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World Journal of Orthopedics 2016年第7期7卷 426-433页

作者： Raju Vaishya Vipul Vijay Vikas P Birla Amit K Agarwal department of orthopaedics Joint Replacement and ArthroscopyIndraprastha Apollo Hospital

AIM: To compare the postoperative mechanical alignment achieved after total knee arthroplasty(TKA) using computer tomography(CT) based patient specific blocks(PSB) to conventional instruments(CI).METHODS: Total 80 knees were included in the study, with 40 knees in both the groups operated using PSB and CI. All the knees were performed by a single surgeon using the same cruciate sacrificing implants. In our study we used CT based PSB to compare with CI. Postoperative mechanical femoro-tibial angle(MFT angle) was measured on long leg x-rays using picture archiving and communication system(PACS). We compared mechanical alignment achieved using PSB and CI in TKA using statistical ***: The PSB group(group 1) included 17 females and seven males while in CI group(group 2) there were 15 females and eight males. The mean age of patients in group 1 was 60.5 years and in group 2 it was 60.2 years. The mean postoperative MFT angle measured on long-leg radiographs in group 1 was 178.23°(SD = 2.67°, range: 171.9° to 182.5°) while in group 2, the mean MFT angle was 175.73°(SD = 3.62°, range: 166.0° to 179.8°). There was significant improvement in postoperative mechanical alignment(P value = 0.001), in PSB group compared to CI. Number of outliers were also found to be less in group operated with PSB(7 Knee) compared to those operated with CI(17 Knee).CONCLUSION: PSB improve mechanical alignment after total knee arthroplasty, compared to CI. This may lead to lower rates of revision in the PSB based TKA as compared to the conventional instrumentation.

关键词： Knee replacement Arthroplasty Patient specific jigs Conventional jigs

Up-regulation of Cartilage Oligomeric Matrix Protein Gene Expression by Insulin-like Growth Factor-Ⅰ Revealed by Real Time Reverse Transcription-Polymerase Chain Reaction

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Acta Biochimica et Biophysica Sinica 2006年第10期38卷 677-682页

作者： Hua TIAN~(1,2*) Ioannis STOGIANNIDIS~2 1 department of orthopaedics,Peking University Third Hospital,Beijing 100083,China 2 Coxa Hospital for joint replacement,Biokatu 6 b,Tampere 33101,Finland department of orthopaedics Peking University Third HospitalBeijing 100083 China Coxa Hospital for joint replacement Biokatu 6 bTampere 33101 Finland

Cartilage oligomeric matrix protein (COMP) strengthens cartilage by binding to type Ⅱ and typeⅨ collagen-forming bridges between collagen *** was hypothesized that perhaps one or more anabolicgrowth factors such as insulin-like growth factor-Ⅰ (IGF-Ⅰ),fibroblast growth factor-1 (FGF-1) or plateletderived growth factor-BB (PDGF-BB) increase COMP gene *** effects on primary humanchondrocytes and the chondrogenic cell line ATDC5 were studied using real time reverse transcript-poly-merase chain reaction (RT-PCR) for ***-Ⅰ,but not the FGF-1 or PDGF-BB,up-regulatedCOMP gene expression by approximate 5-fold in human adult chondrocytes in a dose-and ***-Ⅰ exerted similar effects on ATDC5 *** from these real time RT-PCR experimentswere confirmed by transfecting into ATDC5 cells a full-length mouse COMP promoter cloned upstream of aluciferase reporter *** stimulation with IGF-Ⅰ,the luciferase reporter activity increased by about *** conclusion,IGF-Ⅰ seems to be an important positive regulator of COMP,which may play animportant role in an attempted repair of either traumatized or degenerated cartilage.

