Srinivas Kambhampati - Academia.edu (original) (raw)

Papers by Srinivas Kambhampati

Indian Journal of Orthopaedics, 2022

Knee Surgery, Sports Traumatology, Arthroscopy, 2022

No systematic review has compared the clinical outcome of anterior stabilized ultra-congruent and... more No systematic review has compared the clinical outcome of anterior stabilized ultra-congruent and standard cruciate-retaining inserts in fixed-bearing primary total knee arthroplasty. This study aimed to compare the outcomes and establish the superiority or equivalence of these inserts. Pubmed, EMBASE, Medline, AMED, ERIC, and Proquest databases were searched electronically. PRISMA guidelines were followed in the conduct of the study. The clinical outcomes compared in the meta-analysis were overall knee score, WOMAC, score for knee function, score for knee pain, SF-12 PCS, knee flexion, manipulation under anaesthesia for postoperative knee stiffness, revision total knee arthroplasty or change of polyethylene insert for post-operative instability (relative risk [RR]) and survivorship. Study quality was evaluated using the Newcastle Ottawa Scale and the Modified Jadad scale. Fourteen studies comprising 9989 knees (three RCTs and 11 comparative case-cohort studies) were included for qualitative and quantitative analysis. The pooled analysis of the ultracongruent insert and the standard cruciate retaining insert was based on a cohort of 2860 and 7129 TKA, respectively. Knee pain was significantly better in patients that had standard inserts (p = 0.02; 95% CI − 1.06 to − 0.10), and the physical component of health-related quality of life was also significantly better in patients that had standard inserts (p = 0.02; 95% CI − 6.43 to − 0.64). There was a 72% lesser chance of revision TKA or change of insert for postoperative instability in knees that had been implanted with ultracongruent inserts (RR = 0.28; p = 0.0002; 95% CI 0.15–0.55). There was no difference in the otheroutcome measures. There was no significant difference between the two inserts, considering the minimal clinically important difference or absolute ratio. Differences observed between the two types of inserts were not clinically significant. Therefore, based on current evidence, arthroplasty surgeons can use either of these inserts with cruciate-retaining knee prosthesis. Therapeutic study, Level II.

Knee Surgery & Related Research, 2021

Purpose Arthroscopy is an established sub-speciality in orthopaedics. With advancing technology, ... more Purpose Arthroscopy is an established sub-speciality in orthopaedics. With advancing technology, instrumentation and implants, this sub-speciality has seen an explosion of knowledge and techniques since its inception. The indications for arthroscopic management are increasing and, hence, the number of publications on this topic. There has been no study looking into the bibliometrics of all publications within this speciality. The purpose of this study was to look into the trends of published articles on arthroscopy from PubMed and Scopus including studying their citation numbers. Materials and methods We set out to look into the number of publications from the earliest up to 2019 and their trends and citation numbers in PubMed and Scopus. We also performed a VOS viewer analysis of MeSH terms and titles of publications to look at research trends over time. Results There were 41,149 articles published on PubMed since 1955 and 50,373 articles on Scopus since 1939. The total number of c...

Journal of Arthroscopic Surgery and Sports Medicine, 2021

Quadriceps active (QA) test has been described and well known for the diagnosis of posterior cruc... more Quadriceps active (QA) test has been described and well known for the diagnosis of posterior cruciate ligament (PCL) deficiency. We describe a modification of the QA test to diagnose PCL deficiency. Pushed QA test consists of two components where the examiner pushes the proximal tibia posteriorly with the knee flexed <90° in the first part of the test translating the tibia posteriorly like in the posterior drawer test while the patient reduces the translation actively by contracting the quadriceps in the second part like in the QA test.

Posterior Cruciate Ligament (PCL) one of the major ligaments of the knee. Injuries to PCL are les... more Posterior Cruciate Ligament (PCL) one of the major ligaments of the knee. Injuries to PCL are less frequent than ACL injuries. Management of these injuries has been evolving from purely conservative management in early reports to current philosophy of selective surgical management. Surgical techniques for management of PCL injuries are also evolving. We look at a brief review of the ligament with management of its injuries.

