Gopal Shinde - Academia.edu (original) (raw)

Papers by Gopal Shinde

Research paper thumbnail of Efficacy of Platelet-Rich Plasma versus Hyaluronic Acid for treatment of Knee Osteoarthritis: A systematic review and meta-analysis

Electronic physician, 2016

Introduction: Knee osteoarthritis is a very common chronic degenerative disease that could impose... more Introduction: Knee osteoarthritis is a very common chronic degenerative disease that could impose significant costs to the health system. Although osteoarthritis can affect all joints, knee osteoarthritis is the most common type among adolescents. Non-surgical treatments include corticosteroids injection, hyaluronic acid, and plateletrich plasma. The aim of this study was to investigate the efficiency of platelet-rich plasma versus hyaluronic acid for the treatment of knee osteoarthritis. Methods: Pubmed, Cochran library, Scopus and Ovid databases were investigated to identify related studies from 2000 through August 2015. To study the efficiency, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) outcome using the Standard Mean Difference (SMD) index was calculated using a random model and a confidence interval of 95%. In addition, sensitivity and cumulative analysis were conducted. The data were analyzed using RevMan 5.3.5 and Stata 12 software. Results: Seven studies with 722 subjects (364 participants in PRP and 358 participants in the HA group) were analyzed. The WOMAC PRP compared to HA, SMD =-0.75 (95% CI:-1.33 to-0.18, I2 = 92.6%) in treatment of knee osteoarthritis was statistically significant and PRP was more effective. Conclusion: The results of this meta-analysis two years after PRP injection showed the efficacy of PRP versus HA. However, further studies are required to determine the longer-term effects.

Research paper thumbnail of Retrograde Intramedullary Interlocking Nailing in Fractures of the Distal Femur: A Review of 20 Cases with an Average Follow-Up of One Year

Journal of Medical Research and Surgery

Objectives: In patients with distal femur fractures, we studied the role of retrograde locked int... more Objectives: In patients with distal femur fractures, we studied the role of retrograde locked intramedullary nails. Methods: Retrograde locked intramedullary nailing was used to treat the distal femur fractures of 20 patients (15 males, 5 females; mean age 47 years; range 25 to 69 years). Two patients had fracture of the distal femur and shaft. The fractures were classified as A1 (n=12), A2 (n=6), A3 (n=2), by the AO classification. There were two Grade I open fractures and 18 closed fractures. Three fractures were managed with percutaneous technique. At the mean first follow-up time of 18 months (range 15-48 months and mean second follow up at 27 months (range 12 to 68 months), the concluding functional results were assessed by using the modified Hospital for Special Surgery (HSS) knee assessment scale. Results: The average time to achieve union was 24.2 weeks (range 14 to 42 weeks). One patient had a delayed union (44 weeks). Five knees (25%) had normal joint range of motion, ten ...

Research paper thumbnail of Outerbridge classification as a predictor for the need of patellar resurfacement in total knee arthroplasty: a prospective study

International Journal of Research in Orthopaedics, Feb 22, 2017

Background: Residual anterior knee pain after total knee arthroplasty is one of the common causes... more Background: Residual anterior knee pain after total knee arthroplasty is one of the common causes of early revision surgery in form of patellar resurfacing and even resurfacing the patella in these circumstances may not relieve the symptoms. So, the decision to perform patellar resurfacing during total knee arthroplasty to prevent anterior knee pain remains controversial. The purpose of this study is to determine if the outerbridge classification can predict the need for Patellar resurfacing as part of total knee arthroplasty. Methods: 100 patients with advanced osteoarthritis of knee fulfilling the inclusion and exclusion criteria were randomized into two groups of 50 patients each. In group A-patellar resurfacing done and in group B-patella was not resurfaced while carrying out TKR. Each patient was assessed intraoperatively and his/her patella classified as per Outerbridge classification. Patients were followed-up at 03, 06 and 12 months postoperatively and assessed by modified hospital for special surgery (HSS) knee scores. Results: In case of Outerbridge class III group there is a statistically significant difference (p value-0.002) in HSS score at 03 months, which becomes highly significant at 06 months (p value-0.001) and 01 year (p value <0.001). Similarly, there is statistically significant difference in HSS score (p value-0.001) in Outerbridge class IV group at 03 months, 06 months and 01 year. Conclusions: Patellar resurfacing in patients undergoing total knee arthroplasty with patella in Outerbridge class III and IV can be safely carried out to further improve the functional outcome. There is no distinct advantage of resurfacing patella in Outerbridge class I and II in terms of functional gain. Thus, Outerbridge classification for patella can effectively guide us whether to resurface patella or not in patients undergoing total knee arthroplasty.

