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Orthopaedic Proceedings
Vol. 104-B, Issue SUPP_11 | Pages 9 - 9
1 Nov 2022
Dakhode S Wade R Naik K Talankar T Kokate S
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Abstract

Background

Multi-ligament knee injury is a rare but severe injury. Treatment strategies are challenging for most orthopedic surgeons & optimal treatment remains controversial. The purpose of our study was to assess clinico-radiological and functional outcomes after surgical management of multi-ligament knee injuries & to determine factors that could predict outcome of surgery.

Materials And Method

It is a prospective observational study of 30 consecutive patients of Multi-ligament knee injury conducted between 2018–2020. All patients were treated surgically with single-stage reconstruction of all injured ligaments and followed standardized postoperative rehabilitation protocol. All patients were evaluated for Clinical (VAS score, laxity stress test, muscle-strength, range of motion), Radiological (stress radiographs) & Functional (Lysholm score) outcomes three times-preoperatively, post-operative 3 & 12 months.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XII | Pages 19 - 19
1 Apr 2012
Naik K Guyver PM Wakeling C Norton M
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The treatment of nonunion is challenging providing the surgeon with a variety of different surgical options in order to encourage and achieve bone consolidation. Despite excellent results presented in 2008 of 99% union rates, Judet Osteo-Periosteal Decortication does not seem to be popular at present with bone grafting and distraction osteo-modelling being the favoured option.

Retrospective analysis was performed from December 2002 to December 2008 of 46 cases of osteoperiosteal decortication(Judet technique) for failure of fracture union.

Union was successfully achieved in 39 of the 45 patients(85%) after a mean delay of 10.7 months(range 3-39 months). Thirty patients(65%) achieved union following the decortication procedure without subsequent operations. The mean number of procedures following decortication was 0.6(range 0-4) mostly being performed for metalwork failure. Metal work failure occurred in 13 cases(28%) with the majority occurring in decortications of the femur(n=11,85%). The femur was the location of all persistent non unions in the series. The nonunion scoring system(0-100,Calori et al 2008) means were noticeably worse for the persistent nonunion group(41.67, range 34-46) compared to the union group(29, range 4-52).

Osteoperiosteal decortication remains a highly effective surgical technique in the management of failed fracture union.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XII | Pages 8 - 8
1 Apr 2012
Naik K Guhan B Rangaswamy G Lee A Farmer K
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Aim

To correlate the surgical and MRI findings in acute lateral patellar dislocation and to determine the accuracy of MRI in identifying location of MFPL injury.

Methods

it's a retrospective study. Patients with first time dislocation of patella were admitted after reviewing in fracture clinic and MRI was arranged. Surgical repair of MFPL was performed within 2 weeks of injury. Arthroscopy was performed at the same time to remove osteochondral fragments and to confirm the diagnosis by viewing the area of haemorrhage deep to medial retinaculum. MRI was reported by consultant radiologist with a special interest in musculoskeletal system. MRI and surgical finding were compared.


Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_I | Pages 50 - 50
1 Jan 2011
Naik K Smith S
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Aim: According to NICE guidelines, only indication for arthroscopy of the knee, in patients with OA is clear history of ‘mechanical locking’. Are we meeting NICE guidelines?

Method: This was a retrospective study. Data was collected from the patient’s notes and WebPacs. All the patients aged more than 70 years who had knee arthroscopy in a year were included. Indications for arthroscopy, preservation of knee joint space at the time of procedure, complications and further follow up, were recorded.

Results: There were 77 patients with 79 arthroscopic procedures. Indications noted were true locking, mechanical symptoms, loose bodies, degenerative meniscus, OA, knee pain, and diagnostic procedure. Only 6 patients had mechanical locking. 30 patients had joint space less than 2 mm, 33 had between 2 to 4 mm. There were 3 complications including DVT (2) and recurrent knee swelling (1). Many patients were symptomatic. Out of 77 patients, 31 were already waiting to have, or had, arthroplasty at the time of study.

Conclusion: For patients aged more than 70 years with less than 2 mm joint space, arthroscopy of the knee is rarely indicated.