Jatin Prakash - Academia.edu (original) (raw)
Papers by Jatin Prakash
Clinics in Orthopedic Surgery, 2018
Recurrent patellar dislocation is a result of aberration of normal patellofemoral kinematics. 1,2... more Recurrent patellar dislocation is a result of aberration of normal patellofemoral kinematics. 1,2) The anatomical deterrent resulting in malalignment of the knee may be multifactorial. 3,4) Problems in both static and dynamic stabilizers of the knee joint may have a role, and therefore it is difficult to find a single treatment protocol that would be applicable for all patients uniformly. 5,6) The fact that over 100 procedures have been described for the management of this condition stresses the fact that no single procedure works in all cases. 1-3,5,6) Depending on the etiology, both proximal and dis-tal realignment procedures have been described for the treatment of recurrent patellar dislocation. Proximal realignment using lateral release and medial patellofemoral ligament reconstruction has demonstrated good results. 6,7) However, the indications and results of distal realignment using tuberosity transfer have been controversial. 8-11) Goutallier et al. 12) described the tibial tuberosity-trochlear groove (TT-TG) distance as a quantitative measure of lateralization of the tibial tuberosity on the proximal tibia. Dejour et al. 13) concluded 20 mm as a cutoff for tuberosity transfer. However, the literature has not always shown favorable results of tuberosity transfer, and thus we sought to investigate whether the TT-TG alone is an appropriate criterion to determine the transfer of tibial tuberosity. Since it is important to identify the root cause of malalignment and address the contributing factors, 14) tuberosity transfer would be of aid for patients who have severe tuberosity lateralization. 15) However, the TT-TG dis
Indian journal of orthopaedics
Bleeding is one of the unavoidable complications of total knee arthroplasty (TKA). Tranexamic aci... more Bleeding is one of the unavoidable complications of total knee arthroplasty (TKA). Tranexamic acid (TXA) in last decade has emerged as an effective and safe way to decrease postoperative bleeding and transfusion rates. Although there is little doubt on the efficacy of the drug, the debate on ideal mode is more recent. We undertook this study to find out the most effective and yet safest way of TXA administration. A single institution - two hospital-based, double-blinded, prospective, randomized control trial was conducted from January 2015 to December 2015. One hundred and fifty patients were randomly divided in one of the three groups using computer-generated tables - intravenous (IV), intraarticular and combined. Evident loss through drain, total loss based on gross method and hemoglobin balance method, hidden blood losses, hemoglobin, and hematocrit drop, all possible complications related to TXA were evaluated and compared among groups. The analysis of variance and Tukey'swe...
Knee surgery & related research, 2016
Total knee arthroplasty (TKA) accompanies the risk of bleeding and need for transfusion. There ar... more Total knee arthroplasty (TKA) accompanies the risk of bleeding and need for transfusion. There are several methods to reduce postoperative blood loss and blood transfusion. One such method is using tranexamic acid during TKA. The purpose of this study was to confirm whether tranexamic acid reduces postoperative blood loss and blood transfusion after TKA. A total of 100 TKA patients were included in the study. The tranexamic acid group consisted of 50 patients who received an intravenous injection of tranexamic acid. The control included 50 patients who received a placebo injection. The amounts of drainage, postoperative hemoglobin, and transfusion were compared between the groups. The mean amount of drainage was lower in the tranexamic acid group (580.6±355.0 mL) than the control group (886.0±375.5 mL). There was a reduction in the transfusion rate in the tranexamic acid group (48%) compared with the control group (64%). The hemoglobin level was higher in the tranexamic acid group t...
Knee surgery & related research, 2016
Patellofemoral instability is a common cause of anterior knee pain in adolescents and young adult... more Patellofemoral instability is a common cause of anterior knee pain in adolescents and young adults. Most normal and pathological values for diagnosing patellofemoral instability are based on Western literature. We conducted this radiological study to determine normal values for different patellofemoral parameters in a Korean population and to evaluate their usefulness in diagnosis. We retrospectively reviewed the rotational profile computerized tomography (CT) scans of the patellar dislocation and control groups. Trochlear, patellar, rotational profile, and trochleo-patellar alignment parameters were compared between the groups. Receiver operating characteristic curves were drawn for significant parameters, and sensitivity and specificity were calculated for the cut-off values. There were 48 patients in the patellar dislocation group and 87 patients in the control group. In the control group and patellar dislocation group, the mean sulcus angle was 132.5° and 143.3°, respectively, t...
