Publications by authors named "Roshan Banjara"

4 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

Relationship between height and osteosarcoma at the time of diagnosis in the Indian population: A retrospective study.

J Clin Orthop Trauma 2021 Mar 18;14:162-166. Epub 2020 Apr 18.

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

Background: It has been indicated in several instances that tall stature is also an important risk factor in the development of osteosarcoma. This relationship between height and osteosarcoma is substantiated even more by the increasing evidences being put forth in the recent literature on dependence of certain tumors on the growth factors and their receptors, acting through autocrine or paracrine mechanisms. There has been no study on the Indian population that attempts to define such a relationship.

Purpose: The primary objective of this study was to define relationship between height of patients and osteosarcoma at the time of diagnosis in the Indian population.

Materials/methods: Retrospective data was collected from the old hospital records. Height of patients at the time of diagnosis was compared with expected height of patients of the same age with reference to the standardized growth charts provided by the Indian Academy of Paediatrics.

Results: Out of 98 patients, there were 65 male and 33 female patients with M: F ratio being 1.97:1. The mean age at diagnosis was 17 (SD = 8) years with range of 5-55 years (median = 17 years). Height of the patients at the time of diagnosis was 155.18 (SD = 15.47) cm with range of 115 cm-184 cm (median = 159 cm). Overall, patients with Osteosarcoma were found to be shorter than the expected height deduced from the national growth charts. When patients were divided into two groups of those who were of growing age and those who had completed growth, results were similar.

Conclusion: The observation that majority of patients with osteosarcoma in our study were stunted, is an important finding. It could be deduced from this observation that these patients are unable to mount the usual biological response to the overstimulated growth as part of tumorigenesis in osteosarcoma. This could point to a different scenario in the Indian population and more studies need to be carried out with larger number of patients to further elaborate on this observation.
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http://dx.doi.org/10.1016/j.jcot.2020.04.014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7919943PMC
March 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

Conjoined twins presenting with foot deformities: insights to management and challenges.

BMJ Case Rep 2019 Dec 10;12(12). Epub 2019 Dec 10.

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

Conjoined twins are a rare outcome of conception associated with numerous anomalies involving multiple organ systems. Musculoskeletal abnormalities like vertebral anomalies, sacral agenesis, foot deformities and hip dysplasia have been described in literature. We describe two cases of pyopagus twins with congenital talipes equinovarus and congenital vertical talus deformity which have not been described previously in this type of conjoined twins. The orthopaedist should look actively for such deformities in this patient population and be wary of the difficulties associated with their management.
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http://dx.doi.org/10.1136/bcr-2019-231247DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6936551PMC
December 2019