Professor Ravi Gupta, MS, DNB, FAMS, FRCS, FACS,  MNAMS, FIMSA - Government Medical College Hospital Chandigarh - Professor

Professor Ravi Gupta

MS, DNB, FAMS, FRCS, FACS, MNAMS, FIMSA

Government Medical College Hospital Chandigarh

Professor

Chandigarh, Chandigarh | India

Main Specialties: Orthopaedic Sports Medicine, Orthopaedic Trauma, Orthopaedics

Additional Specialties: Orthopaedics

ORCID logohttps://orcid.org/0000-0002-9705-9863

Professor Ravi Gupta, MS, DNB, FAMS, FRCS, FACS,  MNAMS, FIMSA - Government Medical College Hospital Chandigarh - Professor

Professor Ravi Gupta

MS, DNB, FAMS, FRCS, FACS, MNAMS, FIMSA

Introduction

Primary Affiliation: Government Medical College Hospital Chandigarh - Chandigarh, Chandigarh , India

Specialties:

Additional Specialties:


View Professor Ravi Gupta’s Resume / CV

Education

Jun 2005 - Jun 2005
Hospital for Special Surgery
Educational Visitor
Sports Medicine and Traumatology
Jun 2002 - May 2003
Queen Elizabeth Hospital
Fellowship
Orthopaedics
Jun 1998 - Sep 1998
University of Innsbruck
Fellowship
Traumatology and Sports Medicine
Jun 1988 - May 1991
Government Medical College Patiala
Master of Surgery
Orthopaedics

Experience

May 2017
Government Medical College and Hospital
Medical Supdt
Hospital Administration
Aug 2016
Government Medical College and Hospital
Project Director
Sports Injury Center
Mar 2007 - Mar 2007
Government Medical College and Hospital
Professor
Orthopaedics
Mar 2003 - Mar 2003
Government Medical College and Hospital
Associate Professor
Orthopaedics
Oct 1997 - Oct 1997
Government Medical College and Hospital
Assistant Professor
Ortohpaedics
Sep 1994 - Sep 1994
Government Medical College and Hospital
Senior Registrar
Orthopaedics
Sep 1993 - Sep 1993
Government Medical College and Hospital
Demonstrator
Anatomy

Publications

92Publications

57Reads

-Profile Views

4PubMed Central Citations

Remnant bone debris after ACL reconstruction surgery: a cause of heterotrophic calcification and patellar tendon ossification.

MOJ Sports Med. 2018;2(3):84‒86.

