Dr Vivek Mahajan ,

Assistant Professor, Department of Orthopaedics
Father Muller Medical College, Kankanady,
Mangalore-575002, India
e-mail: mvivek@hotmail.com

Dr Vivek Mahajan has been involved in pioneearing work in PRP and has published reports in Literature. Below is an up-to-date review on current status of PRP in orthopaedics

We thank Dr Vivek to provide us with this write up

Platelet Rich Plasma in Orthopaedics: A Review by Dr Vivek Mahajan

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Dr Alaric Aroojis

MS (Ortho), D’Ortho, DNB (Ortho)

Consultant Paediatric Orthopaedic Surgeon

Kokilaben Dhirubhai Ambani Hospital

Dr Alaric is a well known paediatric Orthopaedic surgeon all across the country. He is academically briliant and has delivered many lectures and conducted numerous workshops and symposiums. Team at Orthopaedic Research Group thank him for sharing his presentation on Orthopaedic Evaluation of Cerebral Plasy. We also like to thank Dr Harshal Patkar for getting permission for putting this presentation online.

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The question of which technique is better exists between double and single bundle ACL Reconstruction.

Recent metanaalysis by Eck et al from University of Pittsburgh Medical Center tries to answer this question

Single-bundle versus double-bundle reconstruction for anterior cruciate ligament rupture: a meta-analysis–does anatomy matter?

Purpose : To determine whether double-bundle anterior cruciate ligament reconstruction leads to better restoration of anterior and rotational laxity and range of motion than single-bundle reconstruction.

METHODS:

A search was performed in the Medline, Embase, CINAHL, and Cochrane databases. All randomized, quasi-randomized, and observational clinical trials that reported the outcome of double- versus single-bundle anterior cruciate ligament reconstruction were included in our meta-analysis. The primary outcomes were anterior laxity (KT arthrometer; MEDmetric, San Diego, CA), pivot shift, and range of motion. Subgroup analyses were performed for more than 2 years’ follow-up, anatomic reconstruction, and nonanatomic reconstruction. The quality of the included studies was scored by use of the GRADE Checklist.

RESULTS:

Included 12 studies in this meta-analysis, 5 of which were randomized. There was a statistically significant difference in favor of double-bundle reconstruction for anterior laxity (KT arthrometer difference, -0.6 mm), Lachman test (64% risk reduction of positive Lachman), and pivot-shift test (69% risk reduction of positive shift). Similar results were found for the subgroup with more than 2 years’ follow-up and anatomic reconstructions. There were no significant differences for the subgroup with nonanatomic reconstructions, except a 2.6 times risk increase of extension deficit with nonanatomic double-bundle reconstruction compared with nonanatomic single-bundle reconstruction. Most of the included studies were found to have at least one serious limitation in study design.

CONCLUSIONS:

In comparison with single-bundle reconstruction, double-bundle reconstruction showed less anterior laxity, as measured by the KT arthrometer and Lachman test, and better rotational laxity, as measured by the pivot-shift test. The majority of the included studies had at least one major limitation in study design that decreased the quality of the study.

LEVEL OF EVIDENCE: Level I, meta-analysis.

Link to Pubmed: click here

IORG Comment: Although the metanalysis talks about better anatomical and objective stability in double bundle, functional outcome is same in both groups. Additioanlly thehe long term followup in term of prevention of osteoarthrosis, failure rate, revision rates are not studied by most reported research. With gears shifting from a more anatomical approach a difference in comparative outcome between an anatomic and non anatomic single and double bundle will be interesting to observe.

Conclusion: The Statement made by Longo et al (2011) holds most accurate ‘With the current evidence available, a simple SB ACL reconstruction is a suitable

technique, and it should be not abandoned until stronger scientific evidence in favour of DB ACL reconstruction will be produced.

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Recent metanaalysis by Eck et al from University of Pittsburgh Medical Center tries to answer this question

Single-bundle versus double-bundle reconstruction for anterior cruciate ligament rupture: a meta-analysis–does anatomy matter?

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The Team of Asian Journal of Arthroplasty is Proud to present the First Announcement of the Asian Journal of Arthroplasty (AJA).

Arthroplasty as a field has seen tremendous growth within last decade, specially in  Asian countries. Number of patients undergoing Arthroplasty has increased tremendously along with number of Surgeons performing these surgeries. This has lead to accumulation of enormous data and research in Asia. Geo-social and economical factors play a major role in Asian countries and huge differences exist in behavior replaced Joints. Although the editors welcome submissions from all over the world, AJA aims to provide a platform for publication of Frontline Arthroplasty Research originating from Asia.  The stress is on latest research in the field of arthritis and arthroplasty including aetiopathology, clinical and radiographic outcomes, surgical technique and implant design, biomechanics, and biomaterials.

