Publications by authors named "Love Kapoor"

6 Publications

  • Page 1 of 1

Outcomes of major musculoskeletal oncological reconstructions using prolene mesh-a retrospective analysis from a tertiary referral centre.

J Clin Orthop Trauma 2021 May 4;16:195-201. Epub 2021 Jan 4.

Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, 110029, India.

Background: Adequate reconstruction of the soft tissue defect following resection of bone tumors is challenging. Prolene mesh, despite being a useful tool, is not widely used due to the fear of deep infection. The aim of this study was to evaluate the functional outcome and complications of using a Prolene mesh in oncological reconstructions.

Methods: A retrospective study was conducted in bone tumor patients with soft tissue reconstruction using Prolene mesh between January 2017 and June 2019. Functional evaluation was done using MSTS 93 score. Complications were recorded and were classified as mechanical (dislocation and extension lag) or biological failure (wound problems and deep infection). Comparison was performed between groups with and without biological failure to identify predictive variables.

Results: Of 116 patients, 68 were males and 48 were females, with median age of 22.5 years. Thirty nine patients had tumors of proximal tibia, 23 of proximal femur, 25 of proximal humerus, 24 of pelvis, and five tumors at other sites. Approximately two-thirds (62.9%) of our patients underwent endoprosthetic reconstruction while the rest underwent either biological or cement spacer reconstructions. Excellent or good functional outcomes were reported in 98.3% patients as per MSTS 93 scoring. Complications were noted in 22 patients (18.9%), of which 16 had biological failure, with four patients requiring debridement and mesh removal. Dislocation of prosthesis occurred in 2 patients of proximal femur replacement. Overall re-surgery rate was 5.1% (6 patients). There was no statistically significant difference between the groups with or without biological failure with respect to demographics, site of tumor, type of procedure, blood loss, duration of surgery and history of chemotherapy.

Conclusion: Prolene mesh is a useful tool to reconstruct the soft tissue defects following bone tumor resections. It is readily available, reliable and provides reproducible results, with no added risk of wound complications.
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http://dx.doi.org/10.1016/j.jcot.2020.12.029DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7920099PMC
May 2021

Bone sarcoma surgery in times of COVID-19 pandemic lockdown-early experience from a tertiary centre in India.

J Surg Oncol 2020 Oct 13;122(5):825-830. Epub 2020 Jul 13.

Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.

Background And Objectives: Coronavirus disease 2019 (COVID-19) lockdown has presented a unique challenge for sarcoma care. The purpose of this study is to evaluate the early results and feasibility of surgeries for bone sarcomas during the COVID-19 lockdown.

Methods: Our prospectively collected orthopaedic oncological database was reviewed to include two groups of patients- those who underwent surgery in the immediate 4 weeks before lockdown (non-lockdown group) and those operated in the first 4 weeks of lockdown (lockdown group). All patients were followed-up clinically and telephonically to collect the outcome data.

Results: Out of the 91 patients who qualified for inclusion, fifty were classified into the non-lockdown group while 41 patients formed the lockdown group. Both the groups were comparable with respect to baseline demographic parameters. However, during the lockdown period 37 patients (90%) had undergone a major surgical intervention as against 24 patients (48%) in the non-lockdown group (P < .001). There was no significant difference in type of anaesthesia, median estimated blood loss and procedure duration. None of the patients/health care workers had evidence of severe acute respiratory syndrome-coronavirus 2 infection at 15 days follow-up.

Conclusion: Our study results suggest that appendicular bone tumours can be safely operated with adequate precautions during the lockdown period.
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http://dx.doi.org/10.1002/jso.26112DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7405233PMC
October 2020

Functional outcome of 'LC-1 pelvic ring injury with incomplete sacral fracture' managed non-operatively.

J Clin Orthop Trauma 2020 Feb 13;11(Suppl 1):S1-S3. Epub 2019 Sep 13.

Department of Orthopaedics, Government Medical College and Hospital, Sector - 32, Chandigarh, 160030, India.

Objectives: Standard guidelines regarding the management of un-displaced LC-1 type pelvic ring injury supported by data in literature are lacking, though it is considered to be stable and widely managed non-operatively. In our study we evaluated the functional outcome of LC-1 pelvic ring injury with incomplete sacral fracture managed non-operatively in patients having age more than 18 years and minimum follow-up of 6 months.

Methods: 46 patients having LC-1 pelvic ring injury with incomplete sacral fractures having age more than 18 years and minimum follow-up of 6 months were identified from the hospital record. All these patients were managed with non-weight bearing walking for first 3 weeks followed by weight bearing as tolerated. Patients were called in outpatient department for final evaluation of functional outcome measured according to Majeed score.