Handbook of Orthopaedic Trauma Implantology, 2021

Journal of Orthopaedic Case Reports, 2020

Introduction: Bilateral shoulder dislocations are rare and can result from sports injuries, epile... more Introduction: Bilateral shoulder dislocations are rare and can result from sports injuries, epileptic seizures, electric shock, or electroconvulsive therapy. Divergent shoulder dislocations are even more rare and difficult to treat. We report a case of bilateral divergent shoulder dislocations with bilateral greater tuberosity fractures. We have reviewed the existing literature and have summarized the mechanisms and outcomes of such injuries. Case Report: A 35-year-old, right-hand dominant male, a known epileptic presented with pain and deformity in both shoulders after an episode of generalized seizures. Radiographs revealed anterior dislocation on the right and posterior dislocation on the left shoulders along with bilateral displaced fractures of the greater tuberosities. The patient was treated with closed reduction of bilateral shoulder dislocations using gentle traction followed by open suture fixation of the greater tuberosity fractures. The greater tuberosity on the posterio...

As we step into a technology powered era, where information is available everywhere, managing dat... more As we step into a technology powered era, where information is available everywhere, managing data forms an important part of professional and everyday life. With developments like online databases, high definition videos and images, social media, robotics, explosion of academic publications, telecommunication, artificial intelligence and internet of things, there is a variable amount of data that the orthopaedic surgeon is exposed to and has to deal with on a regular basis. It is imperative that the surgeon has a basic working knowledge on data and its applications in relation to the field of orthopaedic surgery. This review introduces the surgeon to data and its types, its sources, collection, Electronic Medical Records (EMR), management after collection, Big data and legal issues related to data. Data generators from megabytes to yottabytes are discussed along with options for their storage and analysis. Knowledge on the types of data is important to decide on the type of statist...

CASE We report a rare case of coronal plane infrapatellar plica, also called "Bib-like plica... more CASE We report a rare case of coronal plane infrapatellar plica, also called "Bib-like plica," in a 60-year-old patient. The start-up pain she experienced before arthroscopic excision completely resolved after the procedure. As far as we know, this is the first case of this plica in the literature in a 60-year-old patient who had associated articular cartilage loss over the medial femoral condyle adjacent to the plica, with positive magnetic resonance imaging findings outlining the structure, possibly impinging the infrapatellar fat pad. CONCLUSION Excision of a symptomatic plica by arthroscopy resulted in complete relief of pain in this patient.

The American Journal of Sports Medicine, 2021

Dear Editor: We read the article by Thaunat et al, ‘‘Ramp Lesion Subtypes: Prevalence, Imaging, a... more Dear Editor: We read the article by Thaunat et al, ‘‘Ramp Lesion Subtypes: Prevalence, Imaging, and Arthroscopic Findings in 2156 Anterior Cruciate Ligament Reconstructions,’’ with interest and would like to congratulate the authors on the excellent work on this topic of ‘‘ramp lesions’’ of the meniscus. We want to add some more insight to this topic to enlighten the readers. We have recently described a rare pattern of ramp lesion. Here, the ramp lesion was associated with a fracture of the rim of the posterior medial tibia, avulsion of the posterior horn of the medial meniscus, and a radial tear of the junction of the body and posterior horn. In effect, this lesion had amputated the posterior meniscus. We would value the opinion of the authors on this pattern of a ramp lesion. The authors have presented 2 mechanisms of theories for the ramp lesions. While we accept that the following may not be the case in all the injuries, we believe that the forces are crushing in nature, as we noticed in our report. This view is supported by the fact that several authors have reported bone contusion of the posterior rim of the medial tibia in association with ramp lesions. We believe that the rim fracture in our case was an extension of this contusion. Segmental amputation of the meniscus and the displacement of remnants into the ramp lesion further strengthen this hypothesis. The forces causing this would be directed posterior (as seen in the ‘‘door stopper’’ mechanism of the meniscus during anterior subluxation in anterior cruciate ligament [ACL] injury) along with a heavy component of axial loading causing the fracture. With decreasing magnitude of axial load, a spectrum of ramp lesions with a bone contusion, followed by lesions without a contusion, may be seen. There could be an interplay of axial and posterior compressive forces causing the various injuries that we are seeing, rather than pulling forces from the back. We firmly believe that the compressive forces are responsible for the rim fractures associated with atypical ramp lesions. On the contrary, avulsion forces account for clean breaks perpendicular to the force applied. It is known that the axial load is one of the major forces in the mechanisms causing ACL injuries, which further corroborates the above explanation. The authors reported that 48.4% of the 38 (type 3) ramp lesions had bone contusion in the posterior rim of the medial tibia. We would like to know if there were any associated bone bruises in the adjacent posterior or middle medial femoral condyle. If these were present, then it seems to be due to an impaction type of injury. Perhaps a separate study looking into this aspect would be beneficial, and the authors’ extensive experience on this subject would be very useful in solving this conundrum. We believe further studies on the mechanism of ramp lesion are needed, and inclusion of the mechanism within the classification would be beneficial for diagnosing, understanding, and managing these challenging cases.

