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Article ; Online: Is anterior cervical plating necessary for cage constructs in anterior cervical discectomy and fusion surgery for cervical degenerative disorders? Evidence-based on the systematic overview of meta-analyses.

Viswanathan, Vibhu Krishnan / Muthu, Sathish

World neurosurgery: X

2023 Volume 18, Page(s) 100185

Abstract: Study design: Systematic review of meta-analyses.: Objective: To perform a systematic review of meta-analyses to compare the clinical and radiological outcomes following anterior cervical discectomy and fusion with stand-alone cage (SAC) and anterior ...

Abstract	Study design: Systematic review of meta-analyses. Objective: To perform a systematic review of meta-analyses to compare the clinical and radiological outcomes following anterior cervical discectomy and fusion with stand-alone cage (SAC) and anterior cervical cage-plate constructs (ACCPC). Methods: The systematic overview was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and reported as per Cochrane Handbook for Systematic Reviews of Interventions following the methodology described in reporting Overview of reviews. Results: Based on the available level-1 evidence, SAC offers significantly better benefits over ACCPC, in terms of shorter operative time ( Conclusion: Based on the available evidence, SAC constructs in ACDF reduce blood loss, decreases operative time, mitigates post-operative dysphagia, lessens hospital-related expenditure and minimises long-term ASD rates.
Language	English
Publishing date	2023-03-21
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2590-1397
ISSN (online)	2590-1397
DOI	10.1016/j.wnsx.2023.100185
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: The role of peroneus longus (PL) autograft in the reconstruction of anterior cruciate ligament (ACL): A comprehensive narrative review.

Viswanathan, Vibhu Krishnan / Iyengar, Karthikeyan P / Jain, Vijay Kumar

Journal of clinical orthopaedics and trauma

2024 Volume 49, Page(s) 102352

Abstract: Background: Peroneus longus tendon (PLT) is a known graft utilised in the ligamentous reconstructions of knee. The current review was performed to analyze the available evidence regarding PLT in the arthroscopic anterior cruciate ligament (ACL) ... ...

Abstract	Background: Peroneus longus tendon (PLT) is a known graft utilised in the ligamentous reconstructions of knee. The current review was performed to analyze the available evidence regarding PLT in the arthroscopic anterior cruciate ligament (ACL) reconstruction. Methods: A comprehensive search of literature was performed on March 1, 2023 using 5 databases (for manuscripts published between 2010 and 2023). All studies reporting ACL reconstruction with PL graft in adults ≥18 years were considered; and final studies were shortlisted based on specific exclusion criteria. Results: The search identified 684 articles, among which 26 manuscripts were finally selected. PLT has been used in primary ACL reconstruction (ACLR), revision ACLR, ACLR in multiligamentous injuries and those at risk for anterior knee pain. The full-thickness PLT graft is variable in its dimensions with the mean size ranging between 7 and 8.8 mm (half-PLT grafts ≤8.1 mm). The ultimate strength of doubled PLT graft is significantly higher than native ACL and comparable to the quadrupled hamstring.There was statistically insignificant difference in the laxity and functional outcome of knee following ACLR with PLT, as compared with other autografts (p > 0.05). PLT harvest is associated with satisfactory clinical foot and ankle outcomes, as well as excellent regenerative ability. Overall, studies have demonstrated lower complications with PLT (p < 0.05). Conclusion: The dimensions of harvested PLT graft are more consistent than HT. It has similar functional outcome and survival, as compared to other autografts. It also has lower risk for donor-site morbidity and lower complications than HT. PLT is a promising, alternative autograft choice in patients undergoing ACLR.
Language	English
Publishing date	2024-02-01
Publishing country	India
Document type	Journal Article ; Review
ZDB-ID	2596956-0
ISSN	2213-3445 ; 0976-5662
ISSN (online)	2213-3445
ISSN	0976-5662
DOI	10.1016/j.jcot.2024.102352
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Letter to the Editor: Is Anterior-Only Fixation Adequate for Three-Column Injuries of the Cervical Spine?

