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Biomedical subjects

R G Deshmukh

Publications and source records attributed to R G Deshmukh.

15 recordsLinked to original sources
PubMed2006

Uncemented Austin-Moore and cemented Thompson unipolar hemiarthroplasty for displaced fracture neck of femur--comparison of complications and patient satisfaction.

Austin-Moore and Thompson monobloc prostheses are both commonly used for hemiarthroplasty for displaced fractures of the neck of femur in adults. There is an ongoing debate about, which of these prostheses should be preferred. We present a comparison of two groups of patients with this fracture treated using cemented Thompson prosthesis and uncemented Austin-Moore prosthesis. Mortality, morbidity and patient satisfaction in the two groups were compared. Cemented Thompson hemiarthroplasty was associated with significantly better patient satisfaction scores. There was no difference in the mortality rates and hospital stay. Patients preferred cemented unipolar Thompson hemiarthroplasty over the uncemented unipolar Austin-Moore hemiarthroplasty. A larger randomised prospective trial is needed to confirm this finding.

Aged↗
PubMed2003

Research output of a cohort of orthopaedic consultants in Great Britain.

There has been renewed emphasis on research following the Calman recommendations for higher training. It is often considered essential for progression in training to have participated in research projects and to have some publications to one's credit. Orthopaedic surgery is usually thought to lag behind other disciplines in this respect. It was decided to conduct a review of the research output of a cohort of orthopaedic consultants in Great Britain to obtain baseline information for future comparisons. A group of surgeons who graduated at least 25 years ago was chosen as it was felt this would provide the pattern of research output throughout the surgical career of the cohort. The type of publication and the various factors that may affect research output were studied. There was a significant difference in the output of consultants working in teaching hospitals and large centres compared to those in district general hospitals. Is the soil as important as the seed?

Bibliometrics↗
PubMed2002

Does body weight influence outcome after total knee arthroplasty? A 1-year analysis.

Obesity has been considered an adverse influence on the outcome of total knee arthroplasty (TKA), and overweight patients often are advised against having a TKA. The role of body weight has not been shown conclusively using objective outcome measures. A group of 180 patients undergoing primary TKA performed by a single surgeon for osteoarthritis was studied prospectively. Their baseline health status and knee scores were recorded, and changes in these measures were studied at 3 and 12 months after surgery. The Nottingham Health Profile was used to assess health status, and the Knee Society score was used to assess clinical outcome. Body mass index was used as a measure of obesity. We found that body weight did not influence adversely the outcome of TKA in the short-term.

Adult↗
PubMed1998

A technique to obtain correct rotational alignment during closed locked intramedullary nailing of the femur.

Closed intramedullary nailing is a successful method of treating adult femoral shaft fractures. In comminuted or segmental fractures, this operation is associated with an incidence of rotational malalignment and malunion. After locked nailing, this can only be corrected by further operation. A simple method of judging and obtaining rotational alignment in such cases intra-operatively is described. A comparison of two groups of patients with such fractures, one using this technique and the other using conventional methods of judging alignment, revealed statistically significant improvement in rotational alignment (p = 0.016).

Adolescent↗
PubMed1998

Polyethylene wear and periprosthetic osteolysis in metal-backed acetabular components with cylindrical liners.

A retrospective clinical and radiographic analysis was performed in 27 hips (23 patients), in which a threaded, porous-coated acetabular component with cylindrical liner was implanted (Sintered T-Tab-ST cup, Biomet, Warsaw, IN). Sixteen hips had cemented stems; 11 had cementless, circumferentially porous-coated stems. The mean clinical and radiographic follow-up period was 68 months. The mean patient age was 49 years; the mean patient weight was 68 kg. The mean rates of linear and volumetric wear were 0.25 mm/y and 149 mm3/y, respectively. Osteolysis occurred in 51.8% (14 hips). Wear rate and young age correlated with osteolysis (P = .0002 and P = .01, respectively). There were no cases of distal femoral osteolysis.

Acetabulum↗
PubMed1998

An intramedullary cement spacer in total hip arthroplasty .