The Asian Journal of Arthroplasty will be a peer-reviewed journal which will follow the highest standard of Editorial process, Review process and Publication protocol. A team of most well know Researchers and Academicians is been currently assembled and soon the complete Editorial Board will be announced. The Asian Journal of Arthroplasty will be a quarterly (4 issues per year) print and online journal. The online version will be an open access source and the print version will be made available on subscription. The journal will publish original articles, systematic reviews and meta-analyses, instructional lectures, case reports, technical notes and letters to the editor.

The Journal is affiliated to the ”Orthopaedic Research Group” an organisation dedicated to promoting Evidence Based Clinical Orthopaedic Research

For more information Visit the website of Asian Journal of Arthroplasty  www.asianarthroplasty.com

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Unique feature of course is Live Demonstration of over 10 surgeries and international faculty on field of Arthroscopy from UK and France

Please see the brochure below for registration details

Download Complete Brochure

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There are already quite few presenations on the website and we thank all the authors for sending us the presenations

For Publishing on our website, please send your presenations by email to us at indian.ortho@gmail.com

Please send a short introduction of the author and a digital photograph of the author

Click Here for all presentations

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Recent literature in every field of orthopaedics will be reviewed and interesting articles will be compiled together and presented as weekly updates

This will help in keeping update with recent literature and its controversies and will also help in presenting perspectives from different journals on similiar topics

With numerus articles being published in orthopaedics every month, it is difficult to track the significant ones. IORG Literature Update will not miss and significant article and will post all the articles that we feel add significantly to the current knowledge of orthopaedics will be included in IOG Literature Update.

These Updates will also be put up in varios sub speciality blogs where comments can be posted by viewers and discussions can be generated

To find the list of updates go to following Link

CLICK HERE

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Collaborative Authorship Training Program is an Online Programme with aim to train young orthopaedic surgeons in the art of writing Scientific Papers as a part of Collaborative Authorship Programme.

Under this programme there will be three Phases for the registered members

Phase I – Members who have newly registered with this program will be first asked to write summaries on small topics/ concise reviews. Articles and topics will be provided by IORG Team. Reviewing and editing of the article will be done by IORG Team and the reviews will be Published online in form of a online publication. The IORG member who has worked on the publication will be identified as the primary author of the publication and will be given due  acknowledgement. To complete this phase the member has to attend one Basic Course in Research Methodology organised by IORG.

Phase II – After Finishing at least 10 assignments (or as decided by IORG Core Committee) in Phase I, the member will be then enrolled into Phase II. Here he will be involved in preparing manuscripts for IORG Updates and also in writing review articles. A team of 3 members who have completed the Phase I will be formed and articles and guidelines will be provided to write a review article. Guidance will be provided by IORG team. These reviews will be published online at various platforms including IORG website, IORG Updates and IORG Journals. Authorship will be distributed among the team working on the publication and final decision will be taken by IORG Core Committee. To complete this Phase the Member has to attend the Advanced Course in Research Methodology organised by IORG.

Phase III – Entry in Phase III will be decided by IORG Core Committee and will be a function of members involvement with the writing work and the expertise he has gathered over a period of time. They will have the oppurtunity to be selected in following projects -

- Members from Phase III will be selected to work as Co-Authors on IORG Research Projects. Here the members will be directly involved in writing a scientific articles under direct guidance of IORG team. The contibution will be acknowledged in form of Co-Authorship in the published Journal Article. Invitation for such endevours and decision on the authorship will be decided by IORG Core Committee.

-Phase III Members will also be selected for writing Orthopaedic Literature Updates which will be published online every month and due credit will be given to authors for the publication.

-Members in Phase III will also be given official posts in IORG Journals depending on decision of IORG Core Committee.

-Members in Phase III will be called as speakers for IORG workshops and conferences as per their expertise.

In Phase III Members will be ready to take on their own projects and write their own papers.

We feel this Phase wise progression will help a great deal in step by step training of the orthopaedic surgeons in art and science of Good Clinical Writings and will help in building up confidence in the members when writing scintific Manuscripts. Also since this programme is not time bound, it will help surgeons to select appropriate time which they can dedicate to the work. Guidance from IORG team will help in developing the correct way of writing and preparing Journal Manuscripts. No fees will be involved in this programme and the progress of the member will directly depend on his interest and excellence in research.

Members in Phase III will receive a Certificate from IORG Declaring them as Member of IORG Scientific Research Board

The above terms and conditions are subject to change and IORG Core Committee reserves all rights for selection of members, articles and authorships.

All members who wish to get involved in Collaborative Authorship Programme should send us a mail at indian.ortho@gmail.com

Please write the subject of the mail as ‘Application for Collaborative Authorship Programme’

Please include following paragraph in the mail

- I Dr _________________________  wish to apply for inclusion into IORG Collaborative Authorship Programme. I have read and understood the terms and conditions and am ready to comply with them. I understand that decison of IORG Core committe will be final in terms of selection of topics, articles and authorships.

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