Research paper thumbnail of Comparative study of complications and final outcome between bone patellar tendon bone and hamstring auotgraft in ACL reconstruction

International Journal of Research in Orthopaedics, 2017

Background: The most common current graft choices in ACL reconstruction are the bone-patellar ten... more Background: The most common current graft choices in ACL reconstruction are the bone-patellar tendon–bone (BPTB) graft and the quadrupled Hamstring graft. Though BPTB is considered to be the gold standard; hamstring tendon (HT) grafts have increased in popularity over last decade. Our aim in this study is to assess the complications, comorbidities, difficulties and final outcome between BPTB and Hamstring grafts in ACL reconstruction.Methods: 71 male patients with isolated tear of ACL between age group of 18-45 years were included in the study. 35 patients in group A underwent ACL reconstruction using bone patellar tendon bone autograft and 35 patients in group B were managed by reconstructing ACL using quadrupled Hamstring autograft. All the patients in both the groups were followed up at 08 weeks,06 months and 01 year post surgery and evaluated by Lysholm knee scoring system.Results: The Lysholm scoring scale scores in anterior cruciate ligament reconstruction showed that BPTB gro...

Research paper thumbnail of Tranexamic Acid as Anti-Fibrinolytic to Control Blood Loss during Pre and Post Hemiarthoplasty of Trance Cervical Fracture Neck Femur

1 Dr Kusumchandra Ambhure MS Orthopedics Associate Professor Department of Othropedics SMBT Insti... more 1 Dr Kusumchandra Ambhure MS Orthopedics Associate Professor Department of Othropedics SMBT Institute of Medical Sciences and Research Centre, Dhamangoan, Nashik, Maharashtra, India 2 MS Orthopedics AssistantProfessor Department of Othropedics SMBT Institute of Medical Sciences and Research Centre, Dhamangoan, Nashik, Maharashtra, India 3 MD Pathology Professor Department of Pathology SMBT Institute of Medical Sciences and Research Centre, Dhamangoan, Nashik, Maharashtra, India

Research paper thumbnail of Evaluation of Ponseti method in correction of congenital talipes equinovarus

International Journal of Research in Orthopaedics, 2018

Background: Congenital idiopathic clubfoot is a complex foot deformity often requires many months... more Background: Congenital idiopathic clubfoot is a complex foot deformity often requires many months of treatment and frequently resulted in incomplete or defective correction by older methods. Deformity can be corrected with serial manipulation and casting with minimal or no surgery as reported by Ponseti. This study is an attempt to evaluate the effectiveness of Ponseti technique in treatment of idiopathic congenital talipes equino varus.Methods: 30 patients between age group of 01 to 24 weeks with 48 feet having congenital idiopathic clubfoot were treated using Ponseti technique. The guidelines for treatment were followed as per the Ponseti method of serial manipulation and casting at weekly intervals.Results: 43 (89.58%) cases were treated successfully by using Ponseti technique without need of extensive surgery. 42 feet required tenotomy. 38 (79.16%) feet had an excellent outcome, 5 (10.42%) feet had a fair outcome and 05 feet (10.42%) had poor outcome as measured by the Pirani sc...