The Journal of arthroplasty, Jun 27, 2016
Recently, anatomical designs in total knee arthroplasty are introduced to address asymmetry of th... more Recently, anatomical designs in total knee arthroplasty are introduced to address asymmetry of the resected tibia cutting surface. It is still not well known how much improvement would be achieved in total knee arthroplasty, especially in Asian knees. We evaluated the bony coverage of 4 commercially available posterior-stabilized tibial designs (3 symmetrical: NexGen, Attune, and Vega; 1 anatomical: Persona) by measuring uncovered areas over 3 different regions: lateroposterior (LP), medioposterior (MP), and mediolateral (ML) areas. The implant size was chosen based on lateral anteroposterior dimension of the implant that most closely matched the corresponding surface of tibia. The knee with over coverage <1 mm and under coverage <2 mm was regarded as having optimal fit. The optimal fit of anatomical design in LP dimension was achieved in 76% of the cases, which was not significantly different from other symmetrical designs (P > .05). The anatomical tibial implant had a mor...
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, Jan 3, 2017
The valgus high tibial osteotomy (HTO) in patients with medial osteoarthritis and discoid lateral... more The valgus high tibial osteotomy (HTO) in patients with medial osteoarthritis and discoid lateral meniscus can result in increased load on the lateral compartment and hence a higher chances of tear. This may accelerate the progression of osteoarthritis on lateral compartment. We, therefore, carried out the case control study with a hypothesis that an HTO would accelerate the progression of osteoarthritis (OA) on lateral compartment in patients with complete discoid meniscus. The records of all patients with open wedge HTO from 2008 to 2012 were evaluated for complete lateral discoid meniscus. The patient who had a valgus HTO with or without partial meniscectomy for medial compartmental OA was included for this study. Cases to control were chosen to match age, body mass index (BMI), pre-operative osteoarthritis grade, and deformity angles in ratio 1:2. Patient's records were studied for demographic data, clinical examination records, and pre-operative knee functional scores and r...
The Journal of arthroplasty, 2017
In this study, we tried to assess if combined method (intravenous [IV] and topical) of tranexamic... more In this study, we tried to assess if combined method (intravenous [IV] and topical) of tranexamic acid (TXA) administration, which has been shown to be superior in conventional arthroplasty, has similar effect in navigational arthroplasty compared to administration of drug either individually. In present randomized control trial, 200 patients were randomly divided in one of the 4 groups using computer-generated tables-control, IV, intraarticular, and combined. We studied evident loss through drain, total loss based on Gross method and hemoglobin balance method, hidden losses, hemoglobin and hematocrit drop, functional scores, and all possible complications related to TXA. Evident loss in combined group was 535.55 mL, not significantly less than IV (585 mL, P = .15) and intraarticular group (514 mL, P = .74). However, these were significantly less than control group (696 mL, P = .000). Functional scores and recovery rates were, however, comparable in all 4 groups. No patients in any ...