MOJ Sports Med

AbstractPatellar tendon ossification after anterior cruciate ligament reconstruction (ACLR) with Bone-patellar tendon-bone (BPTB) graft is an extremely rare complication. We are reporting a case of patellar tendon ossification and heterotrophic ossification after ACLR with BPTB graft in the same patient. This patient was managed non-operatively as it was not causing hindrance to his daily activity.Keywords: patellar tendon ossification, heterotrophic ossification, BPTB, ACLIntroductionACLR is a commonly done procedure in orthopaedics. Hamstring tendon graft and BPTB graft are two most commonly used autograft for ACLR. BPTB graft is observed to be associated with more donor site morbidity as compared to hamstring tendon graft1. Patellar tendon ossification is one such rare complication seen with BPTB graft.Case presentationACLR was done using BPTB graft in 30 years old badminton player (recreational). The time interval between index injury and surgery was 1 month. Patient also had a concomitant tear in the posterior horn of the medial meniscus for which meniscal repair was done. Next day after surgery knee bending (up to 90º), quadriceps strengthening exercises and non-weight bearing walking started. At 6 weeks, cycling, full knee bending and half squats were added to the rehabilitation program.At 9 months patients presented to the clinic with anterior knee pain, restricted range of motion and difficulty in doing squats. On examination bony swelling was present on the medial aspect of the knee, tenderness was present at the donor site and the range of motion was restricted (0-110º). All stability was normal. The arthrometer (KT-1000TM) measurement showed that anterior translation of tibia was 4 mm in the normal knee and 5 mm in the operated knee. X-ray of the knee showed that patellar tendon ossification and heterotrophic calcification at the medial femoral condyle (Figure 1). Patient was managed non-operatively as he did not have any limitation of daily activity.Figure 1 AP view of x-ray showing heterotrophic ossification on medial femoral condyle and lateral view of left knee x-ray showing patellar tendon ossification.DiscussionBPTB graft is considered as a gold standard graft for ACLR because of better knee stabilty1,2 and higher return to sports after ACL reconstruction with BPTB graft.1,3,4However, BPTB graft is criticized for donor site morbidity like anterior knee pain, patellar fracture, quadriceps tendon rupture etc.5−7 Among the variously described complication of BPTB graft, patellar tendon ossification is one such rare complication. Patellar tendon ossification has been reported mainly in patients with knee injury,8 total knee replacement,9 partial patellectomy,10,11 intramedullary nail12 and after spinal cord injury.13 Patellar tendon ossification after ACLR is extremely rare. This complication has been reported by only few studies in literature14−18 (Table 1). The cause of patellar tendon ossification is not cleared. Gianluca Camillieri et al.16 gave hypothesis that persistence of bone debris inside the patellar tendon may trigger calcification. However, they did not have an immediate postoperative x-ray to prove their hypothesis. In the present case report, we had postoperative CT scan (5th day) which showed the loose bone fragments in the joint (Figure 2) which support the hypothesis given by Gianluca Camillieri et al.16 & Erdogan et al.19 gave another hypothesis he believed aggressive rehabilitation causes microtrauma within patellar tendon.19 However same rehabilitation protocol was followed by others patients and none of them showed patellar tendon ossification. Another possible pathogenesis given by Bonamo et al.20 he stated that devascularization of the graft during harvested results in avascular necrosis. Heterotrophic ossification is commonly encountered problem in orthopaedics. The incidence of heterotrophic ossification after ACL reconstruction with BPTB graft vary from 1.54%-2.58%.21Mohamed A et al.22 observed that incidence of bone debris after ACL reconstruction surgery was 15% if thorough debridement was done and 65% if no specific debridement protocol was followed.22 Treatment of patellar tendon ossification is still not well established. However, some authors showed good results with surgical resection of ossification.14 We managed our patient non-operatively as he did not have any limitation of daily activity. In the present case report, we observed that patient had both patellar tendon ossification and heterotrophic ossification. There was no case reported in the literature which showed both patellar tendon ossification and heterotrophic calcification in the same patient