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Papers by Pradeep Bhosale

Journal of Orthopaedic Science, Apr 25, 1997

Copyright © 2015 by Journal of Orthpaedic Case Reports Journal of Orthopaedic Case Reports | pISS... more Copyright © 2015 by Journal of Orthpaedic Case Reports Journal of Orthopaedic Case Reports | pISSN 2250-0685 | eISSN 2321-3817 | Available on www.jocr.co.in | doi:10.13107/jocr.2250-0685.311 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Dr. Nikhil A Gokhale Dr. Shaligram Purohit Dr. Pradeep Bhosale Abstract Journal of Orthopaedic Case Reports 2015 July Sep: 5(3):Page 63-65 Case Report

About two third of adults suffer from low back pain at some time. For patients with nonspecific l... more About two third of adults suffer from low back pain at some time. For patients with nonspecific low back pain, a precise pathoanatomical diagnosis is often impossible, which leads to various imprecise diagnosis [1]. Recovery from nonspecific low back pain is generally rapid. In a study, 90 percent of the patients seen within three days of onset recovered in two weeks [2]. Hence, patients with red flags only are recommended investigations and ‘inflammatory back pain’ (IBP) is one such red flag. A study by Calin A, et al [3]. Rudwailt M, et al [4]. and Sieper J, et al. [5] in ASAS (Assessment of SpondyloArthritis international Society) have defined characteristics of inflammatory back pain. Inflammatory back pain is a hallmark of Ankylosing Spondylitis (AS). The term ‘ankylosing spondylitis’ was introduced around 1900 at the time when diagnosis could be made only on the basis of the clinical experience, without the help of imaging or laboratory results. Study Rationale

The Journal of Arthroplasty, 2020

BACKGROUND The role of total hip arthroplasty (THA) in healed tuberculosis (TB) of the hip has be... more BACKGROUND The role of total hip arthroplasty (THA) in healed tuberculosis (TB) of the hip has been reported with success in the past. However, the role and success of THA in active TB of the hip has remained controversial. METHODS We retrospectively evaluated prospective study of 52 THAs done for active TB of the hip in 51 patients. The protocol includes 3-6 months of effective preoperative and 9-18 months postoperative anti-TB therapy. All THAs were performed by the same surgeon (author 1). The selection criteria excluded patients with poor immunity, HIV +ve patient, and presence of discharging sinus. The type of THA implant includes 12 cemented, 38 uncemented, and 2 hybrid fixations. RESULTS The mean follow-up was 10.5 years (2-29). Six patients were (6 THAs) lost to follow up after 4 years, including 2 deaths unrelated to TB or THA. There was no reactivation of TB. Mean Harris Hip Score improved from preop 31.77 (20-51) to postop 88 (72-100) in the last follow-up. Two patients had delayed wound healing up to 21 days postop with no evidence of subsequent episode till last follow-up. There was no case of dislocation, neurological complication in any patient. Seven THAs underwent revision for aseptic loosening unrelated to TB. CONCLUSION Single-stage THA is safe in active advanced tubercular arthritis hip with good immunity status under cover of effective anti-TB therapy using strict preop selection protocol.

$Research paper thumbnail of Steffee plating in management of fracture spine$

International Journal of Orthopaedics Sciences, 2018

Introduction: The diagnosis of a broken back has carried an ominous prognosis, since antiquity. I... more Introduction: The diagnosis of a broken back has carried an ominous prognosis, since antiquity. In the writings of ancient Egyptians, as recorded in Edwn Smith papers, traumatic quadriplegia was considered a, "condition not to be treated ". However, with modern treatment, the outlook towards these patients have changed for the better. Results: Case series consisted of 33 cases, follow up period was from 5 months to 4 years. In most of the cases, implant removal was done after one to one and half years, depeding upon fusion, reduction & bone implant relationship. In most of the patients good fusion in reduced position with no loosening around implants were noted. Conclusion: Since pedicular screws & plates, Steffee variable screw placement (VSP type) fits on both sides of spine, they maintain the reduced and decompressed spine till such a time, when bony fusion occurs, since less load is shared by each plate.

The Bombay Hospital journal

A case of an Odontoid fracture presented to us with neurological deficit. MRI done to look for th... more A case of an Odontoid fracture presented to us with neurological deficit. MRI done to look for the status of cord compression revealed a concurrent vertebral artery dissection, which had been asymptomatic. There being no compressive element on the spinal cord, patient was treated conservatively. Recovery was uneventful and at eight months post injury, patient is mobilising with the use of an external brace. There is no residual effect of the arterial dissection. Review of literature on vertebral artery dissection is presented.

$Research paper thumbnail of One-stage long-stem total knee arthroplasty for arthritic knees with stress fractures$

Journal of orthopaedic surgery (Hong Kong), 2013

PURPOSE. To evaluate the outcome of one-stage long-stem total knee arthroplasty (TKA) for patient... more PURPOSE. To evaluate the outcome of one-stage long-stem total knee arthroplasty (TKA) for patients with arthritic knees and tibiofemoral stress fractures. METHODS. Records of 11 men and 18 women aged 47 to 78 (mean, 66) years who underwent fixed-bearing posterior-stabilised TKA for osteoarthritis or rheumatoid arthritis of the knee with tibial (n=31) and femoral (n=3) stress fractures were reviewed. All the tibial fractures involved the proximal half. There were 7 associated fibular stress fractures. Of the 31 knees with tibial stress fractures, 26 and 5 manifested varus and valgus deformity, respectively. RESULTS. The mean follow-up period was 51 (range, 24-96) months. The mean tibiofemoral angle improved from 23.2 to 1.9 degrees varus. The mean Knee Society knee score improved from 38.5 (range, 15- 63) to 89.6 (range, 80-95) [p<0.05]. The mean Knee Society functional score improved from 25.5 (range, 0-40) to 86.5 (range, 60-100) [p<0.05]. All fractures were united at the las...

