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Article: Surgeon Burnout-Time to Heal the Healers.

Jain, Mantu / Sakale, Harshal / Sriramka, Bhavna / Shyam, Ashok

2024 Volume 14, Issue 2, Page(s) 5–6

Language	English
Publishing date	2024-02-12
Publishing country	India
Document type	Editorial
ZDB-ID	2658169-3
ISSN	2250-0685
ISSN	2250-0685
DOI	10.13107/jocr.2024.v14.i02.4196
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Short-term Follow-up of Autologous Adult Live-Cultured Osteoblasts Implantation in Avascular Necrosis of Femoral Head Secondary to Sickle Cell Anemia-Case Series.

Agrawal, Alok Chandra / Sakale, Harshal / Garg, Ankit Kumar / Inamdar, Anupam

Journal of orthopaedic case reports

2023 Volume 13, Issue 4, Page(s) 57–61

Abstract: Introduction: The prevalence of avascular necrosis (AVN) of the femoral head in sickle cell anemia is 50% whereas untreated cases lead to total hip replacement. The recent development in cellular therapy paves the way to utilize autologous adult live- ... ...

Abstract	Introduction: The prevalence of avascular necrosis (AVN) of the femoral head in sickle cell anemia is 50% whereas untreated cases lead to total hip replacement. The recent development in cellular therapy paves the way to utilize autologous adult live-cultured osteoblasts (AALCO) in the management of AVN of the femoral head secondary to sickle cell anemia. Case report: We performed AALCO implantation in sickle cell anemia cases with AVN of the femoral head and were followed up for 6 months with the regular recording of visual analog score and modified Harris Hip Score. Conclusion: AALCO implantation for the management of AVN of the femoral head due to sickle cell anemia appears to be the biological management of choice as it results in pain reduction and improvement in function.
Language	English
Publishing date	2023-04-05
Publishing country	India
Document type	Case Reports
ZDB-ID	2658169-3
ISSN	2250-0685
ISSN	2250-0685
DOI	10.13107/jocr.2023.v13.i04.3616
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Article: Total Hip Arthroplasty in Neglected Acetabular Fracture with Pipkin Type 4 Femoral Head Fracture. A Case Report.

Agrawal, Alok C / Rai, Bhashker / Rai, Alok / Sakale, Harshal / Garg, Ankit Kumar

Journal of orthopaedic case reports

2023 Volume 13, Issue 11, Page(s) 162–166

Abstract: Introduction: Pipkin type 4 fracture is defined as hip dislocation with femoral head fracture and concomitant acetabular rim fracture. These fractures are rare. Neglected fractures develop adaptive changes in the acetabulum, femoral head, and soft ... ...

Abstract	Introduction: Pipkin type 4 fracture is defined as hip dislocation with femoral head fracture and concomitant acetabular rim fracture. These fractures are rare. Neglected fractures develop adaptive changes in the acetabulum, femoral head, and soft tissues around the hip joint, leading to hip arthritis. Total hip arthroplasty is preferred in such cases. After an extensive literature review, we did not find any guidelines for managing neglected Pipkin type 4 fractures. Case report: A 47-year-old male presented with pain in his left hip and an inability to bear weight on his left lower limb. He had a road traffic accident 1 year ago. On clinical examination, there was a shortening of 3 cm and reduced hip range of motion on 3D computed tomography posterosuperior defect of the acetabular wall along with Pipkin type 4 femoral head fracture was detected. Total hip arthroplasty with acetabular reconstruction using a femoral head autograft was done. At 1 year of follow-up, the patient was pain-free and could walk without any assistance with a normal gait. Conclusion: Uncemented total hip arthroplasty with an autologous structural femoral head graft is a suitable method of treatment for neglected Pipkin type 4 fractures. It preserves bone stock and does not add any financial burden.
Language	English
Publishing date	2023-11-19
Publishing country	India
Document type	Case Reports
ZDB-ID	2658169-3
ISSN	2250-0685
ISSN	2250-0685
DOI	10.13107/jocr.2023.v13.i11.4046
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Article: Use of Vancomycin Mixed Bone Graft and Vancomycin Mixed Saline Wash Before Wound Closure Reduces the Rate of Infection in Lumbar Spine Fusion Surgery.

Kar, Bikram / Venishetty, Nagaraju / Kumar Yadav, Sandeep / Sakale, Harshal

Cureus

2021 Volume 13, Issue 8, Page(s) e17275

Abstract: This study aims to evaluate whether surgical site vancomycin mixed in bone grafts and local vancomycin mixed in normal saline wash before wound closure decrease the infection rates in patients undergoing lumbar spinal instrumentation and posterolateral ... ...

