overall efficacy were favourable after the three-month treatment. Conclusion : The study showed that UC-II, sodium hyaluronate and curcumin in combination effectively improve the symptoms of OA and should be positively considered for the symptomatic management of OA.
背景:骨关节炎(OA)是一种退行性关节疾病,导致软骨破裂,引起关节疼痛、僵硬和活动范围减小。这是一种常见的关节炎,尤其是在老年人中。未变性II型胶原蛋白(UC-II)是一种营养补充剂,已被发现对治疗OA有效。目的:探讨UC-II、透明质酸钠和姜黄素治疗膝关节炎的疗效和安全性。材料与方法:813例膝关节OA患者入组研究。受试者服用含有40毫克UC-II、80毫克透明质酸钠和200毫克姜黄素的胶囊,每天一次,持续三个月。Western Ontario and McMaster Osteoarthritis Index (WOMAC)评估疼痛、关节僵硬和身体功能。采用视觉模拟量表(VAS)评估初始疼痛的严重程度。此外,临床症状评分和患者和医生的整体评估进行了评估。在治疗前和治疗开始后三个月对患者进行评估。结果:3个月后患者疼痛、僵硬、功能的WOMAC评分及VAS评分较基线均有显著改善(P< 0.05)。WOMAC总分提高了73.51%,VAS评分提高了69.92%。临床症状显著减轻,在三个月的治疗后,患者和医生根据总体疗效对治疗进行的总体评估是有利的。结论:本研究表明UC-II、透明质酸钠、姜黄素联合应用能有效改善OA的症状,在OA的症状管理中应积极考虑。
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引用次数: 0
Tubercular dactylitis of left middle finger: A case report 左中指结核性指炎1例
Pub Date : 2023-05-01 DOI: 10.22271/ortho.2023.v9.i2b.3366
D. Ts, D. Hb, Dr. Manju Jayaram, Dr. Yatish R, Dr. BM Bharath Gowda
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引用次数: 0
Functional outcome of unstable intertrochanteric fracture treated with long PFN with or without augmentation 长PFN治疗不稳定转子间骨折的功能结局
Pub Date : 2023-05-01 DOI: 10.22271/ortho.2023.v9.i2c.3369
Dr. V Nishanthan, Dr. R Siddarth, R. Vijayaraghavan
Objective: To evaluate the functional outcomes of the patient having Unstable Inter-trochanteric fracture with or not with sub-trochanteric extension treated by long PFN with or without augmentation. Materials and Methods: In our institute, a prospective study of 24 patients who underwent surgical intervention for inter-trochanteric fractures with or without sub-trochanteric extension using long PFN alone or along with augmentation and studied their mechanism of injury, sex prevalence, classification, outcomes and complications for a period of one year from January 2021 to January 2022. Results: The patients were follow-up for duration of 9 months. At the 6th month, the mean Harris hip score was determined to be 86. Out of the total participants, 10 patients achieved an excellent score, 10 patients had a good score, 2 patients had a fair score, and 2 patients had a poor score. Conclusion: Based on this study, both Long PFN with and without augmentation yield comparable outcomes in terms of functional results, implant-related complications, and fracture healing rates for unstable inter-trochanteric fractures with or without sub-trochanteric extension. The decision to augment the fixation with wire cerclage should be made on a case-by-case basis, considering fracture characteristics, bone quality, and surgeon expertise. Prospective randomized controlled trials.