after ACL reconstruction with BPTB graft.ArticleAge/sexType of graftTreatmentDuration of injuryGianluca Camillieri42/maleBPTBExcision of ossification-Homero Valencia29/maleBPTBExcision of ossification10 monthsMehmet Erdil36/maleBPTBExcision of ossification3 monthsFahri Erdogan45/maleBPTB-5 monthsTable 1 Review of literatureFigure 2 Post-operative (5th day) CT scan showing loose bone debris in the joint.AcknowledgementsWritten and informed consent was taken from the patient.Conflict of interestNo conflict of interest.ReferencesHeijne A, Werner S. A 2-year follow-up of rehabilitation after ACL reconstruction using patellar tendon or hamstring tendon grafts: a prospective randomised outcome study. Knee Surg Sports Traumatol Arthrosc. 2010;18(6):805−13.Li S, Chen Y, Lin Z, et al. A systematic review of randomized controlled clinical trials comparing hamstring autografts versus bone-patellar tendon-bone autografts for the reconstruction of the anterior cruciate ligament. Arch Orthop Trauma Surg. 2012;132(9):1287−97.Nwachukwu BU, Voleti PB, Berkanish P, et al. Return to Play and Patient Satisfaction After ACL Reconstruction: Study with Minimum 2-Year Follow-up. J Bone Joint Surg Am. 2017;99(9):720−5.Gudas R, Jurkonis R, Smailys A. Comparison of Return to Pre-Injury Sport After 10 mm Size Bone-Patellar Tendon-Bone (BPTB) versus 8 mm Hamstring Anterior Cruciate Ligament Reconstruction: A Retrospective Study with a Two-Year Follow-Up. Med Sci Monit. 2018;24:987−96.Monaghan PKL, Salem H, Ross KE, et al. Long-term outcomes in anterior cruciate ligament reconstruction: a systematic review of patellar tendon versus hamstring autografts. Orthop J Sports Med. 2017;5(6).Kartus J, Movin T, Karlsson J. Donor-site morbidity and anterior knee problems after anterior cruciate ligament reconstruction using autografts. Arthroscopy.2001;17(9):971−80.Webster KE, Feller JA, Hartnett N, et al. Comparison of patellar tendon and hamstring tendon anterior cruciate ligament reconstruction: a 15-year follow-up of a randomized controlled trial. Am J Sports Med. 2016;44(1):83−90.Matsumoto H, Kawakubo M, Otani T, et al. Extensive post-traumatic ossification of the patellar tendon: a report of two cases. J Bone Joint Surg Br. 1999;81(1):34−6.Majeed H, McBride D. Massive Patellar Tendon Ossification: Excision and Simultaneous Total Knee Replacement. Scientific Pages Orthop Surg.2017;1(1):17−9.Kelly MA, Insall JN. Postpatellectomy Extensive Ossification of Patellar Tendon: A Case Report. Clin Orthop Relat Res. 1987;(215):148−52.Gosselin RA, Belzer JP. Contreras DM. Heterotopic ossification of the patellar tendon following intramedullary nailing of the tibia: report on two cases. J Trauma.1993;34(1):161−3.Tan L, Wang T, Li Y-H, et al. Patellar tendon ossification after retrograde intramedullary nailing for distal femoral shaft fracture: A case report and review of the literature. Medicine. 2017;96(47):e8875.Yamamoto N, Miki T, Nishiyama A, et al. Extensive Bilateral Patellar Tendon Ossification in a Spinal Cord Injury Patient. Acta Med Okayama. 2018;72(1):89−93.Valencia H, Gavín C. Infrapatellar heterotopic ossification after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2007;15(1):39−42.Erdil M, Aşık M, Sen C, et al. Heterotopic bone formation following anterior cruciate ligament reconstruction with BPTB autograft. Acta Orthop Traumatol Turc.2012;46(1):72−6.Camillieri G, Sanzo V, Ferretti M, et al. Patellar tendon ossification after anterior cruciate ligament reconstruction using bone–patellar tendon–bone autograft. BMC Musculoskelet Disord. 2013;14:164.Erdogan F, Aydingoz O, Kesmezacar H, et al. Calcification of the patellar tendon after ACL reconstruction. Knee Surg Sports Traumatol Arthrosc. 2004;12(4):277−9.Lerat JL, Besse JL, Vincent P, et al. Sequelae in the knee extensor system following graft removal for the "Mac in Jones" type procedure. Rev Chir Orthop Reparatrice Appar Mot. 1995;81(5):404−9.Erdogan F, Aydingoz O, Kesmezacar H, et al. Calcification of the patellar tendon after ACL reconstruction. A case report with long-term follow-up. Knee Surg Sports Traumatol Arthrosc. 2004;12(4):277−9.Bonamo JJ, Krinick RM, Sporn AA. Rupture of the patellar ligament after use of its central third for anterior cruciate reconstruction. A report of two cases. J Bone Joint Surg Am. 1984;66(8):1294−7.Bhandary B, Shetty S, Bangera VV. To study the incidence of heterotopic ossification after anterior cruciate ligament reconstruction. J Clin Diagn Res. 2013;7(5):888−91.Imam MA, Abdelkafy A, Dinah F, et al. Does bone debris in anterior cruciate ligament reconstruction really matter? A cohort study of a protocol for bone debris debridement. SICOT-J. 2015;1:4.