Viswanathan, Vibhu Krishnan / Subramanian, Surabhi

Asian spine journal

2021 Volume 15, Issue 3, Page(s) 408–409

Language	English
Publishing date	2021-06-17
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	2559763-2
ISSN	1976-7846 ; 1976-1902
ISSN (online)	1976-7846
ISSN	1976-1902
DOI	10.31616/asj.2021.0108.r1
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Bilateral erector spinae plane block for postoperative pain relief in lumbar spine surgery: A PRISMA-compliant updated systematic review & meta-analysis.

Muthu, Sathish / Viswanathan, Vibhu Krishnan / Annamalai, Saravanan / Thabrez, Mohammed

World neurosurgery: X

2024 Volume 23, Page(s) 100360

Abstract: Study design: Systematic review.: Objective: Erector spinae plane block (ESPB) is growing in popularity over the recent past as an adjuvant modality in multimodal analgesic management following lumbar spine surgery (LSS). The current updated meta- ... ...

Abstract	Study design: Systematic review. Objective: Erector spinae plane block (ESPB) is growing in popularity over the recent past as an adjuvant modality in multimodal analgesic management following lumbar spine surgery (LSS). The current updated meta-analysis was performed to analyze the efficacy of ESPB for postoperative analgesia in patients undergoing LSS. Methods: We conducted independent and duplicate electronic database searches including PubMed, Embase and Cochrane Library till June 2023 for randomized controlled trials (RCTs) analyzing the efficacy of bilateral ESPB for postoperative pain relief in lumbar spine surgeries. Post-operative pain scores, total analgesic consumption, first analgesic requirement time, length of stay and complications were the outcomes evaluated. Statistical analysis was performed using STATA 17 software. Results: 32 RCTs including 1464 patients (ESPB/Control = 1077/1069) were included in the analysis. There was a significant pain relief in ESPB group, as compared to placebo across all timelines such as during immediate post-operative period ( Conclusion: ESPB offers prolonged post-operative pain relief compared to controls, thereby reducing the need for opioid consumption and its related complications.
Language	English
Publishing date	2024-03-11
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2590-1397
ISSN (online)	2590-1397
DOI	10.1016/j.wnsx.2024.100360
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Does progress in microfracture techniques necessarily translate into clinical effectiveness?

Muthu, Sathish / Viswanathan, Vibhu Krishnan / Sakthivel, Manoharan / Thabrez, Mohammed

World journal of orthopedics

2024 Volume 15, Issue 3, Page(s) 266–284

Abstract: Background: Multitudinous advancements have been made to the traditional microfracture (MFx) technique, which have involved delivery of various acellular 2: Aim: To comparatively analyze the functional, radiological, and histological outcomes, and ... ...

Abstract	Background: Multitudinous advancements have been made to the traditional microfracture (MFx) technique, which have involved delivery of various acellular 2 Aim: To comparatively analyze the functional, radiological, and histological outcomes, and complications of various generations of MFx available for the treatment of cartilage defects. Methods: A systematic review was performed using PubMed, EMBASE, Web of Science, Cochrane, and Scopus. Patients of any age and sex with cartilage defects undergoing any form of MFx were considered for analysis. We included only randomized controlled trials (RCTs) reporting functional, radiological, histological outcomes or complications of various generations of MFx for the management of cartilage defects. Network meta-analysis (NMA) was conducted in Stata and Cochrane's Confidence in NMA approach was utilized for appraisal of evidence. Results: Forty-four RCTs were included in the analysis with patients of mean age of 39.40 (± 9.46) years. Upon comparing the results of the other generations with MFX-I as a constant comparator, we noted a trend towards better pain control and functional outcome (KOOS, IKDC, and Cincinnati scores) at the end of 1-, 2-, and 5-year time points with MFx-III, although the differences were not statistically significant ( Conclusion: The higher generations of traditional MFx technique utilizing acellular and cellular components to augment its potential in the management of cartilage defects has shown only marginal improvement in the clinical and radiological outcomes.
Language	English
Publishing date	2024-03-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	2649712-8
ISSN	2218-5836
ISSN	2218-5836
DOI	10.5312/wjo.v15.i3.266
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: What are the predisposing factors for periprosthetic fractures following total hip arthroplasty? - a National Inpatient Sample-based study.