Abstract	This study aims to evaluate whether surgical site vancomycin mixed in bone grafts and local vancomycin mixed in normal saline wash before wound closure decrease the infection rates in patients undergoing lumbar spinal instrumentation and posterolateral fusion. A retrospective study was performed on cases between 2017 and 2019, who underwent lumbar spine instrumentation and posterolateral fusion for lumbar canal stenosis or listhesis. The routine prophylactic procedures were performed in all patients as per institutional protocol. Patients' records were analysed and categorised into two groups, the vancomycin group (VG), where vancomycin mixed in bone graft and normal saline wash was used at the surgical site, and the control group (CG), where vancomycin was not used. The study included 63 patients, 31 in VG and 32 in CG. There is no statistical difference in age, sex, and diabetes mellitus in both groups. A total of seven cases were infected, six in CG (6/32) and one in VG (1/31). Out of six infections in CG, three patients had diabetes and four infected cases underwent surgery for debridement. In VG, the only single case got infected and treated with intravenous antibiotics. We found that the use of vancomycin added to the bone graft and normal saline in posterior lumbar spinal instrumentation and posterolateral fusion is associated with significantly lower rates of infection (p value=0.049).
Language	English
Publishing date	2021-08-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.17275
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Article: Pathological Fractures of Bilateral Neck of Femur in Geriatric Population: Our Experience and Review of Literature.

Sakale, Harshal / Yadav, Sandeep Kumar / Kar, Bikram Keshri / Kowshik, Sharath / Agrawal, Alok Chandra / Ranjan, Rahul

Journal of orthopaedic case reports

2022 Volume 12, Issue 6, Page(s) 1–4

Abstract: Introduction: Bilateral neck of femur stress fractures is rare clinical presentation in elderly population. Diagnosis of such fractures when presented can be difficult with inconclusive radiographs and hence their early diagnosis by high index of ... ...

Abstract	Introduction: Bilateral neck of femur stress fractures is rare clinical presentation in elderly population. Diagnosis of such fractures when presented can be difficult with inconclusive radiographs and hence their early diagnosis by high index of suspicion and their management can avoid further complications in this age group. In this case series, we report three elderly patients with different predisposing factors for their fractures and treatment options chosen with detailed discussion about the management. Case report: These case series of three elderly patients with bilateral neck of femur fracture were associated with different predisposing factors. Grave's disease or primary thyrotoxicosis, steroid induced osteoporosis, and renal osteodystrophy were the identified risk factors in these patients. Biochemical evaluation for osteoporosis in these patients revealed significant derangement in levels of vitamin D, Alkaline phosphatase, and serum calcium. One of these patients was operated with hemiarthroplasty and osteosynthesis with percutaneous screw fixation on the other side. Management of osteoporosis, dietary modifications, and lifestyle changes in these patients also had significant impact on their prognosis. Conclusion: Stress fractures occurring in elderly individuals with simultaneous bilateral presentation are rare and can be prevented if taken care on their risk factors. As radiographs remain inconclusive few times in these kinds of fracture, a high degree of suspicion is to be kept in mind. With advanced diagnostic tools and surgeries, they carry good prognosis if timely intervention is provided.
Language	English
Publishing date	2022-06-10
Publishing country	India
Document type	Case Reports
ZDB-ID	2658169-3
ISSN	2250-0685
ISSN	2250-0685
DOI	10.13107/jocr.2022.v12.i06.2840
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Article: Plasma Interleukin-33 Cannot Predict Hip Osteonecrosis in Patients With Sickle Cell Disease: A Case-Control Study.

Agrawal, Alok C / Mohapatra, Eli / Nanda, Rachita / Bodhey, Narendra Kuber / Sakale, Harshal / Garg, Ankit Kumar

Cureus

2022 Volume 14, Issue 3, Page(s) e23556

Abstract: Background Plasma interleukin-33 (IL-33), a cytokine associated with inflammatory and autoimmune disease, has been described to be significantly raised in osteonecrosis of the femoral head (ONFH) and hence was recommended for use as a marker for ONFH. ... ...