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February 2019
10 Reads

Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon Autograft With Preserved Insertions

Arthroscopy Techniques, Vol -, No - (Month), 2016: pp e1-e6

Arthroscopy Techniques

We present a technique for anterior cruciate ligament (ACL) reconstruction using hamstring tendon autograft with preserved tibial insertions. The tendons, harvested with an open-ended tendon stripper while their tibial insertions are preserved, are looped around to prepare a quadrupled graft. The femoral tunnel is drilled independently through a transportal technique, whereas the tibial tunnel is drilled in a standard manner. The length of the quadrupled graft and loop of the RetroButton is adjusted so that it matches the calculated length of both tunnels and the intra-articular part of the proposed ACL graft. After the RetroButton is flipped, the graft is manually tensioned with maximal stretch on the free end, which is then sutured to the other end with preserved insertions. We propose that preserving the insertions is more biological and may provide better proprioception. The technique eliminates the need for a tibial-side fixation device, thus reducing the cost of surgery. Furthermore, tibial-side fixation of the free graft is the weakest link in the overall stiffness of the reconstructed ACL, and this technique circumvents this problem. Postoperative mechanical stability and functional outcome with this technique need to be explored and compared with those of ACL reconstruction using free hamstring autograft.

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March 2016
12 Reads

Functional outcome after surgical treatment of perilunate injuries: A series of 12 cases.

J Clin Orthop Trauma 2016 Jan-Mar;7(1):7-11. Epub 2015 Oct 21.

Senior Resident, Department of Orthopedics, Government Medical College and Hospital, Chandigarh, India.

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http://dx.doi.org/10.1016/j.jcot.2015.09.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4735569PMC
February 2016
3 Reads

Neglected anterior dislocation of shoulder with large Hillsach's lesion & deficient glenoid: Treated by autogenous bone graft & modified Latarjet procedure.

J Clin Orthop Trauma 2015 Dec 19;6(4):273-6. Epub 2015 May 19.

Associate Professor, Department of Orthopedics, Government Medical College & Hospital, Chandigarh, India.

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http://dx.doi.org/10.1016/j.jcot.2015.03.010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4600832PMC
December 2015
24 Reads
1 Citation

Acetabular fractures labelled poor surgical choices: Analysis of operative outcome.

J Clin Orthop Trauma 2015 Jun 21;6(2):94-100. Epub 2015 Mar 21.

Consultant Orthopaedics and Musculoskeletal Oncology, Centre for Bone and Joint, Mumbai 400053, India.

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http://dx.doi.org/10.1016/j.jcot.2015.03.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4411371PMC
June 2015
8 Reads
3 Citations

Neglected post burns contracture of hand in children: Analysis of contributory socio-cultural factors and the impact of neglect on outcome.

J Clin Orthop Trauma 2014 Dec 19;5(4):215-20. Epub 2014 Aug 19.

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

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http://dx.doi.org/10.1016/j.jcot.2014.07.011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4263997PMC
December 2014
2 Reads

Klebsiella pneumonia carrying bla NDM-1 gene in orthopedic practice

Indian J Orthop 2014; 48 (5):533-35.

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May 2014
4 Reads

Distal transfer of tibial tuberosity in lateral patella instability with patella alta.

Journal of Medical College Chandigarh 2014;4(1):22-24.

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April 2014
5 Reads

Reliability of tests for proprioception of knee.

Journal of Arthroscopy and Joint Surgery 2014; 1 (1): 45-47.

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January 2014
8 Reads

Pucker sign in proximal humeral fractures: implications on management.

Strategies Trauma Limb Reconstr 2013 Aug 5;8(2):123-6. Epub 2013 Jun 5.