Revision arthroplasty of the hip is often complicated by infection, bone loss, and perioperative fracture of the femur. A simple, inexpensive spacer that keeps tissue planes intact and prevents soft tissue contracture during the interoperative period of a 2-stage revision is described. This can provide intramedullary support to a fractured or weak femur and enable local antibiotic delivery, as well as permit limited mobilization of the patient. It can be easily fabricated during surgery using universally available materials and can be tailored for specific requirements. Such a spacer was used in 5 cases. The experience is presented, and the technique and pitfalls are discussed.

Arthroplasty, Replacement, Hip↗
PubMed1998

Primary hyperparathyroidism presenting with pathological fracture.

Primary hyperparathyroidism (PHPT) is an intriguing condition. Routine automated biochemical screening has made the diagnosis commonplace in developed countries and the disease is diagnosed early in its course when it is often asymptomatic. In developing countries or in recent immigrants from these countries, PHPT is often seen in an advanced stage with bone involvement. Associated dietary deficiencies may alter the biochemical profile and cause a diagnostic dilemma. It is important to include it in the differential diagnosis of pathological fractures. We report three cases of PHPT presenting with pathological fractures and discuss their diagnosis and management.

Adult↗
PubMed1995

Prediction of the long-term durability of all-polyethylene cemented sockets.

A retrospective study was done to determine the correlation between the rate of aseptic loosening and the early radiographic appearance of the bone-cement interface of the acetabulum of primary cemented total hip prostheses. Two hundred thirty-six hips implanted with modern cement technique were studied during an average clinical and radiographic followup of 9 years. Early radiographs and the last available radiographs were studied by 3 independent observers, and the quality of the bone-cement interface was evaluated with a standardized scoring system. On the acetabular side, the authors noted 0.8% clinical failure, a 3% rate of radiographic migration, and a 3.4% rate of progressive global radiolucency. Only 2.2% of hips considered well fixed on the postoperative film were loose. Of the hips considered not well fixed, the rate of aseptic loosening was 14.4%. The authors conclude that (1) the state of the bone-cement interface as seen on the early postoperative radiograph can predict the longevity of a cemented socket with a high degree of probability, and that (2) cementation of an all-polyethylene socket using modern cement technique is an excellent method of fixation for patients 60 years of age and older with degenerative joint disease.

Bone Cements↗
PubMed1995

Acute gonococcal sacro-iliitis--a case report.

Acute infective sacro-iliitis is a rare condition. Though gonococcal arthritis is not uncommon, this organism does not appear to have been isolated from the sacro-iliac joint. The first proven case of gonococcal sacro-iliitis is reported here. Difficulties in correct diagnosis of infective sacro-iliitis are highlighted. Management of gonococcal sacro-iliitis is described. With the increase in number of gonococcal infections, a case can be made for routine culture of joint material N. Gonorrhoeae in cases of septic arthritis in patients at high risk.

Acute Disease↗
PubMed1994

Impact of modern technique on long-term results of total condylar knee arthroplasty.

This study reports the 14-year survivorship for 106 consecutive total condylar knee arthroplasties implanted using modern technique. All were performed by a single surgeon and have been observed prospectively since 1979. Failure was defined as revision for any reason, or radiographic evidence of loosening of the components. Life-table analysis reveals a 95.6% clinical survival rate at 14 years, with no radiographically loose components. Confidence interval is +/- 4.2%. There were 4 revisions, but none for aseptic loosening, and there are no impending revisions. Thirty-seven patients (49 knees) were known to be deceased as of April 1993, and 8 other patients are lost to followup. Clinical results for patients with pre- and postoperative Hospital For Special Surgery knee scores show 72 knees rated excellent and 11 good (mean score, 90 points). The 4 failures were rated poor. Mean flexion was 100 degrees. Radiographs of 93 knees were evaluated using the criteria of the Knee Society. Average overall alignment was 5 degrees valgus. Radiolucencies were present in 29 of 78 femoral components with adequate radiographs, and averaged 1 mm in 1 zone. Tibial radiolucency was present in 42 of 93 tibiae, again averaging 1 mm in 1 zone, with no loose pegs. In comparison with the first series of total condylar prostheses, this series showed comparable clinical results, with improved radiographic results, and no radiographic failures.

Adult↗