目的:评价长PFN带或不带隆突治疗不稳定转子间骨折伴或不伴转子下延伸的功能效果。材料与方法:我院前瞻性研究了自2021年1月至2022年1月为期1年的24例股骨粗隆间骨折伴或不伴股骨粗隆下延伸的患者,采用长PFN单独或联合隆胸进行手术干预,研究其损伤机制、性别患病率、分类、结局及并发症。结果:随访9个月。6个月时,Harris髋关节平均评分为86分。在所有参与者中,优10例,良10例,一般2例,差2例。结论:基于本研究,对于伴有或不伴有转子下延伸的不稳定转子间骨折,Long PFN在功能结果、植入物相关并发症和骨折愈合率方面与不伴有转子下延伸的不稳定转子间骨折具有可比性。应根据具体情况,考虑骨折特征、骨质量和外科医生的专业知识,决定是否增加钢丝环扎固定。前瞻性随机对照试验。
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引用次数: 0
Study of nonunion fracture shaft femur in cases treated by intramedullary nailing in adults 髓内钉治疗成人股骨骨干骨不连骨折的研究
Pub Date : 2023-05-01 DOI: 10.22271/ortho.2023.v9.i2c.3375
M. Afifi, M. Romeih, Muhammad Abdelmoneim Quolquela, O. Amin
Background: For many kinds of fractures of femoral shaft, interlocking intramedullary nailing (IMN) is regarded as the most effective definitive therapy. The aim of this work was to study and evaluate the factors that lead to nonunion fracture shaft femur in adults treated by IMN. Methods: The prospective and retrospective randomized study that carried out by 150 patients, with criteria of diaphyseal fractures shaft femur and closed fractures shaft femur. Antegrade nailing positioning the patient supine on a fracture table, skin traction was applied to the foot, that was put in a boot, the non-injured leg was positioned in hemi-lithotomy manner, abducted and flexed widely. Retrograde nailing: patient was put in supine position on fracture table with roll beneath the thigh to set the knee in a 30° flexed position, disinfect from above the iliac crest to the foot. Results: 11 cases had nonunion (7.33%), and 139 cases achieved successful union (92.67%). There was statistically significant relation between nonunion and BMI (P = 0.004), Diabetes Mellitus (DM) (P = 0.003), using Non-steroidal Anti-inflammatory Drugs (NSAIDs) (P = 0.008), there was statistically significant relation between nonunion type of fracture, nail size (reamed vs unreamed) and delayed weight bearing ( p <0.0001). Conclusions: Nonunion occurred in 7.33% of ILN for fracture shaft femur. Overweight, DM, NSAIDs, type of fractures, nail insertion without reaming and delayed weight bearing had a statistically significant relation with nonunion of femoral shaft fractures that were treated by IMN.
背景:对于多种类型的股骨干骨折,交锁髓内钉(IMN)被认为是最有效的治疗方法。这项工作的目的是研究和评估导致IMN治疗的成人股骨骨干骨折不愈合的因素。方法:对150例患者进行前瞻性和回顾性随机对照研究,标准为股骨骨干骨折和闭合性股骨骨干骨折。患者平卧于骨折床上顺行钉位,足部皮肤牵引,入靴,未伤腿半取石位,外展,大屈曲。逆行髓内钉:将患者置于骨折台上仰卧位,大腿下方滚动,使膝关节呈30°屈曲位,自髂骨上方至足部消毒。结果:不愈合11例(7.33%),成功愈合139例(92.67%)。骨不连与BMI (P = 0.004)、糖尿病(P = 0.003)、是否使用非甾体类抗炎药(NSAIDs) (P = 0.008)、骨折不连类型、指甲大小(扩钉vs未扩钉)与延迟负重有统计学意义(P <0.0001)。结论:7.33%的股骨骨干骨折发生骨不连。超重、糖尿病、非甾体抗炎药、骨折类型、未扩孔钉插入和延迟负重与IMN治疗股骨干骨折不愈合有统计学意义。
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引用次数: 0
Functional outcomes of fixation of radial neck fractures in children by Metaizeau technique: A case series Metaizeau技术固定儿童桡骨颈骨折的功能结果:一个病例系列
Pub Date : 2023-05-01 DOI: 10.22271/ortho.2023.v9.i2b.3364
Dr. Satish Gopaldas Kripalani, Dr. Haresh P Parmar, Dr. Maulik L Bumtaria, Dr. Suryakant Jaiswal, Dr. Achintya Desai
Radial neck fractures account for 1% of all fractures in children and 5% to 14% of traumatic elbow injuries. They are mainly caused by having fallen onto an out-stretched hand . Classification: O’Brien and Judet classification. The purpose of this study was to review the functional outcomes of the management of radial neck fractures in pediatric age group using Métaizeau technique. A prospective observational analysis was performed on 8 patients who underwent closed reduction and internal fixation with elastic intramedullary nailing using Métaizeau technique for fracture neck of the radius. Pediatric patients in the age group of 3-12 years with Judet type 3 and Judet type 4 radial neck fractures were taken for our study. The patients were followed up for a period of 3 months and thorough radiological and clinical examination was carried out with due attention to any complication. The final results were scored on the basis of Mayo Elbow Score. As per the above criteria we recorded 3 excellent, 2 fair outcomes for type 3 fractures, whereas for type 4 fractures 1 excellent, 1 fair and 1 good outcomes. Neurovascular deficit or deep infection was not reported. We did not notice any penetration of the nail into the joint. With Metaizeau technique, there were reported poor results of about 10% in literature. Our results support the Métaizeau technique and postulate that the usage of a nail with reshaped tip may help in avoiding revision surgery by minimizing the loss of reduction.