JBJS Case Connector, 2021

Journal of Clinical Orthopaedics and Trauma, 2021

Indian Journal of Orthopaedics, 2020

Introduction Elite and Olympian athletes are often stretching the upper limits of normal physiolo... more Introduction Elite and Olympian athletes are often stretching the upper limits of normal physiology and biomechanics of the musculoskeletal system in their efforts to excel in their sport. For them to get back to their sport at the same level after injury, the management, repair techniques, and rehabilitation protocols should be robust to permit healing of tissues to allow supra-normal loading and performance. The knee and the meniscus are commonly injured in these sports. Yet, the incidence, mechanisms, types of injuries to the meniscus, and their management are not known across different sports in the Olympics. Methods We set out to look into the incidence and the trends of publications on meniscal injuries of the knee in Olympic games. A search of the PubMed and Scopus for these injuries using a search strategy gave 79 and 116 articles, respectively. Results There were very few publications giving the incidence of meniscal injuries in the Olympics. Football is the sport with the highest rate of meniscal injuries. Different sports are popular in different countries, and depending on the popularity and the country reporting these injuries, incidences differed. There was data available from India and Brazil for Elite athlete from diverse sports, whereas most data from other countries were for football and soccer. Knee was found to be the second most commonly injured part of the body in both Winter and Summer Olympics as well as the Youth Winter Olympics. Data were not available from the Youth Summer Olympics to make any conclusions. The number of publications on this topic is low. We presented the timeline of publications and citations of articles on this topic. The top country, language, journal, university, and author were USA, English, American Journal of Sports Medicine, Hospital of Special Surgery in New York and Brophy RH, respectively. The data on the risk factors for meniscal injuries were analyzed, discussed, and presented for football, as this was the most extensively studied sport. Conclusions Even though the knee is one of the commonly injured anatomical locations in elite athletes, there is a lack of literature on meniscal injuries in this subset of population. We looked at possible reasons and made recommendations to improve data collection on these injuries.

Indian Journal of Orthopaedics, 2020

Journal of Arthroscopic Surgery and Sports Medicine, 2021

Objectives: Arthroscopy is becoming more popular as a specialty in recent times in India. We look... more Objectives: Arthroscopy is becoming more popular as a specialty in recent times in India. We looked into the publications done by Indian authors in journals listed in the Scopus database. Materials and Methods: A search was carried out from the first publication until the end of 2019. The total number of publications was 638. We analyzed the output, looking into the top 10 authors, universities, journals in numbers, and citations. We also looked into the year-on-year growth of all articles and in each branch of arthroscopy to identify more academically active subspecialties. Results: There has been a steady increase in the number of publications in this branch of orthopedics with a steep increase after 2016. The knee joint was the most published, followed by the shoulder. Maulana Azad Medical College and Lok Nayak Hospital was the most published university, followed by All India Institute of Medical Sciences, New Delhi. We identify the limitations and make recommendations to identif...

Journal of Arthroscopic Surgery and Sports Medicine, 2021

One of the most important requirements for a good arthroscopic procedure is a clear view of the o... more One of the most important requirements for a good arthroscopic procedure is a clear view of the operating field. Infrapatellar fat pad is known to obstruct the field of view inside the knee for an arthroscopic surgeon. A clear view also shortens the operating time and saves valuable time under tourniquet. Different methods have been used to either avoid the fat pad, shave the fat pad, or retract to give a clear view inside the knee joint. We describe a technique using sutures which is simple, safe, inexpensive, reproducible, and effective in providing retraction of the fat pad.