Research paper thumbnail of Comparative study between proximal femoral nailing and dynamic hip screw with proximal femoral locking compression plates in intertrochanteric fracture of femur

International Journal of Research in Orthopaedics, 2017

Trochanteric fractures are common in the elderly people. The frequency of these fractures has inc... more Trochanteric fractures are common in the elderly people. The frequency of these fractures has increased primarily due to the increasing life span and more sedentary life style brought on by urbanization. Trochanteric fractures occur in the younger population due to high velocity trauma, whereas in the elderly population it is most often due to trivial trauma. 1 Dynamic hip screws (DHS) have been considered as the standard fixation for extra-capsular femoral fracture and yielded good results in the patients with stable intertrochanteric fractures. 2,3 However, its value for ABSTRACT Background: Intertrochanteric fractures occur in people with poor bone quality, about half of the intertrochanteric fractures are comminuted and unstable. The purpose of the present study was to compare the outcome of surgical treatment of proximal femoral fracture by dynamic hip screw (DHS), proximal femoral nail (PFN) and proximal femoral locking compression plate (PFLCP). Methods: This prospective comparative observational study had included cases presented with intertrochanteric fractures of femur attended orthopedic OPD and emergency department were treated with dynamic hip screw (DHS), proximal femoral nailing (PFN) or proximal femoral locking compression plate. Post-operative x-rays were done to assess reduction and progress of union (non-union/mal-union), any post-operative complications e.g. operative wound infection, implant failure etc. Results: In our study, we found that PFNs prove to be more useful in difficult fractures with a subtrochanteric extension or reversed obliquity. The rotational stability was higher when proximal femoral nail is used in these fractures. The incidence of wound infection was found to be lower with intramedullary implants which resulted in early ambulation of the patients. Conclusions: In our study, we found that proximal femoral nails prove to be more useful in difficult fractures with a sub-trochanteric extension or reversed obliquity. The rotational stability was higher when PFN is used in these fractures. The incidence of wound infection was found to be lower with intramedullary implants which resulted in early ambulation of the patients. Non-union of trochanteric fracture although is a rare entity.

Research paper thumbnail of Efficacy of Platelet-Rich Plasma versus Hyaluronic Acid for treatment of Knee Osteoarthritis: A systematic review and meta-analysis

Electronic physician, 2016

Introduction: Knee osteoarthritis is a very common chronic degenerative disease that could impose... more Introduction: Knee osteoarthritis is a very common chronic degenerative disease that could impose significant costs to the health system. Although osteoarthritis can affect all joints, knee osteoarthritis is the most common type among adolescents. Non-surgical treatments include corticosteroids injection, hyaluronic acid, and plateletrich plasma. The aim of this study was to investigate the efficiency of platelet-rich plasma versus hyaluronic acid for the treatment of knee osteoarthritis. Methods: Pubmed, Cochran library, Scopus and Ovid databases were investigated to identify related studies from 2000 through August 2015. To study the efficiency, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) outcome using the Standard Mean Difference (SMD) index was calculated using a random model and a confidence interval of 95%. In addition, sensitivity and cumulative analysis were conducted. The data were analyzed using RevMan 5.3.5 and Stata 12 software. Results: Seven studies with 722 subjects (364 participants in PRP and 358 participants in the HA group) were analyzed. The WOMAC PRP compared to HA, SMD =-0.75 (95% CI:-1.33 to-0.18, I2 = 92.6%) in treatment of knee osteoarthritis was statistically significant and PRP was more effective. Conclusion: The results of this meta-analysis two years after PRP injection showed the efficacy of PRP versus HA. However, further studies are required to determine the longer-term effects.