Viswanathan, Vibhu Krishnan / Subramanian, Surabhi / Mounasamy, Varatharaj / Sambandam, Senthil

Archives of orthopaedic and trauma surgery

2024

Abstract: Introduction: With a progressive rise in the number of total hip arthroplasties (THA) over the past decades, the proportion of patients sustaining peri-prosthetic fractures (PPF) has been substantially increasing. In this context, the need for clearly ... ...

Abstract	Introduction: With a progressive rise in the number of total hip arthroplasties (THA) over the past decades, the proportion of patients sustaining peri-prosthetic fractures (PPF) has been substantially increasing. In this context, the need for clearly understanding the factors predisposing patients to PPF following THA and the impact of these adverse complications on the overall healthcare burden cannot be understated. Materials and methods: Based upon the Nationwide Inpatient Sample (NIS) database, the patients who underwent THA in the United States between 2016 and2019 (with ICD-10 CMP code) were identified. The patients were divided into 2 groups; group A - patients who sustained PPF and group B - those who did not. The information about the patients' demographic profile, medical comorbidities; and hospital admission (including length of stay and expenditure incurred) were analysed; and compared between the 2 groups. Results: Overall, 367,890 patients underwent THA, among whom 4,425 (1.2%) sustained PPF (group A). The remaining patients were classified under group B (363,465 patients). On the basis of multi-variate analysis (MVA), there was a significantly greater proportion of females, elderly patients, and emergent admissions (p < 0.001) in group A. The length of hospital stay, expenditure incurred and mortality were also significantly higher (p = 0.001) in group A. Based on MVA, Down's syndrome (odd's ratio 3.15, p = 0.01), H/O colostomy (odd's ratio 2.09, p = 0.008), liver cirrhosis (odd's ratio 2.01, p < 0.001), Parkinson's disease (odd's ratio 1.49, p = 0.004), morbid obesity (odd's ratio 1.44, p < 0.001), super obesity (odd's ratio 1.49, p = 0.03), and H/O CABG (coronary artery bypass graft; odd's ratio 1.21, p = 0.03) demonstrated significant association with PPF (group A). Conclusion: Patients with PPF require higher rates of emergent admission, longer hospital stay and greater admission-related expenditure. Female sex, advanced age, morbid or super obesity, and presence of medical comorbidities (such as Down's syndrome, cirrhosis, Parkinson's disease, previous colostomy, and previous CABG) significantly enhance the risk of PPF after THA. These medical conditions must be kept in clinicians' minds and close follow-up needs to be implemented in such situations so as to mitigate these complications.
Language	English
Publishing date	2024-04-25
Publishing country	Germany
Document type	Journal Article
ZDB-ID	80407-1
ISSN	1434-3916 ; 0003-9330 ; 0344-8444
ISSN (online)	1434-3916
ISSN	0003-9330 ; 0344-8444
DOI	10.1007/s00402-024-05343-0
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Article ; Online: Letter to the Editor

Vibhu Krishnan Viswanathan / Surabhi Subramanian

Asian Spine Journal, Vol 15, Iss 3, Pp 408-

Is Anterior-Only Fixation Adequate for Three-Column Injuries of the Cervical Spine?

2021 Volume 409

Keywords	Medicine ; R
Language	English
Publishing date	2021-06-01T00:00:00Z
Publisher	Korean Spine Society
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Letter to the Editor: Does Combined Anterior-Posterior Approach Improve Outcomes Compared with Posterior-only Approach in Traumatic Thoracolumbar Burst Fractures?: A Systematic Review.