Indian Journal of Medical Sciences, 2020

The COVID-19 pandemic has prompted an explosion of publications to report, understand, further re... more The COVID-19 pandemic has prompted an explosion of publications to report, understand, further research, and manage this condition. While publications are analyzing the bibliometrics on this condition, there are none available specifically for the impact of COVID-19 on trauma and orthopedics. The aim of this study, therefore, was to perform a bibliometric analysis on COVID-19 and trauma and orthopedics to assess its impact on the specialty. A search for articles on COVID-19 concerning trauma and orthopedics, with the keywords: “COVID-19, New coronavirus, SARS-Cov-2, Orthopedic*, trauma, bone, and joint” were performed on the June 19, 2020, using SCOPUS and PUBMED and this resulted in 272 and 887 articles, respectively. Later, on the same day, we searched for orthopedic journals exclusively and extracted 258 articles from 58 journals. Furthermore, we analyzed the Altmetric data through the dimensions website to find the most popular articles on social media on this topic. After analy...

Journal of Arthroscopy and Joint Surgery, 2020

Abstract Introduction Injuries to the acromioclavicular joint (AC) are not uncommon accounting fo... more Abstract Introduction Injuries to the acromioclavicular joint (AC) are not uncommon accounting for 9% of all shoulder injuries. Surgical management is the mainstay of treatment in severe injuries. Numerous surgical techniques have been described in the literature with variable results. Arthroscopic stabilization using a suspensory fixation is one of the most commonly performed procedure. Current study was done to evaluate the functional and radiological results of arthroscopic acromioclavicular joint reconstruction using dog bone button, a special type of suspensory fixation. Materials and methods Our study included 14 cases of Rockwood type III and V acute AC joint disruptions. A thorough clinico-radiological evaluation was done preoperatively including a Zanca view and compared with the contralateral side. All patients underwent arthroscopic acromioclavicular joint reconstruction using dog bone button. Radiological and functional results were studied during follow up at 6 weeks, 3 months and 6 months. Functional results were assessed using DASH (Disabilities of the Arm, Shoulder and Hand) score. Results The mean pre-operative coracoclavicular (CC) distance was 16.11 mm with SD ± 1.94 and mean post-operative CC distance was 10.76 mm with SD of ±2.76. Mean DASH scores during follow up were 60, 9.71 and 0.36 at 6 weeks, 3 months and 6 months respectively. There was a significant difference in the pre and post-operative CC distance and DASH t scores (P Conclusion Our study results infer that arthroscopic AC joint reconstruction using dog bone button construct in acute cases provides good functional and radiological results. No significant postoperative complications were associated with the same procedure.

Journal of Arthroscopic Surgery and Sports Medicine, 2020

Arthroscopy is a rapidly expanding and sub-specializing field of orthopedic surgery. We set out t... more Arthroscopy is a rapidly expanding and sub-specializing field of orthopedic surgery. We set out to list the most cited papers in the field of arthroscopy to get an insight of how influential and to what disciplines these papers belong to. We have listed most cited papers from Scopus in different categories which included individual joint related arthroscopy, for each decade and based on the type of study from the titles of citations. This report will help the novice arthroscopic surgeon to gain an insight into the fields and types of research that are happening and guide to explore the literature on this subject. We discussed the advantages and limitations of such a search and listing.

Knee Surgery & Related Research, 2019

Proximal fibular osteotomy has been proposed as a simple and inexpensive alternative to high-tibi... more Proximal fibular osteotomy has been proposed as a simple and inexpensive alternative to high-tibial osteotomy and unicondylar knee arthroplasty and may be useful for low-income populations that cannot afford expensive treatment methods. However, there is no consensus existing regarding the mechanism by which it acts nor the outcome of this procedure. This study was performed to analyze the available evidence on the benefits of proximal fibular osteotomy and to understand the possible mechanisms in play. There are various mechanisms that are proposed to individually or collectively contribute to the outcomes of this procedure, and include the theory of non-uniform settlement, the too-many cortices theory, slippage phenomenon, the concept of competition of muscles, dynamic fibular distalization theory and ground reaction vector readjustment theory. The mechanisms have been discussed and future directions in research have been proposed. The current literature, which mostly consists of ...