Abstract	Background Plasma interleukin-33 (IL-33), a cytokine associated with inflammatory and autoimmune disease, has been described to be significantly raised in osteonecrosis of the femoral head (ONFH) and hence was recommended for use as a marker for ONFH. The concentration of plasma interleukin-33 level has not been estimated in any studies conducted in patients with sickle cell disease (SCD); hence, we investigated the levels of plasma interleukin-33 in patients with sickle cell disease with or without ONFH to assess whether it can be used as a marker for the early detection of ONFH in this disease also. Methods Forty-four consecutive patients with sickle cell disease with osteonecrosis of the femoral head and matched controls without ONFH were evaluated for plasma interleukin-33 levels by enzyme-linked immunosorbent assay (ELISA). All patients were confirmed for sickle cell disease using high-performance liquid chromatography (HPLC). ONFH was diagnosed in patients with sickle cell disease using clinical-radiological findings. Univariate and multivariate analyses were performed using the IL-33 level as the dependent variable. Results Plasma IL-33 levels were comparable in 44 patients with sickle cell disease with osteonecrosis of the femoral head as compared with 24 patients with sickle cell disease without ONFH (2.05 ± 4.57 pg/mL versus 1.50 ± 2.89 pg/mL, p-value = 0.590). There was no significant difference in IL-33 levels in different stages of avascular necrosis (AVN). Conclusions Plasma interleukin-33 levels cannot act as a marker of ONFH as were being considered in idiopathic ONFH or ONFH caused by other causes such as trauma and chronic steroid or alcohol usage.
Language	English
Publishing date	2022-03-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.23556
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Article: Outcomes of Tumor Resection and Reconstruction by Megaprosthesis around Knee: Our Experience.

Kar, Bikram Kesari / Ojha, Mukund Madhav / Yadav, Sandeep Kumar / Agrawal, Alok Chandra / Sakale, Harshal

Journal of orthopaedic case reports

2022 Volume 11, Issue 6, Page(s) 49–52

Abstract: Introduction: In this modern era, limb reconstructive surgeries have become a standardized procedure for malignant tumor of lower limbs. We performed limb salvage surgeries for tumor around the knee with en bloc resection and subsequent reconstruction ... ...

Abstract	Introduction: In this modern era, limb reconstructive surgeries have become a standardized procedure for malignant tumor of lower limbs. We performed limb salvage surgeries for tumor around the knee with en bloc resection and subsequent reconstruction with a megaprosthesis. Methods: A total of six cases of malignant and locally aggressive tumor around the knee were operated on from 2017 to 2018, with resection and mega prosthetic reconstruction. Interpretation of functional outcome after surgery was performed with musculoskeletal tumor society (MSTS) score. Complications such as infection, local recurrence of tumor, implant failure, and distant metastases were evaluated during each follow-up. Results: Postoperatively, one patient developed superficial infection; one local recurrence with metastasis and the rest cases were uneventful. Patients were regularly followed for atleast1 year, and none of them developed any sign of deep infection, implant failure,or loosening. At the beginning of treatment, the average MSTS score was 8.83, which showed a significant increment to 25.83 after 12 months of follow-up. Conclusion: Albeit few cases were operated on, we draw this inference from our short-term experience that mega prosthesis acts as a boon to orthopedic surgeons in musculoskeletal tumor management, thereby uplifting the quality of life of patients even during terminal care.
Language	English
Publishing date	2022-04-14
Publishing country	India
Document type	Case Reports
ZDB-ID	2658169-3
ISSN	2250-0685
ISSN	2250-0685
DOI	10.13107/jocr.2021.v11.i06.2254
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Article: Usage of Accessory Anteromedial Portal for Anatomical Placement of Femoral Tunnel in Transportal Anterior Cruciate Ligament Reconstruction: A Prospective Study.

Sakale, Harshal / Agrawal, Alok C / Ojha, Mukund Madhav / Kar, Bikram / J, Rakshit / Choudhary, Ranjeet

Cureus

2021 Volume 13, Issue 8, Page(s) e17095

Abstract: Background and objective The anterior cruciate ligament (ACL) has an essential role in preserving the function and stability of the knee joint. It acts primarily to prevent anterior tibial translation. Arthroscopic ACL reconstruction using quadrupled ... ...