桡骨颈骨折占所有儿童骨折的1%,占外伤性肘部损伤的5%至14%。它们主要是由掉到伸出的手上造成的。分类:O 'Brien和Judet分类。本研究的目的是回顾使用m taizeau技术治疗儿童年龄组桡骨颈骨折的功能结果。本文对8例桡骨颈骨折患者应用m taizeau技术行闭合复位及弹性髓内钉内固定进行前瞻性观察分析。我们的研究对象是3-12岁的Judet 3型和Judet 4型桡骨颈骨折患儿。患者随访3个月,进行了全面的放射学和临床检查,并注意任何并发症。最终结果根据Mayo肘部评分进行评分。根据上述标准,我们记录了3型骨折的3个优秀,2个一般结果,而4型骨折的1个优秀,1个一般和1个良好结果。神经血管缺损或深部感染未见报道。我们没有注意到钉子有任何刺入关节的地方。使用Metaizeau技术,文献报道的不良结果约为10%。我们的研究结果支持m taizeau技术,并假设使用尖端重塑的指甲可以通过减少复位损失来帮助避免翻修手术。
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引用次数: 0
Assessment of disease activity score with respect to vitamin D in rheumatoid arthritis 类风湿关节炎中维生素D的疾病活动度评分评估
Pub Date : 2023-05-01 DOI: 10.22271/ortho.2023.v9.i2b.3363
D. Singh, Dr. Nikhil Digra, Dr. Ramkrishna Verma, D. Shikha, Dr. Navjot Kaur, Dr. Pawandeep Kaur Sarao
Background: Rheumatoid Arthritis (RA) is a crippling disorder with articular, extra-articular as well as systemic drawbacks. The present study was conducted to assess disease activity score with respect to vitamin D in rheumatoid arthritis.
背景:类风湿性关节炎(RA)是一种具有关节、关节外以及全身缺陷的致残性疾病。本研究旨在评估类风湿性关节炎患者的疾病活动度评分与维生素D的关系。
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引用次数: 0
“Study of outcome of proximal humerus fracture treated with proximal humerus internal locking system (Philos) plating” 肱骨近端内锁系统(Philos)钢板治疗肱骨近端骨折的疗效研究
Pub Date : 2023-05-01 DOI: 10.22271/ortho.2023.v9.i2b.3359
Dr. Yogesh C Patel, Dr. Soham Majumdar, D. S. Shah, Dr. Hardik Ramjibhai Lathiya, Dr. Akshay Bhadani
Introduction: Proximal humerus fractures are common and debilitating injuries, especially in elderly as osteoporosis and deforming forces of muscle attached. Wide range of treatment modalities ranging from conservative management to shoulder arthroplasty. In our study we have evaluated proximal humerus interlocking osteosynthesis (PHILOS) plate in internal fixation of proximal humerus fracture. Background and Objective: The objective of study 1) To evaluate and analyse the functional outcomes of PHILOS plate for displaced fractures of proximal humerus 2) To improve stability in osteoporotic humeral bone 3) To preserve the biological integrity of the humeral head and to secure an anatomical reduction with multiple locking screws with angular stability 4) To study the complication rates of PHILOS plating in proximal humerus fractures Material and Method: A prospective study of treatment of proximal humerus fractures treated with PHILOS plate was carried out at our institute, at the Department of Orthopaedics, S.S.G. Hospital Vadodara from June 2021 to august 2022, where after applying exclusion and inclusion criterion, 20 patients of proximal humerus fractures were included in our study. Fractures were classified as per AO classification. Assessment of union, movements at shoulder, constant score and complications were done during regular follow-up of 4 month. The functional outcome was measured using Constant and Murley Shoulder Scoring System. Results: We had 20% excellent, 55% good results, 15% fair & 10% poor results. Discussion and Conclusion: The divergent and convergent orientation of the locking screws of PHILOS plate provides stable biological fixation with high union rate to use for treatment of fractures of the proximal humerus in Neer’s 2-part, 3-part, and 4-part with better functional and radiological outcome especially in osteoporotic bone due to low complication and early postoperative mobilization. Potential minimal complication can be prevented by advanced surgical skill and expertise and rotator cuff tying.