关键词： cartilage oligomeric matrix protein (COMP) insulin-like growth factor-Ⅰ(IGF-Ⅰ) gene expression

Navigating the ethical terrain:Off-label and experimental treatments in medical case reports

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World Journal of Methodology 2025年第1期15卷 1-5页

作者： Madhan Jeyaraman Naveen Jeyaraman Swaminathan Ramasubramanian Sangeetha Balaji department of orthopaedics ACS Medical College and HospitalDr MGR Educational and Research InstituteChennai 600077India department of orthopaedics Government Medical CollegeOmandurar Government EstateChennai 600002India

This article explores the ethical considerations surrounding the reporting of offlabel and experimental treatments in medical case reports,with a focus on fields such as oncology,psychiatry,and *** emphasizes the balance between innovation and evidence-based medicine,highlighting the critical role of case reports in disseminating clinical experiences and advancing medical *** discussion delves into the ethical framework guiding case reporting,including principles of patient autonomy,informed consent,non-maleficence,beneficence,justice,and *** such as negative outcome reporting,commercial interests,and the balance between innovation and caution are *** for ethical vigilance,the development of comprehensive guidelines,and the role of regulatory bodies are proposed to ensure patient safety and uphold scientific *** article concludes by underscoring the importance of a collaborative effort among clinicians,researchers,ethicists,and regulatory bodies to foster the responsible advancement of medical science while adhering to the highest ethical standards.

关键词： Ethical considerations Patient autonomy Informed consent Non-maleficence Beneficence Transparency Evidence-based medicine

Malpractice or masterful practice?Navigating vicarious liability in healthcare

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World Journal of Clinical Cases 2025年第2期13卷 10-13页

作者： Satvik N Pai Naveen Jeyaraman Madhan Jeyaraman Swaminathan Ramasubramanian department of orthopaedics PES University Institute of Medical Sciences and ResearchBengaluru 560100KarnatakaIndia department of orthopaedics ACS Medical College and HospitalDr MGR Educational and Research InstituteChennai 600077Tamil NaduIndia department of orthopaedics Government Medical CollegeOmandurar Government EstateChennai 600002Tamil NaduIndia

In the intricate landscape of healthcare,vicarious liability looms large,shaping the responsibilities and actions of healthcare practitioners and administrators *** by a poignant scenario of a medication error,this article navigates the complexities of vicarious liability in *** explains the legal basis and ramifications of this theory,emphasizing its importance in fostering responsibility,protecting patient welfare,and easing access to *** paper explores the practical effects of vicarious responsibility on day-to-day operations,leadership practices,and decision-making processes via the eyes of senior consultants,junior doctors,and hospital *** comprehensive insights and real-world examples,it underscores the imperative of fostering a culture of accountability,communication,and quality care to navigate the intricate web of liabilities inherent in modern healthcare.

关键词： Vicarious liability Healthcare Responsibility Litigation Patient welfare

Beyond statistical significance:Embracing minimal clinically important difference for better patient care

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World Journal of Methodology 2025年第1期15卷 33-41页

作者： Naveen Jeyaraman Madhan Jeyaraman Swaminathan Ramasubramanian Sangeetha Balaji Sathish Muthu department of orthopaedics ACS Medical College and HospitalDr MGR Educational and Research InstituteChennai 600077Tamil NaduIndia department of Research Methods Orthopaedic Research GroupCoimbatore 641045Tamil NaduIndia department of orthopaedics Government Medical CollegeOmandurar Government EstateChennai 600002Tamil NaduIndia department of Biotechnology Faculty of EngineeringKarpagam Academy of Higher EducationCoimbatore 641021Tamil NaduIndia department of orthopaedics Government Medical CollegeKarur 639004Tamil NaduIndia