Abstract	Background and objective The anterior cruciate ligament (ACL) has an essential role in preserving the function and stability of the knee joint. It acts primarily to prevent anterior tibial translation. Arthroscopic ACL reconstruction using quadrupled hamstring graft is the widely practiced modality for treating ACL injuries nowadays. The objective of this study was to assess the functional outcomes of ACL reconstruction using the transportal approach for a femoral tunnel through an accessory anteromedial portal (AAM). Materials and methods This prospective study included 35 patients who met the inclusion criteria. All patients underwent arthroscopic reconstruction of ACL using quadrupled hamstring tendon graft via transportal technique for femoral canal reaming through AAM. Patients were assessed for the functional outcome for a year using the Tegner-Lysholm knee scoring system. Results The analysis of the studied cases revealed that the mean age of the patients was around 27 years. Males were affected more than females. The left side (77.14%) was affected more than the right side (22.86%); 54.28% of patients had a history of road traffic accidents (RTAs). Preoperatively, 19 (54.28%) patients had poor and 16 (45.72%) patients had fair Tegner-Lysholm scores. After one year of follow-up, 29 (82.85%) of the patients had an excellent score as per the Tegner-Lysholm scoring system. Three patients had knee pain and thigh muscle wasting (2-3 cm), and two of them also had a sense of giving away during follow-up. Conclusion Anatomical reattachment of tendon graft for ACL reconstruction at femoral and tibial footprints is indispensable for good functional outcome and knee kinematics, and the usage of the AAM provides good visualization of femoral footprint and ease to surgeons during ACL reconstruction for making a near-accurate femoral tunnel and thereby achieving better outcomes.
Language	English
Publishing date	2021-08-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.17095
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Article: Mammoth Giant Cell Tumor of the First Metacarpal: A Case Report and Management Trends.

Agrawal, Alok C / Verma, Shilp / Kar, Bikram / Sakale, Harshal / Choudhary, Ranjeet

Cureus

2021 Volume 13, Issue 7, Page(s) e16150

Abstract: Giant cell tumor (GCT) is classically described as a locally aggressive, epiphyseo-metaphyseal osteolytic tumor occurring in young adults. They are mostly seen in long bones while some are also found in the iliac bone and spine and a very small ... ...

Abstract	Giant cell tumor (GCT) is classically described as a locally aggressive, epiphyseo-metaphyseal osteolytic tumor occurring in young adults. They are mostly seen in long bones while some are also found in the iliac bone and spine and a very small proportion occurs in hand bones. Due to the rarity of GCT in metacarpal, there is a paucity of treatment options available. In an extensive literature search on PubMed, Embase, Medline, and Ovid from 2004 till date, very few cases were reported. The various treatment options available are intralesional curettage with or without adjuvant therapy, wide resection, free osteoarticular metatarsal transfer, and, occasionally, ray amputation may also be done. After simple curettage, a reasonably high recurrence rate also imposes comprehensive en-bloc excision, but still, there are many case reports of recurrence. Experience with a case of GCT of the whole first metacarpal extending from the carpometacarpal to the metacarpophalangeal joint is not thoroughly described in the literature. We hereby report a mammoth GCT of the first metacarpal treated by excision and reconstruction by free fibular graft and adjacent joint fusion with an excellent functional outcome at one-year follow-up.
Language	English
Publishing date	2021-07-03
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.16150
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Article: Role of decompression in late presentation of cervical spinal cord disorders.

Shrivastava, Sandeep / Sakale, Harshal / Dulani, Rajesh / Singh, Pradeep K / Sanrakhia, Manoj

Asian spine journal

2014 Volume 8, Issue 2, Page(s) 183–189

Abstract: Study design: Prospective study conducted at Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, India.: Purpose: To show the efficacy of decompression in the late presentation of cervical spinal cord disorders.: ... ...

Abstract	Study design: Prospective study conducted at Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, India. Purpose: To show the efficacy of decompression in the late presentation of cervical spinal cord disorders. Overview of literature: Studies by various authors have shown that early spinal decompression results in better neurological outcomes. Methods: From January 2003 to January 2005, 11 of the 41 patients with cervical spinal cord compression, meeting the inclusion criteria, underwent anterior decompression; interbody graft placement and stabilization by anterior cervical locking plate. The neurologic and functional outcomes were recorded. Results: Five patients had spinal cord injury and 6 patients had compressive cervical myelopathy. Complications included 1 death and 1 plate loosening. No patient lost their preoperative neurological status. One patient had no improvement, 2 patients showed full recovery. The mean follow-up is 28.3 month. At the of rehabilitation, 6 were able to walk without support), 2 could walk with support, and 1 needed a wheelchair. The average American Spinal Injury Association motor score on admission to the hospital, 32.8 (standard deviation [SD], 30.5); admission to rehabilitation, 38.6 (SD, 32.4); discharge from rehabilitation, 46.2 (SD, 33.7). The most recent follow-up was 64.0 (SD, 35.3). Conclusions: The anterior approach for cervical decompression allows for adequate decompression. This decompression is the best chance offered in even late reported cases, including posttraumatic cases where there is no evidence of cord transactions. The use of anterior cervical plates reduces the chances of graft loosening, extruding, or collapsing.
Language	English
Publishing date	2014-04-08
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	10.4184/asj.2014.8.2.183
Database	MEDical Literature Analysis and Retrieval System OnLINE

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