Vivek A Patel

Abstract

Introduction: Total knee arthroplasty is one of the commonest musculoskeletol pain relieving surgery now a days. The long legacy of the different surgical techniques attracts the orthopaedic surgeons to opt for better results oriented techniques. Since in the mid 19s of origin of early knee arthroplasty to 2014 of gap balancing vs measured resection technique from US to the recent navigation & robotics era, different study showed improved results. For developing countries with financial constrains cost effective & results oriented more studies warranted. Objectives: To study the results of all femoral cuts first followed by tibial cuts as a measured resection technique based on anatomical landmarks followed by scientific soft tissue balancing for total knee arthroplasty. Materials and Methods: We have analyzed total (n= 126) the total knee replacement surgeries operated by our team during last 48 months retrospectively. Mean age was 66 years. All the Knee arthritis classified by Kellgren & Lawrence classification preoperatively. Results were evaluated by Oxford knee score (OKS). Results: According to OKS 92.91% had excellent to good results & 7.09% had fair to poor results (95% CI).Out of fair to poor results group 33.56% patients were 65 years of age. Conclusion: Total femur first followed by tibial measured resection cuts based on anatomical landmarks backed up with scientific soft tissue balancing & admission of all the other disciplines for total knee arthroplasty is a results oriented technique for increasing burden of operative patients & decreasing social morbidity. Keywords: Knee arthroplasty, Soft tissue balancing, Anatomical land marks, Arthritis, Femur first.

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Abstract

Introduction: Surgical site Infections (SSI) of the musculoskeletal system leads to High morbidity, mortality and sometimes limb amputation. In 1999 US Centre for Disease Prevention and Control (CDC) gave guidelines for prevention and hoped for preventing emergence of antimicrobial resistance for surgeries. Orthopaedic surgeries and arthroplasty inferences from high turnover centers of developing countries with cost effectiveness are always awaited with development of new surgical skill and techniques, better instruments and better anti-infective approach. Objectives: To study the effectiveness of intrawound vancomycin Powder and Special Multidisciplinary approach to control SSI in musculoskeletol surgeries. Materials and Methods: We have analysed (n=210) patients operated for trauma, joint reconstruction and arthroplsty orthopedic surgeries during 12 months duration retrospectively. Mean age was 51 and all operated with multidiscipline approach. Patients were evaluated by ASEPSIS Score. Results: In our study SSI rate was 13.88% in open fractures surgery out of (n= 36) patients and 1.33% in closed procedures out of (n=150) patients and total rate of Surgical site infection was 3.33% in our study with 95% confidence Interval (95% CI). Conclusion: Intrawound vancomycin Powder with strict adherence and implementation of Multidiscipline approach is effective to control SSI which allows major step forward in Preventing SSI and reducing national morbidity. Keywords: Arthroplsty, Orthopaedic, Vancomycin, Multidiscipline approach Introduction

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