The minimal clinically important difference(MCID)represents a pivotal metric in bridging the gap between statistical significance and clinical relevance,addressing the direct impact of medical interventions from the patient's *** comprehensive review analyzes the evolution,applications,and challenges of MCID across medical specialties,emphasizing its necessity in ensuring that clinical outcomes not only demonstrate statistical significance but also offer genuine clinical utility that aligns with patient expectations and *** discuss the evolution of MCID since its inception in the 1980s,its current applications across various medical specialties,and the methodologies used in its calculation,highlighting both anchor-based and distribution-based ***,the paper delves into the challenges associated with the application of MCID,such as methodological variability and the interpretation difficulties that arise in clinical *** for the future include standardizing MCID calculation methods,enhancing patient involvement in setting MCID thresholds,and extending research to incorporate diverse global *** steps are critical to refining the role of MCID in patient-centered healthcare,addressing existing gaps in methodology and interpretation,and ensuring that medical interventions lead to significant,patient-perceived improvements.

关键词： Minimal clinically important difference Patient-centered care Clinical relevance Global health

Global trend of publications in orthopaedics and sports medicine:1996-2021

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Chinese Journal of Traumatology 2024年第6期27卷 368-371页

作者： Raju Vaishya Abhishek Vaish department of orthopaedics and joint replacement Surgery Indraprastha Apollo HospitalSarita ViharNew Delhi110076India

We studied the publication trend in the field of orthopaedics and sports medicine over the last 25 years(1996-2021),by various countries,and regions of the *** was an increasing trend in publications,across the *** of the Asian countries like China and India have shown a substantial growth in their research *** continent has contributed the most publications in the last 25 years,whereas the United States as a country has been on the top of the list of *** research-publications came from high-income countries and disproportionately less from low-and middle-income countries.

关键词： Publications Research Orthopedics Sports medicine Medicine

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Wooden foreign body impalement through the right shoulder region–an unusual penetrating injury:A case report

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World Journal of Orthopedics 2022年第12期13卷 1064-1068页

作者： Abhay Harsh Kerketta Ritesh Kumar Seelora Sahu Jayanta Kumar Laik Manoj Kumar Rajak department of joint replacement and orthopaedics Tata Main HospitalSinghbhum 831001JharkhandIndia department of Anaesthesiology Tata Main HospitalJamshedpur 831001JharkhandIndia

BACKGROUND Impalement of the body is a rare injury and comes with varied *** is no set classification or defined protocols for managing this *** case report aims to create awareness among trauma surgeons about unusual presentation and management of such *** SUMMARY A 45-year-old man presented to the emergency department with a sharp penetrating wooden plank at right clavicular region between the neck and shoulder following a road traffic *** vehicle had crashed into a roadside wooden hut,thus causing an impalement *** was meticulously worked up and taken to emergency *** wooden plank was removed and the wound healed ***,he had fairly good shoulder function and was able to return back to work *** Each impalement injury brings in challenges in management as no two cases are the *** varied presentation and risks involved should be known to medical professionals handling the *** multidisciplinary team approach is needed for successful outcome.

关键词： Impaling Wooden Foreign body Sharp object Trunk Case report

Brachioradialis tendon transfer and palmaris longus tendon graft for thumb avulsion:A case report and review of literature

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World Journal of Clinical Cases 2025年第4期13卷 48-55页

作者： Pierre Curings Sonia Ramos-Pascual Kinga Michalewska Nicolas Gibert Lionel Erhard Mo Saffarini AlexisNogier department of Hand Surgery Clinique TrenelSainte-Colombe 69560France Medical Research ReSurg SANyon 1260VaudSwitzerland department of Hand Surgery Hand and Upper Limb Surgical InstituteVilleurbanne 69100France department of orthopaedics Clinique TrenelSainte-Colombe 69560France