Pratheep, K Guna / Viswanathan, Vibhu Krishnan

Asian spine journal

2020 Volume 14, Issue 5, Page(s) 760–761

Language	English
Publishing date	2020-10-14
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	2559763-2
ISSN	1976-7846 ; 1976-1902
ISSN (online)	1976-7846
ISSN	1976-1902
DOI	10.31616/asj.2020.0388.r1
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: An updated meta-analysis comparing complications, functional, clinically relevant and radiological outcomes of accelerometer based portable navigation and conventional technique of total knee arthroplasty.

Vishwanathan, Karthik / Jain, Vijay Kumar / Patralekh, Mohit Kumar / Viswanathan, Vibhu Krishnan

Journal of orthopaedics

2023 Volume 46, Page(s) 24–50

Abstract: Introduction: Since previous studies, including small-scale meta-analyses comparing accelerometer-based portable navigation (APN-TKA) and conventional techniqueof total knee arthroplasty (CONV-TKA), have reported divergent results, there is a need for ... ...

Abstract	Introduction: Since previous studies, including small-scale meta-analyses comparing accelerometer-based portable navigation (APN-TKA) and conventional techniqueof total knee arthroplasty (CONV-TKA), have reported divergent results, there is a need for an updated meta-analysis to compare complications, functional outcomes, clinically relevant outcomes and radiographic alignment of components. Methods: This meta-analysis was conducted as per PRISMA guidelines. Randomised controlled trials, and non-randomised comparative cohort studies in English language on primary TKA were included. The complications compared were Deep Vein Thrombosis (DVT), Pulmonary Embolism (PE), infection, manipulation under anaesthesia (MUA) for postoperative knee stiffness, re-operation and mortality. The functional outcomes compared were the Knee Society Knee Score, Knee Society Score function, Oxford Knee Score, Knee Injury and Osteoarthritis Outcome Score and Western Ontario and McMaster Universities Arthritis Index. The evaluated clinically relevant outcomes were surgical time, blood loss, drop in haematocrit, tourniquet time, postoperative knee flexion and complications). The number of radiological outliers; as well as the absolute values of the alignment of the overall prosthesis, femoral and tibial components in both coronal and sagittal planes, was assessed. Results: Twenty-five studies were included. Both the groups were comparable in terms of preoperative demographic features. There was no difference in complications and functional outcomes. Operation time was longer in APN-TKA (p < 0.00001) but there was no difference in rest of the clinically relevant outcomes. Restoration of the lower limb mechanical axis (p = 0.003) and coronal femoral alignment angle (p = 0.0002) was better with APN. APN also significantly reduced the risk of the odds of outliers of lower limb mechanical axis (p < 0.0001), coronal femoral alignment (p = 0.03), coronal tibial alignment (p < 0.0001) and sagittal tibial alignment (p = 0.0001). Conclusion: The improvement in the accuracy of implantation by the use of APN-TKA, as determined by the overall alignments of prosthesis, or femoral and tibial components, does not necessarily translate into lesser complications and better functional and clinical outcomes. Level of evidence: Therapeutic study, Level II.
Language	English
Publishing date	2023-10-27
Publishing country	India
Document type	Journal Article
ZDB-ID	2240839-3
ISSN	0972-978X
ISSN	0972-978X
DOI	10.1016/j.jor.2023.10.012
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Letter to the Editor: Long-term Outcomes of

Subramanian, Surabhi / Viswanathan, Vibhu Krishnan

Asian spine journal

2017 Volume 11, Issue 5, Page(s) 843–844

Language	English
Publishing date	2017-10-11
Publishing country	Korea (South)
Document type	Journal Article ; Comment
ZDB-ID	2559763-2
ISSN	1976-7846 ; 1976-1902
ISSN (online)	1976-7846
ISSN	1976-1902
DOI	10.4184/asj.2017.11.5.843
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