Indian Journal of Orthopaedics, 2022

Knee Surgery, Sports Traumatology, Arthroscopy, 2022

No systematic review has compared the clinical outcome of anterior stabilized ultra-congruent and... more No systematic review has compared the clinical outcome of anterior stabilized ultra-congruent and standard cruciate-retaining inserts in fixed-bearing primary total knee arthroplasty. This study aimed to compare the outcomes and establish the superiority or equivalence of these inserts. Pubmed, EMBASE, Medline, AMED, ERIC, and Proquest databases were searched electronically. PRISMA guidelines were followed in the conduct of the study. The clinical outcomes compared in the meta-analysis were overall knee score, WOMAC, score for knee function, score for knee pain, SF-12 PCS, knee flexion, manipulation under anaesthesia for postoperative knee stiffness, revision total knee arthroplasty or change of polyethylene insert for post-operative instability (relative risk [RR]) and survivorship. Study quality was evaluated using the Newcastle Ottawa Scale and the Modified Jadad scale. Fourteen studies comprising 9989 knees (three RCTs and 11 comparative case-cohort studies) were included for qualitative and quantitative analysis. The pooled analysis of the ultracongruent insert and the standard cruciate retaining insert was based on a cohort of 2860 and 7129 TKA, respectively. Knee pain was significantly better in patients that had standard inserts (p = 0.02; 95% CI − 1.06 to − 0.10), and the physical component of health-related quality of life was also significantly better in patients that had standard inserts (p = 0.02; 95% CI − 6.43 to − 0.64). There was a 72% lesser chance of revision TKA or change of insert for postoperative instability in knees that had been implanted with ultracongruent inserts (RR = 0.28; p = 0.0002; 95% CI 0.15–0.55). There was no difference in the otheroutcome measures. There was no significant difference between the two inserts, considering the minimal clinically important difference or absolute ratio. Differences observed between the two types of inserts were not clinically significant. Therefore, based on current evidence, arthroplasty surgeons can use either of these inserts with cruciate-retaining knee prosthesis. Therapeutic study, Level II.

Knee Surgery & Related Research, 2021

Purpose Arthroscopy is an established sub-speciality in orthopaedics. With advancing technology, ... more Purpose Arthroscopy is an established sub-speciality in orthopaedics. With advancing technology, instrumentation and implants, this sub-speciality has seen an explosion of knowledge and techniques since its inception. The indications for arthroscopic management are increasing and, hence, the number of publications on this topic. There has been no study looking into the bibliometrics of all publications within this speciality. The purpose of this study was to look into the trends of published articles on arthroscopy from PubMed and Scopus including studying their citation numbers. Materials and methods We set out to look into the number of publications from the earliest up to 2019 and their trends and citation numbers in PubMed and Scopus. We also performed a VOS viewer analysis of MeSH terms and titles of publications to look at research trends over time. Results There were 41,149 articles published on PubMed since 1955 and 50,373 articles on Scopus since 1939. The total number of c...

Journal of Arthroscopic Surgery and Sports Medicine, 2021

Quadriceps active (QA) test has been described and well known for the diagnosis of posterior cruc... more Quadriceps active (QA) test has been described and well known for the diagnosis of posterior cruciate ligament (PCL) deficiency. We describe a modification of the QA test to diagnose PCL deficiency. Pushed QA test consists of two components where the examiner pushes the proximal tibia posteriorly with the knee flexed <90° in the first part of the test translating the tibia posteriorly like in the posterior drawer test while the patient reduces the translation actively by contracting the quadriceps in the second part like in the QA test.

Posterior Cruciate Ligament (PCL) one of the major ligaments of the knee. Injuries to PCL are les... more Posterior Cruciate Ligament (PCL) one of the major ligaments of the knee. Injuries to PCL are less frequent than ACL injuries. Management of these injuries has been evolving from purely conservative management in early reports to current philosophy of selective surgical management. Surgical techniques for management of PCL injuries are also evolving. We look at a brief review of the ligament with management of its injuries.