简介:肱骨近端骨折是一种常见的使人衰弱的损伤,特别是在老年人骨质疏松症和肌肉变形力附着。广泛的治疗方式,从保守管理到肩关节置换术。在我们的研究中,我们评估了肱骨近端联锁接骨(PHILOS)钢板在肱骨近端骨折内固定中的应用。背景与目的:研究目的:1)评价和分析PHILOS钢板治疗肱骨近端移位性骨折的功能效果;2)提高肱骨骨质疏松的稳定性;3)保护肱骨头的生物完整性,用角度稳定的多枚锁定螺钉固定解剖复位;4)研究PHILOS钢板治疗肱骨近端骨折的并发症发生率。本研究于2021年6月至2022年8月在我所Vadodara s.s.g医院骨科进行PHILOS钢板治疗肱骨近端骨折的前瞻性研究,应用排除纳入标准,纳入20例肱骨近端骨折患者。骨折按AO分类。随访4个月,评估关节愈合、肩关节活动、固定评分及并发症。使用Constant和Murley肩部评分系统测量功能结果。结果:优秀率为20%,优秀率为55%,优秀率为15%,优秀率为10%。讨论与结论:PHILOS钢板锁定螺钉的辐辏定位提供稳定的生物固定,愈合率高,用于治疗肱骨近端Neer 2-part、3-part和4-part骨折,具有较好的功能和放射学效果,特别是对于骨质疏松性骨,由于并发症少,术后早期活动。通过先进的手术技术和专业知识以及肩袖绑扎可以预防潜在的最小并发症。
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引用次数: 0
Bilateral congenital idiopathic clubfoot treatment with the Ponseti technique in Umuahia: A comparison of individual foot characteristics Umuahia Ponseti技术治疗双侧先天性特发性内翻足:个体足特征的比较
Pub Date : 2023-05-01 DOI: 10.22271/ortho.2023.v9.i2c.3372
C. Udemezue, PI Amaraegbulam, K. Madu, Ub Aguocha
Background: Clubfoot is the commonest musculoskeletal congenital deformity affecting the foot. The idiopathic variety is the most common type and worldwide the agreed treatment method is the Ponseti method. In bilateral cases, the feet may have different anthropometric characteristics. These differences were evaluated in this study. Objective: To assess the effect of the differences in the anthropometric parameters of the legs and feet (Calf circumference, foot length, degrees of cavus, adduction and equinus and Pirani score) in a child with bilateral clubfoot on the treatment outcome and recurrence of the deformity. Method: This was a prospective study that analyzed idiopathic bilateral clubfoot patients aged 0-5 years and treated using the Ponseti Technique at Federal Medical Center, Umuahia from October 2019 to September 2020. The Pirani scores, the lengths of the feet, the calf circumferences and degrees of cavus, adduction and equinus were measured at initial presentation, commencement of bracing and 3 months after commencement of treatment. These measurements were then compared. Results: A total of 47 patients participated in the study with a male preponderance. The right calf circumference and length of the right foot were consistently bigger than the left at each measurement; and these differences were statistically significant. The degrees of cavus, adduction and equinus were significantly worse on the right foot at presentation. Thirty-six patients (76.6%) had the same Pirani score on both feet at presentation. The differences in anthropometry parameters did not predict the number of casts needed to correct the deformity, the need for tenotomy nor the recurrence of the deformity. Conclusion: Although there were differences in the lower limb anthropometry of children with bilateral clubfoot, they did not predict deformity correction nor recurrence.