Research paper thumbnail of Retrograde Intramedullary Interlocking Nailing in Fractures of the Distal Femur: A Review of 20 Cases with an Average Follow-Up of One Year

Journal of Medical Research and Surgery

Objectives: In patients with distal femur fractures, we studied the role of retrograde locked int... more Objectives: In patients with distal femur fractures, we studied the role of retrograde locked intramedullary nails. Methods: Retrograde locked intramedullary nailing was used to treat the distal femur fractures of 20 patients (15 males, 5 females; mean age 47 years; range 25 to 69 years). Two patients had fracture of the distal femur and shaft. The fractures were classified as A1 (n=12), A2 (n=6), A3 (n=2), by the AO classification. There were two Grade I open fractures and 18 closed fractures. Three fractures were managed with percutaneous technique. At the mean first follow-up time of 18 months (range 15-48 months and mean second follow up at 27 months (range 12 to 68 months), the concluding functional results were assessed by using the modified Hospital for Special Surgery (HSS) knee assessment scale. Results: The average time to achieve union was 24.2 weeks (range 14 to 42 weeks). One patient had a delayed union (44 weeks). Five knees (25%) had normal joint range of motion, ten ...

Research paper thumbnail of Outerbridge classification as a predictor for the need of patellar resurfacement in total knee arthroplasty: a prospective study

International Journal of Research in Orthopaedics, Feb 22, 2017

Background: Residual anterior knee pain after total knee arthroplasty is one of the common causes... more Background: Residual anterior knee pain after total knee arthroplasty is one of the common causes of early revision surgery in form of patellar resurfacing and even resurfacing the patella in these circumstances may not relieve the symptoms. So, the decision to perform patellar resurfacing during total knee arthroplasty to prevent anterior knee pain remains controversial. The purpose of this study is to determine if the outerbridge classification can predict the need for Patellar resurfacing as part of total knee arthroplasty. Methods: 100 patients with advanced osteoarthritis of knee fulfilling the inclusion and exclusion criteria were randomized into two groups of 50 patients each. In group A-patellar resurfacing done and in group B-patella was not resurfaced while carrying out TKR. Each patient was assessed intraoperatively and his/her patella classified as per Outerbridge classification. Patients were followed-up at 03, 06 and 12 months postoperatively and assessed by modified hospital for special surgery (HSS) knee scores. Results: In case of Outerbridge class III group there is a statistically significant difference (p value-0.002) in HSS score at 03 months, which becomes highly significant at 06 months (p value-0.001) and 01 year (p value <0.001). Similarly, there is statistically significant difference in HSS score (p value-0.001) in Outerbridge class IV group at 03 months, 06 months and 01 year. Conclusions: Patellar resurfacing in patients undergoing total knee arthroplasty with patella in Outerbridge class III and IV can be safely carried out to further improve the functional outcome. There is no distinct advantage of resurfacing patella in Outerbridge class I and II in terms of functional gain. Thus, Outerbridge classification for patella can effectively guide us whether to resurface patella or not in patients undergoing total knee arthroplasty.

Research paper thumbnail of Comparative study of complications and final outcome between bone patellar tendon bone and hamstring auotgraft in ACL reconstruction

International Journal of Research in Orthopaedics, 2017

Background: The most common current graft choices in ACL reconstruction are the bone-patellar ten... more Background: The most common current graft choices in ACL reconstruction are the bone-patellar tendon–bone (BPTB) graft and the quadrupled Hamstring graft. Though BPTB is considered to be the gold standard; hamstring tendon (HT) grafts have increased in popularity over last decade. Our aim in this study is to assess the complications, comorbidities, difficulties and final outcome between BPTB and Hamstring grafts in ACL reconstruction.Methods: 71 male patients with isolated tear of ACL between age group of 18-45 years were included in the study. 35 patients in group A underwent ACL reconstruction using bone patellar tendon bone autograft and 35 patients in group B were managed by reconstructing ACL using quadrupled Hamstring autograft. All the patients in both the groups were followed up at 08 weeks,06 months and 01 year post surgery and evaluated by Lysholm knee scoring system.Results: The Lysholm scoring scale scores in anterior cruciate ligament reconstruction showed that BPTB gro...