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

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http://dx.doi.org/10.1007/s11751-013-0162-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3732668PMC
August 2013
14 Reads

Iatrogenic ulnar nerve injury resulting from a venous cut down procedure.

BMJ Case Rep 2008 20;2008:bcr0620080264. Epub 2008 Nov 20.

Government Medical College Hospital, Department of Orthopaedics, Chandigarh, 160047, India.

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http://dx.doi.org/10.1136/bcr.06.2008.0264DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3124750PMC
July 2013
2 Reads

19. Gupta R. Lipoma Arbroscense of the knee. A report of three cases.

Orthopaedics Today 2013; XV (4):152-55.

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April 2013
10 Reads

Why the Proximal Femoral Nail (PFN) failed: Lessons to be learnt.

Journal of Medical College Chandigarh 2013;3(1):38-41.

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January 2013
5 Reads

A new low cost universal interlocking nail extractor (UNILEX Systerm).

Punjab Journal of Orthopaedics 2012; XIII (1):22-24.

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December 2012
7 Reads

Bursa over K nail presenting as pseudo tumour in gluteal region.

J Clin Orthop Trauma. 2012 Dec; 3(2): 130–132.

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December 2012
6 Reads

Endoscopic carpal tunnel decompression.

Punjab Journal of Orthopaedics 2012; XIII (1):1-15

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December 2012
8 Reads

Hoffa’s Disease In A Skeletal Immature Patient With Plica Syndrome - A Rare Case Report.

The Internet Journal of Orthopedic Surgery. 2012 Volume 19 Number 2. DOI: 10.5580/2b2f

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December 2012
3 Reads

Hip fracture registry: the need of the hour.

Punjab Journal of Orthopaedics 2012; XIII (1): Editorial.

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December 2012
6 Reads

Repair of the torn distal biceps tendon by endobutton fixation.

Indian J Orthop 2012; 46:71-6.

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September 2012
3 Reads

Treatment of finger tip injuries with ‘V-Y’ flap.

Journal of Medical College Chandigarh 2012;1(2):35-6.

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February 2012
9 Reads

Osteoid osteoma of trapezium.

Orthopaedics Today 2011; XIII (4): 163-165.

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December 2011
8 Reads

Osteochondritis dessicans of the talus in a 26-year-old woman.

BMJ Case Rep 2009 14;2009. Epub 2009 Apr 14.

Government Medical College Hospital, Department of Orthopaedics, Sector 32 B, Chandigarh, 160031, India.

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http://dx.doi.org/10.1136/bcr.06.2008.0091DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3028610PMC
November 2011
4 Reads

Salvage of a severely mangled lower limb a case report.

Journal of Medical College Chandigarh 2011;1(2):64-8.

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April 2011
8 Reads

. Bilateral displaced acetabular fractures associated with an open book injury of pelvis and sacral fracture.

Journal of Clinical Orthopaedics and Trauma (JCOT) 2011; 2(1): 57-59.

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February 2011
7 Reads

Treatment Options for Osteochondral Defects.

Journal of Clinical Orthopaedics and Trauma (JCOT) 2010; 1(1):16-22.

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December 2010
8 Reads

36. Training of Orthpaedic Surgeons. Editorial.

Punjab Journal of Orthopaedics 2010; XI (1).

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December 2010
6 Reads

Osteochondritis dissecans of the talus in a 26 year old housewife" .

BMJ Case Reports 2009 doi: 10.1136/bcr.06.2008.0091.

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December 2009
6 Reads

Current Concepts in meniscal injuries.

Punjab Journal of Orthopaedics 2009; X1 (1):49-55.

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December 2009
6 Reads

Computer assisted placement of pedicle screws: Our initial experience with new paradigm.

Punjab Journal of Orthopaedics 2008; X (1):10-13

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December 2008
5 Reads

Ankle arthroscopy: Indications and techniques: Current Concept.