Handbook of Orthopaedic Trauma Implantology, 2021

Journal of Orthopaedic Case Reports, 2020

Introduction: Bilateral shoulder dislocations are rare and can result from sports injuries, epile... more Introduction: Bilateral shoulder dislocations are rare and can result from sports injuries, epileptic seizures, electric shock, or electroconvulsive therapy. Divergent shoulder dislocations are even more rare and difficult to treat. We report a case of bilateral divergent shoulder dislocations with bilateral greater tuberosity fractures. We have reviewed the existing literature and have summarized the mechanisms and outcomes of such injuries. Case Report: A 35-year-old, right-hand dominant male, a known epileptic presented with pain and deformity in both shoulders after an episode of generalized seizures. Radiographs revealed anterior dislocation on the right and posterior dislocation on the left shoulders along with bilateral displaced fractures of the greater tuberosities. The patient was treated with closed reduction of bilateral shoulder dislocations using gentle traction followed by open suture fixation of the greater tuberosity fractures. The greater tuberosity on the posterio...

As we step into a technology powered era, where information is available everywhere, managing dat... more As we step into a technology powered era, where information is available everywhere, managing data forms an important part of professional and everyday life. With developments like online databases, high definition videos and images, social media, robotics, explosion of academic publications, telecommunication, artificial intelligence and internet of things, there is a variable amount of data that the orthopaedic surgeon is exposed to and has to deal with on a regular basis. It is imperative that the surgeon has a basic working knowledge on data and its applications in relation to the field of orthopaedic surgery. This review introduces the surgeon to data and its types, its sources, collection, Electronic Medical Records (EMR), management after collection, Big data and legal issues related to data. Data generators from megabytes to yottabytes are discussed along with options for their storage and analysis. Knowledge on the types of data is important to decide on the type of statist...

CASE We report a rare case of coronal plane infrapatellar plica, also called "Bib-like plica... more CASE We report a rare case of coronal plane infrapatellar plica, also called "Bib-like plica," in a 60-year-old patient. The start-up pain she experienced before arthroscopic excision completely resolved after the procedure. As far as we know, this is the first case of this plica in the literature in a 60-year-old patient who had associated articular cartilage loss over the medial femoral condyle adjacent to the plica, with positive magnetic resonance imaging findings outlining the structure, possibly impinging the infrapatellar fat pad. CONCLUSION Excision of a symptomatic plica by arthroscopy resulted in complete relief of pain in this patient.

The American Journal of Sports Medicine, 2021

Dear Editor: We read the article by Thaunat et al, ‘‘Ramp Lesion Subtypes: Prevalence, Imaging, a... more Dear Editor: We read the article by Thaunat et al, ‘‘Ramp Lesion Subtypes: Prevalence, Imaging, and Arthroscopic Findings in 2156 Anterior Cruciate Ligament Reconstructions,’’ with interest and would like to congratulate the authors on the excellent work on this topic of ‘‘ramp lesions’’ of the meniscus. We want to add some more insight to this topic to enlighten the readers. We have recently described a rare pattern of ramp lesion. Here, the ramp lesion was associated with a fracture of the rim of the posterior medial tibia, avulsion of the posterior horn of the medial meniscus, and a radial tear of the junction of the body and posterior horn. In effect, this lesion had amputated the posterior meniscus. We would value the opinion of the authors on this pattern of a ramp lesion. The authors have presented 2 mechanisms of theories for the ramp lesions. While we accept that the following may not be the case in all the injuries, we believe that the forces are crushing in nature, as we noticed in our report. This view is supported by the fact that several authors have reported bone contusion of the posterior rim of the medial tibia in association with ramp lesions. We believe that the rim fracture in our case was an extension of this contusion. Segmental amputation of the meniscus and the displacement of remnants into the ramp lesion further strengthen this hypothesis. The forces causing this would be directed posterior (as seen in the ‘‘door stopper’’ mechanism of the meniscus during anterior subluxation in anterior cruciate ligament [ACL] injury) along with a heavy component of axial loading causing the fracture. With decreasing magnitude of axial load, a spectrum of ramp lesions with a bone contusion, followed by lesions without a contusion, may be seen. There could be an interplay of axial and posterior compressive forces causing the various injuries that we are seeing, rather than pulling forces from the back. We firmly believe that the compressive forces are responsible for the rim fractures associated with atypical ramp lesions. On the contrary, avulsion forces account for clean breaks perpendicular to the force applied. It is known that the axial load is one of the major forces in the mechanisms causing ACL injuries, which further corroborates the above explanation. The authors reported that 48.4% of the 38 (type 3) ramp lesions had bone contusion in the posterior rim of the medial tibia. We would like to know if there were any associated bone bruises in the adjacent posterior or middle medial femoral condyle. If these were present, then it seems to be due to an impaction type of injury. Perhaps a separate study looking into this aspect would be beneficial, and the authors’ extensive experience on this subject would be very useful in solving this conundrum. We believe further studies on the mechanism of ramp lesion are needed, and inclusion of the mechanism within the classification would be beneficial for diagnosing, understanding, and managing these challenging cases.