Orthopedics, 2016
T otal knee arthroplasty (TKA) is one of the most frequently performed surgeries in the field of ... more T otal knee arthroplasty (TKA) is one of the most frequently performed surgeries in the field of orthopedics, due to the extension of the average life span. Total knee arthroplasty has a high success rate in relieving pain and improving knee function. 1 Important factors for successful TKA are proper patient selection, surgical technique, instrumentation and rehabilitation. Among these various factors, the surgical technique, and in particular an ideal underlying arrangement owing to accurate bone resection, is the most important factor. Improper alignment and imbalance can lead to increased and early polyethylene wear, early loosening, and decreased survival of implants. 2-4 Better resection methods to meet the anatomical characteristics of the patients were proposed, but it is a fact that it is difficult to standardize such methods for all patients. Computer-assisted TKA has been developed to achieve more precise and accurate postoperative alignment, but this technique involves time-consuming registration, increased surgical time, risk for pin site infection, and fracture. 1
Clinics in Orthopedic Surgery, 2018
Recurrent patellar dislocation is a result of aberration of normal patellofemoral kinematics. 1,2... more Recurrent patellar dislocation is a result of aberration of normal patellofemoral kinematics. 1,2) The anatomical deterrent resulting in malalignment of the knee may be multifactorial. 3,4) Problems in both static and dynamic stabilizers of the knee joint may have a role, and therefore it is difficult to find a single treatment protocol that would be applicable for all patients uniformly. 5,6) The fact that over 100 procedures have been described for the management of this condition stresses the fact that no single procedure works in all cases. 1-3,5,6) Depending on the etiology, both proximal and dis-tal realignment procedures have been described for the treatment of recurrent patellar dislocation. Proximal realignment using lateral release and medial patellofemoral ligament reconstruction has demonstrated good results. 6,7) However, the indications and results of distal realignment using tuberosity transfer have been controversial. 8-11) Goutallier et al. 12) described the tibial tuberosity-trochlear groove (TT-TG) distance as a quantitative measure of lateralization of the tibial tuberosity on the proximal tibia. Dejour et al. 13) concluded 20 mm as a cutoff for tuberosity transfer. However, the literature has not always shown favorable results of tuberosity transfer, and thus we sought to investigate whether the TT-TG alone is an appropriate criterion to determine the transfer of tibial tuberosity. Since it is important to identify the root cause of malalignment and address the contributing factors, 14) tuberosity transfer would be of aid for patients who have severe tuberosity lateralization. 15) However, the TT-TG dis
Indian journal of orthopaedics
Bleeding is one of the unavoidable complications of total knee arthroplasty (TKA). Tranexamic aci... more Bleeding is one of the unavoidable complications of total knee arthroplasty (TKA). Tranexamic acid (TXA) in last decade has emerged as an effective and safe way to decrease postoperative bleeding and transfusion rates. Although there is little doubt on the efficacy of the drug, the debate on ideal mode is more recent. We undertook this study to find out the most effective and yet safest way of TXA administration. A single institution - two hospital-based, double-blinded, prospective, randomized control trial was conducted from January 2015 to December 2015. One hundred and fifty patients were randomly divided in one of the three groups using computer-generated tables - intravenous (IV), intraarticular and combined. Evident loss through drain, total loss based on gross method and hemoglobin balance method, hidden blood losses, hemoglobin, and hematocrit drop, all possible complications related to TXA were evaluated and compared among groups. The analysis of variance and Tukey'swe...
Knee surgery & related research, 2016
Total knee arthroplasty (TKA) accompanies the risk of bleeding and need for transfusion. There ar... more Total knee arthroplasty (TKA) accompanies the risk of bleeding and need for transfusion. There are several methods to reduce postoperative blood loss and blood transfusion. One such method is using tranexamic acid during TKA. The purpose of this study was to confirm whether tranexamic acid reduces postoperative blood loss and blood transfusion after TKA. A total of 100 TKA patients were included in the study. The tranexamic acid group consisted of 50 patients who received an intravenous injection of tranexamic acid. The control included 50 patients who received a placebo injection. The amounts of drainage, postoperative hemoglobin, and transfusion were compared between the groups. The mean amount of drainage was lower in the tranexamic acid group (580.6±355.0 mL) than the control group (886.0±375.5 mL). There was a reduction in the transfusion rate in the tranexamic acid group (48%) compared with the control group (64%). The hemoglobin level was higher in the tranexamic acid group t...
Knee surgery & related research, 2016
Patellofemoral instability is a common cause of anterior knee pain in adolescents and young adult... more Patellofemoral instability is a common cause of anterior knee pain in adolescents and young adults. Most normal and pathological values for diagnosing patellofemoral instability are based on Western literature. We conducted this radiological study to determine normal values for different patellofemoral parameters in a Korean population and to evaluate their usefulness in diagnosis. We retrospectively reviewed the rotational profile computerized tomography (CT) scans of the patellar dislocation and control groups. Trochlear, patellar, rotational profile, and trochleo-patellar alignment parameters were compared between the groups. Receiver operating characteristic curves were drawn for significant parameters, and sensitivity and specificity were calculated for the cut-off values. There were 48 patients in the patellar dislocation group and 87 patients in the control group. In the control group and patellar dislocation group, the mean sulcus angle was 132.5° and 143.3°, respectively, t...