Punjab Journal of Orthopaedics 2008; X (1):66-71.

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December 2008
9 Reads

Ganglion cyst of anterior cruciate ligament: a case report.

Punjab Journal of Orthopaedics 2008; X (1): 72-73.

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December 2008
6 Reads

Changing concepts of management of orthopaedic trauma.

Punjab Journal of Orthopaedics 2008; X (1).

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December 2008
6 Reads

Cricket ball injury: a cause of symptomatic muscle hernia of leg.

Br J Sports Med. 2008 Dec;42(12):1002-3

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December 2008
6 Reads

Iatrogenic ulnar nerve injury resulting from a venous cut down.

BMJ Case Reports 2008 doi: 10.1136/bcr.06.2008.0264.

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March 2008
6 Reads

Carpal Tunnel Syndrome – Review Article.

DJO (Delhi Journal of Orthopaedics) 2008; 4 (2): 77-83.

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February 2008
7 Reads

Stabilisation of DRUJ with a double-breasted slip of extensor retinaculum.

J Bone Joint Surg (Br) 2008; 90 –B (2): 200-2.

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February 2008
7 Reads

Displaced Acetabular Fractures: First Hand Experience From North West India.

J.Orthopaedics 2007;4(2)e36. J.Orthopaedics 2007;4(2)e36

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April 2007
6 Reads

Accessory soleus muscle in clubfoot deformity: a report in four feet.

J Pediatr Orthop B. 2007 Mar;16(2):106-9.

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March 2007
8 Reads

Acromioclavicular dislocation as a sports injury: a review and our experience.

Punjab Journal of Orthopaedics 2006 December;VIII(II):57-63.

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December 2006
7 Reads

Repair of acute Achilles tendon rupture using a double-ended needle.

J Orthop Surg (Hong Kong). 2006 Aug;14(2):142-6.

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August 2006
9 Reads

Orthopaedics and family physicians – Editorial

Current Medical Journal 2005 April; XI (1):29-32

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April 2005
8 Reads

53. Gupta R. Arthroscopy –an overview.

Current Medical Journal 2005 April; XI (1):29-324.

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April 2005
9 Reads

Fracture of the Posterior process of talus.

Injury 2004 Dec; 35 (12): 1341-4.

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December 2004
5 Reads

Pregnancy complicated by paraplegia due to Pott’s spine.

J Indian Med Assoc September 2004; 102(9) : 508 & 518.

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September 2004
7 Reads

Carpal Tunnel Syndrome.

Current Medical Journal 2004 August; X (5):13-18.

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August 2004
9 Reads

Traumatic hip dislocation in a child – case report.

Punjab Journal of orthopaedics – 2002.

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December 2002
8 Reads

Osteoarthritis – Recent Advances in Management.

Current Medical Journal 2002 March; VII (12):13-20.

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March 2002
6 Reads

Frozen Shoulder.

Current Medical Journal 2001 Dec; VII (9):31-4.

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December 2001
4 Reads

Tuberculosis of the sternoclavicular joints.

Acta Orthop Scand. 2001 Oct, 72 (5):514-7.

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October 2001
8 Reads

Management of Gouty Arthritis.

Current Medical Journal 2001; VI (6):23 – 8.

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June 2001
5 Reads

Epitheloid Haemangioendothelioma of the rib – a case report.

Indian J Pathol. Microbiol 2001; 44 (3): 375-7.

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March 2001
5 Reads

Bilateral sternoclavicular joint tuberculosis.

Arch Orthop Trauma Surg 2000;120(5-6) :363-5.

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November 2000
6 Reads

Cervical spine injuries -Recent trends in stabilization.

Current Medical Journal 2000; V (10):53-56.

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October 2000
6 Reads

Odontoid fracture associated with a pharangeal tear.

J Bone Joint Surg Am. 2000 Aug; 82-A(8): 1154-1156.