JBJS Case Connector, 2021

Journal of Clinical Orthopaedics and Trauma, 2021

Indian Journal of Orthopaedics, 2020

Introduction Elite and Olympian athletes are often stretching the upper limits of normal physiolo... more Introduction Elite and Olympian athletes are often stretching the upper limits of normal physiology and biomechanics of the musculoskeletal system in their efforts to excel in their sport. For them to get back to their sport at the same level after injury, the management, repair techniques, and rehabilitation protocols should be robust to permit healing of tissues to allow supra-normal loading and performance. The knee and the meniscus are commonly injured in these sports. Yet, the incidence, mechanisms, types of injuries to the meniscus, and their management are not known across different sports in the Olympics. Methods We set out to look into the incidence and the trends of publications on meniscal injuries of the knee in Olympic games. A search of the PubMed and Scopus for these injuries using a search strategy gave 79 and 116 articles, respectively. Results There were very few publications giving the incidence of meniscal injuries in the Olympics. Football is the sport with the highest rate of meniscal injuries. Different sports are popular in different countries, and depending on the popularity and the country reporting these injuries, incidences differed. There was data available from India and Brazil for Elite athlete from diverse sports, whereas most data from other countries were for football and soccer. Knee was found to be the second most commonly injured part of the body in both Winter and Summer Olympics as well as the Youth Winter Olympics. Data were not available from the Youth Summer Olympics to make any conclusions. The number of publications on this topic is low. We presented the timeline of publications and citations of articles on this topic. The top country, language, journal, university, and author were USA, English, American Journal of Sports Medicine, Hospital of Special Surgery in New York and Brophy RH, respectively. The data on the risk factors for meniscal injuries were analyzed, discussed, and presented for football, as this was the most extensively studied sport. Conclusions Even though the knee is one of the commonly injured anatomical locations in elite athletes, there is a lack of literature on meniscal injuries in this subset of population. We looked at possible reasons and made recommendations to improve data collection on these injuries.

Indian Journal of Orthopaedics, 2020

Journal of Arthroscopic Surgery and Sports Medicine, 2021

Objectives: Arthroscopy is becoming more popular as a specialty in recent times in India. We look... more Objectives: Arthroscopy is becoming more popular as a specialty in recent times in India. We looked into the publications done by Indian authors in journals listed in the Scopus database. Materials and Methods: A search was carried out from the first publication until the end of 2019. The total number of publications was 638. We analyzed the output, looking into the top 10 authors, universities, journals in numbers, and citations. We also looked into the year-on-year growth of all articles and in each branch of arthroscopy to identify more academically active subspecialties. Results: There has been a steady increase in the number of publications in this branch of orthopedics with a steep increase after 2016. The knee joint was the most published, followed by the shoulder. Maulana Azad Medical College and Lok Nayak Hospital was the most published university, followed by All India Institute of Medical Sciences, New Delhi. We identify the limitations and make recommendations to identif...

Journal of Arthroscopic Surgery and Sports Medicine, 2021

One of the most important requirements for a good arthroscopic procedure is a clear view of the o... more One of the most important requirements for a good arthroscopic procedure is a clear view of the operating field. Infrapatellar fat pad is known to obstruct the field of view inside the knee for an arthroscopic surgeon. A clear view also shortens the operating time and saves valuable time under tourniquet. Different methods have been used to either avoid the fat pad, shave the fat pad, or retract to give a clear view inside the knee joint. We describe a technique using sutures which is simple, safe, inexpensive, reproducible, and effective in providing retraction of the fat pad.