Research paper thumbnail of Tranexamic Acid as Anti-Fibrinolytic to Control Blood Loss during Pre and Post Hemiarthoplasty of Trance Cervical Fracture Neck Femur

1 Dr Kusumchandra Ambhure MS Orthopedics Associate Professor Department of Othropedics SMBT Insti... more 1 Dr Kusumchandra Ambhure MS Orthopedics Associate Professor Department of Othropedics SMBT Institute of Medical Sciences and Research Centre, Dhamangoan, Nashik, Maharashtra, India 2 MS Orthopedics AssistantProfessor Department of Othropedics SMBT Institute of Medical Sciences and Research Centre, Dhamangoan, Nashik, Maharashtra, India 3 MD Pathology Professor Department of Pathology SMBT Institute of Medical Sciences and Research Centre, Dhamangoan, Nashik, Maharashtra, India

Research paper thumbnail of Evaluation of Ponseti method in correction of congenital talipes equinovarus

International Journal of Research in Orthopaedics, 2018

Background: Congenital idiopathic clubfoot is a complex foot deformity often requires many months... more Background: Congenital idiopathic clubfoot is a complex foot deformity often requires many months of treatment and frequently resulted in incomplete or defective correction by older methods. Deformity can be corrected with serial manipulation and casting with minimal or no surgery as reported by Ponseti. This study is an attempt to evaluate the effectiveness of Ponseti technique in treatment of idiopathic congenital talipes equino varus.Methods: 30 patients between age group of 01 to 24 weeks with 48 feet having congenital idiopathic clubfoot were treated using Ponseti technique. The guidelines for treatment were followed as per the Ponseti method of serial manipulation and casting at weekly intervals.Results: 43 (89.58%) cases were treated successfully by using Ponseti technique without need of extensive surgery. 42 feet required tenotomy. 38 (79.16%) feet had an excellent outcome, 5 (10.42%) feet had a fair outcome and 05 feet (10.42%) had poor outcome as measured by the Pirani sc...

Research paper thumbnail of Comparative study between proximal femoral nailing and dynamic hip screw with proximal femoral locking compression plates in intertrochanteric fracture of femur

International Journal of Research in Orthopaedics, 2017

Trochanteric fractures are common in the elderly people. The frequency of these fractures has inc... more Trochanteric fractures are common in the elderly people. The frequency of these fractures has increased primarily due to the increasing life span and more sedentary life style brought on by urbanization. Trochanteric fractures occur in the younger population due to high velocity trauma, whereas in the elderly population it is most often due to trivial trauma. 1 Dynamic hip screws (DHS) have been considered as the standard fixation for extra-capsular femoral fracture and yielded good results in the patients with stable intertrochanteric fractures. 2,3 However, its value for ABSTRACT Background: Intertrochanteric fractures occur in people with poor bone quality, about half of the intertrochanteric fractures are comminuted and unstable. The purpose of the present study was to compare the outcome of surgical treatment of proximal femoral fracture by dynamic hip screw (DHS), proximal femoral nail (PFN) and proximal femoral locking compression plate (PFLCP). Methods: This prospective comparative observational study had included cases presented with intertrochanteric fractures of femur attended orthopedic OPD and emergency department were treated with dynamic hip screw (DHS), proximal femoral nailing (PFN) or proximal femoral locking compression plate. Post-operative x-rays were done to assess reduction and progress of union (non-union/mal-union), any post-operative complications e.g. operative wound infection, implant failure etc. Results: In our study, we found that PFNs prove to be more useful in difficult fractures with a subtrochanteric extension or reversed obliquity. The rotational stability was higher when proximal femoral nail is used in these fractures. The incidence of wound infection was found to be lower with intramedullary implants which resulted in early ambulation of the patients. Conclusions: In our study, we found that proximal femoral nails prove to be more useful in difficult fractures with a sub-trochanteric extension or reversed obliquity. The rotational stability was higher when PFN is used in these fractures. The incidence of wound infection was found to be lower with intramedullary implants which resulted in early ambulation of the patients. Non-union of trochanteric fracture although is a rare entity.