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August 2000
6 Reads

Femoral shaft fractures in adults -trends in management.

Current Medical Journal 2000 June; VI (3): 52-56.

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June 2000
6 Reads

Orthopaedic shoes.

Current Medical Journal 2000 April; VI (1): 51-56.

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April 2000
7 Reads

Anticonvulsant induced osteomalacia.

Indian Paediatrics 2000; 37: 325-29.

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March 2000
5 Reads

Multifocal involvement of foot in tuberculosis.

J Foot Surg (Ind) 2000; XV (1): 55-59.

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January 2000
9 Reads

Extracapsular proximal femoral fractures and their management.

Current Medical Journal 1999; V (7):30-36.

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July 1999
4 Reads

Inferomedial (Subsustentacular) Dislocation of Navicular- A Case Report.

Foot & Ankle International 1999; 30 (3):196-200.

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March 1999
8 Reads

Undiagnosed medial dislocation of the elbow joint - a case report.

Indian J Orthopaedics 1999; 33(1): 59-61.

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January 1999
7 Reads

Multifocal extrapulmonary tubercular disease – a case report.

The Cardiothoracic Journal 1998; 3 (12) : 37 -39.

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March 1998
7 Reads

Spinal Tuberculosis - an unusual presentation.

Indian J Tubercul 1997; 44 : 35 - 38.

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December 1997
7 Reads

POP cast and early weight bearing for tibial shaft fractures.

Bulletin PGIMER 1997; 31 (1) : 25 - 28.

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November 1997
5 Reads

Anterior dislocation of first metacarpophalangeal joint with myositis.

Bulletin PGIMER 1997; 31 : 68 - 70.

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October 1997
4 Reads

Neglected posterior dislocations of elbow in children.

Indian J Orthop 1997; 31 (3) : 193 - 195.

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March 1997
6 Reads

Plasmacytoma of the calcaneus.

J Foot Surg 1996; 11 (1) : 47 - 50.

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November 1996
7 Reads

Multifocal extrapulmonary tuberculosis involving calcaneus, 4th metatarsal & axillary lymphnodes.

Indian Journal of Clinical Practice. 1996; 7 (5):27 - 29.

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November 1996
9 Reads

Bilateral epitrochlear lymphadenitis and tubercular dactylitis.

Surgical Journal of North India 1996; 12 (1) :67 - 68.

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November 1996
6 Reads

Treatment of Haglund’s disease with local cortisone and xylocaine.

J Foot Surg 1996; 11 (1) :22 - 24.

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September 1996
4 Reads

Reappraisal of BCG vaccine.

Indian J clin Practice 1996; 7 (6) : 27- 28.

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June 1996
5 Reads

Practical aspects of fiberoptic endoscopy.

Surg J N India 1996; 12 (1) : 13 -15.

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January 1996
4 Reads

A low cost functioning prosthetic hand for upper limb amputees in developing countries.

Orthopaedic Journal of M.P Chapter 1993; 8(1):11-16.

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January 1993
7 Reads

Arthroscopic Decompression Of Paralabral Cyst Around Suprascapular Notch Causing Suprascapular

doi:10.1016/j.jcot.2015.03.007

Journal of Clinical Orthopaedics and Trauma

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4 Reads

Role of meniscal tear and meniscectomy in ACL deficient knee for evaluation of mechanical stability.

Knee. 2018 Dec;25(6):1051-1056.

Knee

Abstract

BACKGROUND:

The role of an intact meniscus in providing mechanical stability to the knee of anterior cruciate ligament (ACL) deficient and ACL reconstructed patients has not been well studied.