Results: Mean Majeed score was 82.59 ± 6.77 (excellent in 27 patients and good in 19 patients). 8 patients had fractures in addition to pelvic ring injury and 3 patients had abdominal injuries (3 excellent, 8 good). 11 patients had follow-up less than 12 months (mean Majeed score 84.36 ± 5.75; 8 excellent, 3 good) and 35 patients had follow-up more than 12 months (mean Majeed score 82.03 ± 7.04; 19 excellent, 16 good). There was no mortality in any group.

Conclusion: LC-1pelvic ring injury with incomplete sacrum fracture can be managed non-operatively with non-weight bearing walking for first 3 weeks followed by weight bearing as tolerated with excellent or good functional outcome. The best functional outcome for a patient is achieved within 12 months and does not change after that period. Also being a low energy trauma this injury has low mortality rate.
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http://dx.doi.org/10.1016/j.jcot.2019.09.013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6978179PMC
February 2020

Mechanism of injury based classification of proximal tibia fractures.

J Clin Orthop Trauma 2019 Jul-Aug;10(4):785-788. Epub 2018 Aug 7.

Department of Orthopaedics, Government Medical College and Hospital, Sector - 32, Chandigarh, 160032, India.

Introduction: We treated proximal tibia fractures according to our own CT based classification in which we divided these fractures into different varus and valgus fractures. We also provide a guide for reduction of these fractures and the sequence in which different fractured fragments of proximal tibia should be fixed.

Materials And Methods: Patients were identified from the hospital records, treated according to classification based upon mechanism of injury, from August 2014 to December 2016. Patients were called for follow up in outpatient department for evaluation. Functional evaluation was done according to Rasmussen functional grading score.

Results: Twenty one patients of proximal tibia fracture were treated between august 2014 to December 2016 according to our method. There were 17 male and 4 female. Age ranged from 20 year to 65 year (average 35.19 year). 17 patients were turned up for latest follow up who were analysed for Rasmusssen functional grading score. 14 patients had excellent and 3 patients had good function according to Rasmussen functional grading score.

Conclusions: Our classification system provides a guide for reduction of proximal tibia fractures and also tells us the sequence of different fracture fragments.
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http://dx.doi.org/10.1016/j.jcot.2018.08.012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6611915PMC
August 2018

Immediate post-operative pain in anterior cruciate ligament reconstruction surgery with bone patellar tendon bone graft versus hamstring graft.

J Orthop Surg Res 2016 Jun 8;11(1):67. Epub 2016 Jun 8.

Department of Orthopaedics, Government Medical College and Hospital, Chandigarh, India.

Background: Pain in the immediate post-operative period after anterior cruciate ligament (ACL) surgery, apart from an unpleasant experience for the patient, can act as a barrier for static quadriceps contractions and optimum execution of the initial rehabilitation protocol resulting in slow recovery and a later return to full function for a sportsperson. There is no report in the literature comparing pain in the immediate post-operative period after using the two most widely used autografts, bone patellar tendon bone (BPTB) graft and hamstring graft.

Methods: The present study compared the visual analogue scale (VAS) pain score in the immediate post-operative period after arthroscopic ACL reconstruction with the BPTB and hamstring autografts. Both groups consisted of 50 patients each. The mean age of the BPTB and hamstring cohorts was 26.9 ± 7.3 years (age range 18-59 years) and 26.7 ± 9.0 years (age range 17-52 years), respectively. Unpaired t test was applied to compare pain scores between the BPTB and hamstring cohorts.

Results: In the present study, patients in the BPTB cohort showed higher mean pain scores across all the post-operative time intervals except at 6 h. However, the difference in the mean VAS pain score at post-operative 6, 12,18, 24, 36 and 48 h in the two groups was statistically not significant (p value of 1, 0.665, 0.798, 0.377, 0.651 and 0.215 at 6, 12, 18, 24, 36 and 48 h, respectively).

Conclusions: Our study concludes that the arthroscopic ACL reconstruction with BPTB autograft and hamstring autograft is associated with similar pain in the immediate post-operative period. As a result, aggressive physiotherapy regime is not affected by the type of graft being used for ACL reconstruction, as the pain scores in the immediate post-operative period are similar for both techniques.

Trial Registration: Clinical Trials Registry-India, CTRI/2016/01/006502.
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http://dx.doi.org/10.1186/s13018-016-0399-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4898387PMC
June 2016

Arthroscopic decompression of paralabral cyst around suprascapular notch causing suprascapular neuropathy.

J Clin Orthop Trauma 2015 Sep 9;6(3):184-6. Epub 2015 Apr 9.

Senior Resident, Department of Orthopaedics, Government Medical College & Hospital, Sector 32, Chandigarh, India.

A case of 22 year old male gymnast, who suffered from suprascapular neuropathy due to compression of suprascapular nerve by paralabral cysts around suprascapular notch, leading to marked atrophy of supraspinatus and infraspinatus muscles. After arthroscopic decompression of paralabral cysts, weakness and atrophy of the supraspinatus and infraspinatus muscles improved.
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http://dx.doi.org/10.1016/j.jcot.2015.03.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4487971PMC
September 2015