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Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_18 | Pages 10 - 10
1 Apr 2013
Humphry S Raghavan R Dwyer A Chambler A
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Shoulder resurfacing arthroplasty is a bone conserving option for patients with glenohumeral arthritis. We report the early results of this procedure at our unit with a minimum follow up of 2 years (mean follow up of 36 months).

A historical analysis of prospectively collected clinical data was reviewed on a consecutive series of 22 patients (mean age of 73 years) with end stage gleno-humeral arthrosis who had undergone humeral resurfacing hemiarthroplasty performed by a single surgeon. Pain and function were assessed using the Oxford shoulder score and patient satisfaction was recorded. Radiographs were evaluated for implant loosening.

82% of patients had significant improvement in their oxford shoulder score from pre-operatively to two years post-operatively. Complications included one case of intra-operative conversion to a stemmed hemiarthroplasty due to fracture of the humeral head, one case of adhesive capsulitis that required MUA and arthroscopic capsular release and two cases of revision to a total shoulder replacement for pain. Humeral resurfacing arthroplasty is a viable treatment option for glenohumeral arthritis with good short term results.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XLIV | Pages 5 - 5
1 Oct 2012
Singh V Trehan R Kamat Y Varkey R Raghavan R Adhikari A
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Total Knee Arthroplasty (TKA) in obese patients has been under rigorous scrutiny due concerns of less satisfying results and increased risk of perioperative complications. We conducted a prospective study to observe functional scores between obese and non obese patients at two years after mini-robot computer assisted TKA. Average stay, time for wound to be dry and perioperative complications were also compared.

A prospective study was conducted between February 2007 and February 2008 involving 50 patients. Two different groups of 25 each were made on the basis of body mass index (BMI). Oxford and Knee society scores were obtained at two years to observe difference in functional scores between these groups.

Rate of post operative complications or hospital stay was comparable between the two groups. Oxford and Knee society scores improved significantly in both the groups postoperatively. Obese patients had better Oxford and Knee society scores, which were not statistically significant.

There is no difference in early functional outcome and complications between obese and non obese patients after navigated TKA. Navigated TKA in obese patients help precise component placement with appropriate soft tissue balancing leading to improved results.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XLIV | Pages 4 - 4
1 Oct 2012
Singh V Trehan R Kamat Y Varkey R Raghavan R Adhikari A
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Computer navigated Total Knee Arthroplasty is routinely performed with gratifying results. New navigation software is now designed to help surgeons balance soft tissues in Total Knee Arthroplasty (TKA). The aim of our study was to compare functional scores at two years between two different techniques of knee balancing.

A prospective randomized control study was conducted between February 2007 and February 2008 involving 52 patients. Two different techniques of knee balancing were used namely, measured resection and gap balancing technique. Each group had 26 patients. Oxford and Knee society scores were done at two years to understand if one technique was better than other.

Oxford and Knee Society Scores improved significantly in both the groups but gap balancing technique achieved slightly better functional scores which were not significant on statistical analysis.

Computer assisted measured resection and gap balancing techniques in TKA reliably improves functional scores postoperatively. Either of the techniques if performed correctly with appropriate patient selection will have satisfactory outcomes.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_III | Pages 123 - 123
1 Feb 2012
Raghavan R Parker M
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1133 patients with an intracapsular fracture of femoral neck treated by internal fixation were prospectively studied. All surviving patients were followed up for a minimum of one year from injury. The overall incidence of non-union was 229 (20.2%) and the incidence of avascular necrosis was 61 (5.4%). Fracture non-union was less common for undisplaced fracture in comparison to displaced fractures (48 out of 565 (8.5%) versus 181 out of 568 (31.9%)) and in males than females (45 out of 271 (16.6%) versus 184 out of 862 (21.3%)). The incidence of non-union progressively increased with age from one out of 17 (5.9%) in those aged below 40 years to 84 out of 337 (24.9%) in those in their seventies. For those in their eighties the incidence of non-union began to fall, but if those patients who died within one year from injury were excluded, then the incidence was found to continue to increase. For avascular necrosis there was a falling incidence with age from 9 out of 68 (13.2%) in those aged less than 50 years to 10 out of 388 (2.6%) in those aged over 80 years.

The information from this large series of patients treated by contemporary methods enables the surgeon to use the three factors of age, sex and presence of fracture displacement to predict the risk of non-union or avascular necrosis occurring.


Orthopaedic Proceedings
Vol. 91-B, Issue SUPP_I | Pages 168 - 168
1 Mar 2009
Parker M Raghavan R Gurusamy K
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1133 patients with an intracapsular fractures of femoral neck treated by internal fixation were prospectively studied. All surviving patients were followed up for a minimum of one year from injury. The overall incidence of non-union was 229(20.2%) and the incidence of avascular necrosis was 61(5.4%). Fracture non-union was less common for undisplaced fracture in comparison to displaced fractures [48 out of 565(8.5%) versus 181 out of 568(31.9%)] and in males than females [45 out of 271(16.6%) versus 184 out of 862(21.3%)]. The incidence of non-union progressively increased with age from one out of 17(5.9%) in those aged below 40 years to 84 out of 337(24.9%) in those in their seventies. For those in their eighties the incidence of non-union began to fall, but if those patients who died within one year from injury were excluded, then the incidence was found to continue to increase. For avascular necrosis there was a falling incidence with age from 9 out of 68(13.2%) in those aged less than 50 years to 10 out of 388(2.6%) in those aged over 80 years.

The information from this large series of patients treated by contemporary methods enables to surgeon to use the three factors of age, sex and present of fracture displacement to predict the risk of non-union or avascular necrosis occurring.