The Journal of arthroplasty, Jun 27, 2016
Recently, anatomical designs in total knee arthroplasty are introduced to address asymmetry of th... more Recently, anatomical designs in total knee arthroplasty are introduced to address asymmetry of the resected tibia cutting surface. It is still not well known how much improvement would be achieved in total knee arthroplasty, especially in Asian knees. We evaluated the bony coverage of 4 commercially available posterior-stabilized tibial designs (3 symmetrical: NexGen, Attune, and Vega; 1 anatomical: Persona) by measuring uncovered areas over 3 different regions: lateroposterior (LP), medioposterior (MP), and mediolateral (ML) areas. The implant size was chosen based on lateral anteroposterior dimension of the implant that most closely matched the corresponding surface of tibia. The knee with over coverage <1 mm and under coverage <2 mm was regarded as having optimal fit. The optimal fit of anatomical design in LP dimension was achieved in 76% of the cases, which was not significantly different from other symmetrical designs (P > .05). The anatomical tibial implant had a mor...
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, Jan 3, 2017
The valgus high tibial osteotomy (HTO) in patients with medial osteoarthritis and discoid lateral... more The valgus high tibial osteotomy (HTO) in patients with medial osteoarthritis and discoid lateral meniscus can result in increased load on the lateral compartment and hence a higher chances of tear. This may accelerate the progression of osteoarthritis on lateral compartment. We, therefore, carried out the case control study with a hypothesis that an HTO would accelerate the progression of osteoarthritis (OA) on lateral compartment in patients with complete discoid meniscus. The records of all patients with open wedge HTO from 2008 to 2012 were evaluated for complete lateral discoid meniscus. The patient who had a valgus HTO with or without partial meniscectomy for medial compartmental OA was included for this study. Cases to control were chosen to match age, body mass index (BMI), pre-operative osteoarthritis grade, and deformity angles in ratio 1:2. Patient's records were studied for demographic data, clinical examination records, and pre-operative knee functional scores and r...
The Journal of arthroplasty, 2017
In this study, we tried to assess if combined method (intravenous [IV] and topical) of tranexamic... more In this study, we tried to assess if combined method (intravenous [IV] and topical) of tranexamic acid (TXA) administration, which has been shown to be superior in conventional arthroplasty, has similar effect in navigational arthroplasty compared to administration of drug either individually. In present randomized control trial, 200 patients were randomly divided in one of the 4 groups using computer-generated tables-control, IV, intraarticular, and combined. We studied evident loss through drain, total loss based on Gross method and hemoglobin balance method, hidden losses, hemoglobin and hematocrit drop, functional scores, and all possible complications related to TXA. Evident loss in combined group was 535.55 mL, not significantly less than IV (585 mL, P = .15) and intraarticular group (514 mL, P = .74). However, these were significantly less than control group (696 mL, P = .000). Functional scores and recovery rates were, however, comparable in all 4 groups. No patients in any ...
Orthopedics, 2016
T otal knee arthroplasty (TKA) is one of the most frequently performed surgeries in the field of ... more T otal knee arthroplasty (TKA) is one of the most frequently performed surgeries in the field of orthopedics, due to the extension of the average life span. Total knee arthroplasty has a high success rate in relieving pain and improving knee function. 1 Important factors for successful TKA are proper patient selection, surgical technique, instrumentation and rehabilitation. Among these various factors, the surgical technique, and in particular an ideal underlying arrangement owing to accurate bone resection, is the most important factor. Improper alignment and imbalance can lead to increased and early polyethylene wear, early loosening, and decreased survival of implants. 2-4 Better resection methods to meet the anatomical characteristics of the patients were proposed, but it is a fact that it is difficult to standardize such methods for all patients. Computer-assisted TKA has been developed to achieve more precise and accurate postoperative alignment, but this technique involves time-consuming registration, increased surgical time, risk for pin site infection, and fracture. 1