Indian Journal of Orthopaedics, 2014

Background: It is common in medical practice to see patients having persistent pain and radiculop... more Background: It is common in medical practice to see patients having persistent pain and radiculopathy even after undergoing discectomy surgery. Inflammatory cytokines, such as interleukins are produced at the site of disc herniation and are now considered responsible for the pain perceived by the patient. This study has used high sensitive C-reactive protein (HSCRP) assay for predicting inflammation around the nerve roots on very same principle, which has used HSCRP for predicting coronary artery diseases in current clinical practice. Thus, purpose of this study is to test whether HSCRP can stand as an objective tool to predict postoperative recovery in patients undergoing lumbar discectomy. That is, to study association between preoperative HSCRP blood level and postoperative recovery with the help of modified Oswestry Back Disability Score. Materials and Methods: A study group consisting of 50 cases of established lumbar disc disease and control group of 50 normal subjects, matched with the study group. Both the study and control groups were subjected to detailed evaluation with the help of modified Oswestry Low Back Pain Scale both pre and postoperatively at 3 months, 6 months and 1-year. The preoperative blood samples were analyzed to assess the HSCRP concentration. All the cases underwent surgery over a period of 1-year by the same surgeon. Results: The level of HSCRP in the study group was between 0.050-and 0.710 mg/dL and in the control group, 0.005-0.020 mg/dL. There was highly significant positive correlation between preoperative HSCRP level and postoperative score at P < 0.005. Cases with HSCRP level in the range of 0.1820 ± 0.079 mg/dL, showed better recovery (score improved > 10 points), while those with HSCRP level in the range of 0.470 ± 0.163 mg/dL, showed poor recovery (score improved < 10 points). Conclusion: HSCRP will serve as a good supplementary prognostic marker for operative decision making in borderline and troublesome cases of lumbar disc disease.

International Journal of Shoulder Surgery, 2011

Sprengel's deformity or congenital elevation of scapula is a complex deformity of the pectoral gi... more Sprengel's deformity or congenital elevation of scapula is a complex deformity of the pectoral girdle, and results in symptomatic cosmetic and functional disability. Several studies have attempted to analyze the three-dimensional aspects of this deformity; optimal methodologies of quantification and surgical correction techniques have been debated since the condition was first described. This article presents a concise review of the exact pathoanatomy, clinical presentation, imaging techniques, and surgical procedures described in the management of this condition.

Rheumatology, 1972

Background/Aims: To review the existing literature on pigmented villonodular synovitis (PVNS) of ... more Background/Aims: To review the existing literature on pigmented villonodular synovitis (PVNS) of the temporomandibular joint (TMJ) and report a rare case of PVNS of the TMJ presenting with unilateral hearing loss. Methods: Review of the existing literature and a description of personal experience with PVNS of the TMJ presenting with unilateral hearing loss. Results: Review of the existing literature revealed 76 reported cases of PVNS of the TMJ. The most common presenting symptom was of a slowly enlarging mass or swelling of the preauricular area, with dysfunctional TMJ also frequently reported. All patients underwent surgical excision with some pursuing radiation as adjuvant therapy. Presented Patient: A 46-year-old man presented with several months of unilateral subjective hearing loss and aural fullness. Imaging revealed a mass centered along the superior TMJ with expansion through the squamous temporal bone and extra-axial intracranial extension into the middle cranial fossa. Imaging characteristics and fine-needle aspiration biopsy were consistent with PVNS. Intervention: The patient underwent near-total excision of the mass via frontotemporal craniectomy and lateral temporal bone resection. Follow-Up: At the 16-month follow-up there was no evidence of disease recurrence. Conclusion: PVNS of the TMJ represents a rare entity that can present with a variety of symptoms including unilateral hearing loss.

Indian Journal of Orthopaedics, 2012

Background: Though Austin Moore (AM) replacement prosthesis has fairly good short term results fo... more Background: Though Austin Moore (AM) replacement prosthesis has fairly good short term results for intracapsular femoral neck fractures in the elderly, it still is a compromised option and has a high failure rate in the long run. The objective of the present retrospective study is to analyze the functional outcome, assess survivorship of revision total hip arthroplasty (THA) at mid to long term followup, and evaluate intraoperative difficulties faced during conversion of failed aseptic AM prosthesis to cemented THA. Materials and Methods: Eighty-nine cemented THA surgeries for failed AM prosthesis were performed between 1986 and 2005. AM failures were classified into seven groups on the basis of mode of failure. Infected failures were excluded from the study. There were 35 men and 54 women in the study group. The mean age was 68 years (range 57-91 years). Mean followup was 8 years (range 5-13 years). Results: Average Harris Hip Score improved from 65 preoperatively (range 42-73) to 87 (range 76-90) at 1 year postoperatively and to 86 (range 75-89) at the last followup. The overall complication rate was 4.5%. Conclusion: Conversion THA is an excellent treatment strategy for symptomatic failed AM hemiarthroplasty in terms of pain relief and restoration of function and mobility as near as possible to the preinjury level. Also, hemiarthroplasty should not be used in physically active patients, even in elderly individuals. Careful patient selection for hemiarthroplasty versus THA is vital and may decrease the incidence of complications and ameliorate the outcomes in the treatment of intracapsular femoral neck fractures.