背景:内翻足是影响足部最常见的先天性肌肉骨骼畸形。特发性品种是最常见的类型,世界范围内公认的治疗方法是Ponseti方法。在双侧病例中,双脚可能具有不同的人体测量特征。本研究对这些差异进行了评估。目的:探讨双侧内翻足儿童的小腿和足部人体测量参数(小腿围、足长、足弓度、内收、马蹄和皮拉尼评分)的差异对治疗效果和畸形复发的影响。方法:这是一项前瞻性研究,分析了2019年10月至2020年9月在Umuahia联邦医疗中心使用Ponseti技术治疗的0-5岁特发性双侧内翻足患者。皮拉尼评分,脚的长度,小腿的周长和腔窝的程度,内收和马蹄形是在最初的表现,开始支撑和治疗后3个月测量的。然后对这些测量结果进行比较。结果:共有47例患者参与了研究,其中男性居多。每次测量时,右小腿围和右脚长度始终大于左小腿;这些差异在统计上是显著的。在就诊时,右脚的弓足、内收和马蹄的程度明显较差。36例患者(76.6%)就诊时双脚皮拉尼评分相同。人体测量参数的差异并不能预测矫正畸形所需的石膏数量、肌腱切开术的需要以及畸形的复发。结论:虽然双侧内翻足儿童的下肢人体测量值存在差异,但它们并不能预测畸形矫正或复发。
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引用次数: 0
A comparative study to analyze the efficacy of platelet rich plasma versus corticosteroids in treatment of chronic plantar fasciitis 富血小板血浆与皮质类固醇治疗慢性足底筋膜炎的疗效对比研究
Pub Date : 2023-05-01 DOI: 10.22271/ortho.2023.v9.i2b.3365
Dr. R Siddarth, Dr. V Nishanthan, Dr. R Vijayaragavan
Plantar Fasciitis is responsible for 15% of all foot problems. Over ten percent of the population will be affected at some point in their lives. It is caused by inflammation of a broad band of tissue that links your heel bone to your toes and runs across the bottom of your foot (plantar fascia). Plantar fasciitis is a type of plantar fasciitis that causes stabbing pain when you take your first steps in the morning. The discomfort usually goes away as you get up and move around, but it may come back after long periods of standing or when you stand up after sitting. Runners are more likely to get plantar fasciitis. The plantar fascia is made up of of white-coloured fibers that run longitudinally from the calcaneum to the toes. The attachments include the following: Proximal- Affixed to the calcaneum's medial tubercle. The fascia fanning out into five slips against the metatarsophalangeal joints and attaches to the base of the appropriate toes' proximal phalanges. Chronic heel pain is a difficult condition to treat and takes a long time to resolve. This study outlines both PRP and steroid are effective and safe modalities in the treatment of plantar fasciitis. But statistical data suggest that steroid injection is effective for immediate pain relief. And PRP injection is better for long term pain relief in plantar fasciitis with no side effects.
足底筋膜炎占所有足部问题的15%。超过10%的人口将在他们生命中的某个阶段受到影响。它是由连接脚后跟骨和脚趾并贯穿脚底(足底筋膜)的一大块组织的炎症引起的。足底筋膜炎是足底筋膜炎的一种,当你早上迈出第一步时,会引起刺痛。当你站起来走动时,这种不适通常会消失,但长时间站立或坐着站起来后,这种不适可能会再次出现。跑步者更容易得足底筋膜炎。足底筋膜由白色纤维组成,从跟骨纵向延伸至足趾。附着物包括:近端-附着于跟骨内侧结节。筋膜沿跖趾趾关节呈扇形展开成5个卡卡,并附着于相应脚趾近端指骨的基部。慢性脚后跟疼痛是一种难以治疗的疾病,需要很长时间才能解决。本研究概述了PRP和类固醇是治疗足底筋膜炎的有效和安全的方式。但统计数据表明,类固醇注射对立即缓解疼痛有效。而PRP注射对足底筋膜炎的远期镇痛效果较好,且无副作用。
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引用次数: 0
Outcomes and management of acute and chronic medial meniscus injury 急性和慢性内侧半月板损伤的结局和处理
Pub Date : 2023-05-01 DOI: 10.22271/ortho.2023.v9.i2b.3362
Dr. Sharad Parmar, Dr. Sanyam Panchani, Dr. Samarth Patel, Dr. Amay Khara
This study aims to identify various criteria which can affect the Functional outcome of acute and chronic medial meniscus repair done by arthroscopic surgery and study the associated knee injuries seen with damage to the medial meniscus. This is a retrospective study done in Civil Hospital Ahmedabad for patients operated in 2016-2017 calendar year, inclusion and exclusion criteria’s have been listed. Assessment is done using the Tegner Lysholm score
本研究旨在确定各种可能影响关节镜手术急性和慢性内侧半月板修复功能结果的标准,并研究内侧半月板损伤相关的膝关节损伤。这是一项在艾哈迈达巴德民用医院对2016-2017日历年手术的患者进行的回顾性研究,列出了纳入和排除标准。评估是使用Tegner Lysholm分数完成的
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引用次数: 0
期刊
International Journal of Orthopaedics Sciences
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