Indian Journal of Medical Sciences, 2020

The COVID-19 pandemic has prompted an explosion of publications to report, understand, further re... more The COVID-19 pandemic has prompted an explosion of publications to report, understand, further research, and manage this condition. While publications are analyzing the bibliometrics on this condition, there are none available specifically for the impact of COVID-19 on trauma and orthopedics. The aim of this study, therefore, was to perform a bibliometric analysis on COVID-19 and trauma and orthopedics to assess its impact on the specialty. A search for articles on COVID-19 concerning trauma and orthopedics, with the keywords: “COVID-19, New coronavirus, SARS-Cov-2, Orthopedic*, trauma, bone, and joint” were performed on the June 19, 2020, using SCOPUS and PUBMED and this resulted in 272 and 887 articles, respectively. Later, on the same day, we searched for orthopedic journals exclusively and extracted 258 articles from 58 journals. Furthermore, we analyzed the Altmetric data through the dimensions website to find the most popular articles on social media on this topic. After analy...

Journal of Arthroscopy and Joint Surgery, 2020

Abstract Introduction Injuries to the acromioclavicular joint (AC) are not uncommon accounting fo... more Abstract Introduction Injuries to the acromioclavicular joint (AC) are not uncommon accounting for 9% of all shoulder injuries. Surgical management is the mainstay of treatment in severe injuries. Numerous surgical techniques have been described in the literature with variable results. Arthroscopic stabilization using a suspensory fixation is one of the most commonly performed procedure. Current study was done to evaluate the functional and radiological results of arthroscopic acromioclavicular joint reconstruction using dog bone button, a special type of suspensory fixation. Materials and methods Our study included 14 cases of Rockwood type III and V acute AC joint disruptions. A thorough clinico-radiological evaluation was done preoperatively including a Zanca view and compared with the contralateral side. All patients underwent arthroscopic acromioclavicular joint reconstruction using dog bone button. Radiological and functional results were studied during follow up at 6 weeks, 3 months and 6 months. Functional results were assessed using DASH (Disabilities of the Arm, Shoulder and Hand) score. Results The mean pre-operative coracoclavicular (CC) distance was 16.11 mm with SD ± 1.94 and mean post-operative CC distance was 10.76 mm with SD of ±2.76. Mean DASH scores during follow up were 60, 9.71 and 0.36 at 6 weeks, 3 months and 6 months respectively. There was a significant difference in the pre and post-operative CC distance and DASH t scores (P Conclusion Our study results infer that arthroscopic AC joint reconstruction using dog bone button construct in acute cases provides good functional and radiological results. No significant postoperative complications were associated with the same procedure.

Journal of Arthroscopic Surgery and Sports Medicine, 2020

Arthroscopy is a rapidly expanding and sub-specializing field of orthopedic surgery. We set out t... more Arthroscopy is a rapidly expanding and sub-specializing field of orthopedic surgery. We set out to list the most cited papers in the field of arthroscopy to get an insight of how influential and to what disciplines these papers belong to. We have listed most cited papers from Scopus in different categories which included individual joint related arthroscopy, for each decade and based on the type of study from the titles of citations. This report will help the novice arthroscopic surgeon to gain an insight into the fields and types of research that are happening and guide to explore the literature on this subject. We discussed the advantages and limitations of such a search and listing.

Knee Surgery & Related Research, 2019

Proximal fibular osteotomy has been proposed as a simple and inexpensive alternative to high-tibi... more Proximal fibular osteotomy has been proposed as a simple and inexpensive alternative to high-tibial osteotomy and unicondylar knee arthroplasty and may be useful for low-income populations that cannot afford expensive treatment methods. However, there is no consensus existing regarding the mechanism by which it acts nor the outcome of this procedure. This study was performed to analyze the available evidence on the benefits of proximal fibular osteotomy and to understand the possible mechanisms in play. There are various mechanisms that are proposed to individually or collectively contribute to the outcomes of this procedure, and include the theory of non-uniform settlement, the too-many cortices theory, slippage phenomenon, the concept of competition of muscles, dynamic fibular distalization theory and ground reaction vector readjustment theory. The mechanisms have been discussed and future directions in research have been proposed. The current literature, which mostly consists of ...