METHODS:

This was a prospective cohort study. A total of 205 patients undergoing ACL reconstruction were enrolled, of which 61 had normal menisci, 49 had a tear in the posterior horn of the medial meniscus (PHMM) (tear <40% of width = 19; >40% of width = 30), 35 had a tear in the lateral meniscus (<40% of width = 15; >40% = 20), 13 had a tear in the body and/or anterior horn of the medial meniscus (<40% of width = 6; >40% = 7) and 47 patients had a tear in both menisci. Patients with a tear in both menisci were excluded. The anterior translation of the tibia (ATT) was calculated preoperatively and postoperatively at three months and six months using KT-1000. Partial meniscectomy was performed in all unstable meniscal tears.

RESULTS:

The mean age at the time of surgery was 25.2 ± 5.1 years. Patients with a normal meniscus showed side to side difference in KT-1000 of 4.8 ± 2.5 mm whereas those with a <40% tear and >40% tear in PHMM had a difference of 5.36 ± 3.07 mm (P = 0.46) and 7.08 ± 2.78 mm (P = 0.0002), respectively. Patients with a lateral meniscus <40% and >40% tear had a mean difference of 5.68 ± 2.96 mm (P = 0.22) and 5.95 ± 2.39 mm (P = 0.09), respectively. Patients with body and/or anterior horn of medial meniscus <40% and >40% had a difference of 5.41 ± 1.11 mm (P = 0.59) and 5.78 ± 2.38 mm (P = 0.35), respectively. At three months and six months KT-1000 differences of 2.3 ± 1.2 mm and 2.1 ± 1.2 mm were seen in patients with normal meniscus; 2.26 ± 1.51 mm and 2.16 ± 0.9 mm with partial meniscectomy of the PHMM <40%; 2.65 ± 1.53 mm and 2.4 ± 1.35 mm with partial meniscectomy of the PHMM >40%; 2.27 ± 1.19 mm and 2.07 ± 1.52 mm with partial meniscectomy of the lateral meniscus <40%; and 2.27 ± 1.44 mm and 2.07 ± 1.14 mm with partial meniscectomy of the lateral meniscus >40%; 2.55 ± 1.56 mm and 1.91 ± 1.09 mm with partial meniscectomy in body and/or anterior horn of medial meniscus <40% and 2.07 ± 1.81 and 2.14 ± 1.10 mm with partial meniscectomy in body and/or anterior horn of medial meniscus >40% (P > 0.05).

CONCLUSION:

PHMM acts as a secondary stabilizer of the knee joint in the absence of functional ACL. There is no effect of partial meniscectomy on mechanical stability of the knee in ACL reconstructed patients. Medial or lateral partial meniscectomy performed at the time of ACL reconstruction does not affect the stability of ACL reconstructed knee. However, the presence of a concomitant tear in PHMM is associated with increased instability in ACL deficient knee.

KEYWORDS:

ACL tear; Knee stability; Meniscus tear

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November -0001
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Mechanism of injury based classification of proximal tibia fractures

Authors:
Soni A Gupta R.

onliine Jounral of Clinical Orthop Trauma https://doi.org/10.1016/j.jcot.2018.08.012

Journal of Clinical Orthopaedics and Trauma

Abstract

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.

Keywords

Fracture
Proximal tibia
Condyle
Classification
Mechanism

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November -0001
6 Reads

Top co-authors

Nipun Jindal
Nipun Jindal

Government Medical College and Hospital

3
Kulbhushan Kamboj
Kulbhushan Kamboj

Government Medical College and Hospital

2
Rajiv Kansay
Rajiv Kansay

Government Medical College Hospital

2
Varun Aggarwal
Varun Aggarwal

Kalawati Saran Children's Hospital and Lady Hardinge Medical College

2
Ankush Jindal
Ankush Jindal

Government Medical College and Hospital

1
Amit Kumar
Amit Kumar

Hohai University

1
Manish Pruthi
Manish Pruthi

Tata Memorial Hospital

1
Vivek Jangira
Vivek Jangira

LHMC and Dr. Ram Manohar Lohia Hospital

1
Rohit Jindal
Rohit Jindal

Massachusetts General Hospital

1