Abstract Context: Anterior ankle impingement (AAI) is a frequent cause of chronic distal limb pain and restricted range of motion. Aims: This study evaluated the clinical, functional, and radiological efficacy of arthroscopic debridement for AAI. Settings and Design: A quasi-experimental prospective study was conducted on 30 patients at Suez Canal University Hospitals presenting with refractory ankle pain. Materials and Methods: Assessment tools included the Visual Analog Scale, foot functional index (FFI), and Scranton and McDermott Classification. Patients were monitored at 1, 3, and 6 months postoperatively. Statistical Analysis Used: Data were analyzed using the SPSS software version 20 (IBM Corporation, Armonk, NY; USA). Paired t -tests and the Wilcoxon signed-rank test were utilized to compare the longitudinal quantitative parametric and nonparametric data, respectively, with significance set at P < 0.05. Results: Soft-tissue impingement was identified as the predominant pathological type. Following the 6-month intervention period, median FFI subscale scores demonstrated highly significant improvements ( P < 0.001): the pain subscale decreased from 6 to 3, disability from 7 to 4, and activity limitation from 6 to 2. An overall improvement in the total FFI score was observed in 93.33% of the cohort. Postoperative complications were infrequent and primarily minor, with arthrofibrosis and transient neurological symptoms each occurring in 6.67% of patients. Conclusions: Arthroscopic management of AAI, whether involving osseous or soft-tissue impingement, is a highly effective therapeutic approach. It is associated with significant improvement in analgesic and functional parameters and maintains a favorable safety profile with a low incidence of minor postoperative complications.
Abstract Background: Bipolar hemiarthroplasty (HA) is a standard treatment for displaced femoral neck fractures in the elderly, offering reliable long-term survivorship. However, mechanical fracture of the femoral component is a rare, technically demanding complication with poorly defined revision strategies. Aims and Objectives: To evaluate the clinical presentation, surgical strategies, and short-term outcomes of revision procedures in patients with fractured bipolar hip prostheses. Materials and Methods: This retrospective study reviewed six consecutive patients (five males and one female; mean age: 68 ± 11 years) who presented with fractured bipolar stems between 2022 and 2024. Failures occurred at a mean of 8.5 years postindex surgery following low-energy falls. Five cemented stems fractured at the shaft, while one uncemented stem failed at the trunnion. No clinical or laboratory evidence of infection was found. All patients except one underwent conversion to total hip arthroplasty (THA). To facilitate difficult implant extraction, an extended trochanteric osteotomy (ETO) was utilized in four cases. Femoral reconstruction was achieved using diaphyseal-engaging revision stems in five patients and a cemented polished tapered stem in one. Results: The mean operative time was 128 ± 11 min. At a 12-month mean follow-up, all osteotomies had united, and radiographs confirmed stable components without loosening. No complications, such as infection or dislocation, were observed. Functional outcomes, measured by the Harris Hip Score, were excellent in one patient, good in four, and fair in one. Conclusion: While uncommon, bipolar stem fractures necessitate complex revision. Conversion to THA or HA using appropriate strategies – including timely use of ETO and diaphyseal fixation – is a safe approach that yields favorable early functional outcomes for these challenging cases.
Abstract Joint-related conditions, like osteoarthritis, are quite prevalent in low-income communities predominantly due to restricted access to preventive healthcare services. Surgical interventions such as knee or hip replacement remain the last approach for long-term pain relief and reduction in suffering. Although these surgeries can significantly improve mobility, they are nonetheless associated with physical, financial, and social challenges. There lies the scope of extending rehabilitative services (nonsurgical intervention) to people living in such settings to arrest the progression of the underlying conditions and reduce the socioeconomic burden. In conclusion, a significant proportion of elderly people suffer from joint conditions, which need to be promptly addressed. The timely provision of rehabilitation in low-income nations can significantly reduce the prevalence of joint conditions, address the disparities in access to rehabilitative services, and strengthen healthcare delivery systems.
Abstract Objectives: The objective of this study was to determine early complications at 90 days following bilateral simultaneous total knee arthroplasty and to find out the correlation between various demographic parameters (age, sex, body mass index [BMI], and preoperative hemoglobin), Functional Comorbidity Index (FCI), and American Society of Anesthesiologists (ASA) scores with these complications. Materials and Methods: All the patients undergoing bilateral simultaneous total knee arthroplasty over a period of 5 years at a tertiary care hospital were evaluated in the present prospective interventional study. Patients were followed up 90 days postsurgery and assessed for complications, if any. All complications were divided into four broad categories – cardiorespiratory, functional, wound-related, and miscellaneous (delirium, seizures, pyrexia, gastrointestinal, dyselectrolytemia, etc.). They were also classified into major and minor complications. Data analysis was done using Python software. Pearson correlation was calculated. A t -test was run. Gradient boosting rather than logistic regression was used to calculate precision, sensitivity, and F1 score, as the data were of an unbalanced nature. Results: Out of 1121 patients, 271 (24.1%) developed complications at 90 days follow-up, out of which 34 (12.5%) were cardiorespiratory, 140 (51.6%) were functional, 49 (18.1%) were wound-related, and 48 (17.8%) were miscellaneous. There was a slight increased incidence of developing early complications with increasing age ( P = 0.047), BMI, and ASA grade. FCI showed a negative correlation (−0.0339) with early complications at 90 days. Conclusions: Incidence of developing complications within 90 days after bilateral simultaneous total knee arthroplasty is 24.1%. Age, BMI, FCI, and ASA score show weak correlation in the occurrence of complications post total knee arthroplasty; however, these parameters do not show a cause–effect relationship.
Abstract One of the most frequent knee injuries is anterior cruciate ligament (ACL) injury. ACL reconstruction (ACLR) remains the gold standard for the treatment of ACL injuries. The augmentation of ACLR with Suture tape augmentation (STA) has been shown to provide promising results. This study aimed to compare patient-reported outcomes such as International Knee Documentation Committee (IKDC) Score, Lysholm score, Tegner score, single assessment numeric evaluation (SANE), rate of graft failure, complications, and return to sport among patients who underwent ACLR with and without STA. A Literature search was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines. Databases PubMed, Google Scholar, and Cochrane Library were reviewed for randomized controlled trial and cohort studies that compared ACLR with and without STA up to August 2022. Patient-reported outcomes were meta-analyzed and summarized. To compare postoperative result between ACLR with and without STA, summary event rates for graft failure, complication, and return to sport were calculated. Four studies were included, involving 289 participants. In general, the results of this meta-analysis indicated that the STA group was better in most of the clinical outcomes. Statistically significant differences in favor of STA were observed for IKDC Score (weighted mean difference [WMD] =2.08; P = 0.04), Lysholm score (WMD = 2.63; P = 0.09), Tegner score (WMD = 0.70; P < 0.00001), and SANE (WMD = 4.24; P = 0.01). When analyzing the graft failure (odds ratio = 0.41; P = 0.09) and return to sport (WMD = −0.25; P = 0.19), the two groups showed no significant difference. This study demonstrates that ACLR with STA was associated with better clinical outcomes compared to ACLR alone. In terms of rate of graft failure and return to sport, the STA group was not superior.