BACKGROUND Thumb replantation following complete traumatic avulsion requires complex techniques to restore function,especially in cases of avulsion at the level of the metacarpophalangeal joint(MCP I)and avulsion of the flexor pollicis longus(FPL)at the musculotendinous *** treatments include direct tendon suture or tendon transfer,most commonly from the ring *** optimize function and avoid donor finger complications,we performed thumb replantation with flexion restoration using brachioradialis(BR)tendon transfer with palmaris longus(PL)tendon *** SUMMARY A 20-year-old left-handed male was admitted for a complete traumatic left thumb amputation following an accident while sliding from the top of a *** patient presented with skin and bone avulsion at the MCP I,avulsion of the FPL tendon at the musculotendinous junction(zone 5),avulsion of the extensor pollicis longus tendon(zone T3),and avulsion of the thumb’s collateral arteries and *** patient was treated with two stage thumb *** first intervention consisted of thumb replantation with MCP I arthrodesis,resection of avulsed FPL tendon and implantation of a silicone tendon *** second intervention consisted of PL tendon graft and BR tendon ***-up at 10 months showed good outcomes with active interphalangeal flexion of 70°,grip strength of 45 kg,key pinch strength of 15 kg and two-point discrimination threshold of 4 *** Flexion restoration after complete thumb amputation with FPL avulsion at the musculotendinous junction can be achieved using BR tendon transfer with PL tendon graft.

关键词： Brachioradialis tendon transfer Flexor pollicis longus Palmaris longus tendon graft Replantation Thumb amputation Thumb avulsion Case report

Virtual preoperative planning and 3D printing are valuable for the management of complex orthopaedic trauma

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Chinese Journal of Traumatology 2019年第6期22卷 350-355页

作者： Abhishek Mishra Tarun Verma Abhishek Vaish Riya Vaish Raju Vaishya Lalit Maini department of orthopaedics and joint replacement Surgery Maulana Azad Medical CollegeLok Nayak HospitalNew Delhi 110001India department of orthopaedics and joint replacement Surgery Indraprastha Apollo HospitalSaritaViharNew Delhi 110076India

Purpose:The technology of 3D printing(3DP)exists for quite some time,but it is still not utilized to its full potential in the field of orthopaedics and traumatology,such as underestimating its worth in virtual preoperative planning(VPP)and designing various models,templates,and *** can be a significant tool in the reduction of surgical morbidity and better surgical outcome avoiding various associated ***:An observational study was done including 91 cases of complex trauma presented in our institution requiring operative *** preoperative planning and 3DP were used in the management of these *** managing these cases were given a set of questionnaire and responses were recorded and assessed as a quantitative ***:In all the 91 cases,where VPP and 3DP were used,the surgeons were satisfied with the outcome which they got intraoperatively and *** time was reduced,with a better *** dimensional models of complex fracture were helpful in understanding the anatomy and sketching out the plans for optimum reduction and *** average score of the questionnaire was 4.5,out of a maximum of 6,suggesting a positive role of 3DP in ***:3DP is useful in complex trauma management by accurate reduction and placement of implants,reduction of surgical time and with a better *** there is an initial learning curve to understand and execute the VPP and 3DP,these become easier with practice and experience.

关键词： Three-dimensional printing Bone fractures Fracture dislocation X-ray computed tomography

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Bilateral segmental pelvic and femoral fractures in a young female： A rare case report

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Chinese Journal of Traumatology 2016年第5期19卷 286-289页

作者： Raju Vaishya Amit Kumar Agarwal Nishint Gupta Vipul Vijay department of orthopaedics and joint replacement Surgery lndraprastha Apollo Hospitals New Delhi 110076 India

The management of multiple complicated injured patients remains a great challenge despite advance- ments in modern medical care. We present a rare case of bilateral unstable pelvic fractures associated with bilateral segmental femoral shaft fractures. We have proposed a mechanism of such complex injury pattern and discussed the plan of management. We believe that a timely and aggressive surgical inter- vention to fix all the major fractures soon after medically stabilizing the patient helped our patient tc overcome these serious and lethal injuries. It is necessary to establish an optimal protocol for man- agement of such complex fractures by conducting prospective and multicentric studies in the future.

关键词： Pelvis Femoral fractures Rib fractures

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