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V S Pai

Publications and source records attributed to V S Pai.

At least 19 recordsLinked to original sources
PubMed2006

Assessment of bony union following surgical stabilisation for lumbar spondylolysis: a comparative study between radiography and computed tomography.

PURPOSE: To compare the status of bony union seen on plain radiography versus computed tomography (CT) following tension band repair for refractory spondylolysis. METHODS: 14 patients (12 men and 2 women; mean age, 23 years; age range, 16-56 years) with a mean follow-up period of 6.35 years were included. All patients were operated on by one senior surgeon using either a Scott procedure (n=2) or van Dam modification of the Scott procedure (n=12). Bony union of the pars was assessed using both plain radiography (anteroposterior, lateral, and oblique views) and reverse gantry CT. The presence of bony union was determined if a bridging bone was shown in the images. The Oswestry Disability Index was measured at 6-year follow-up. RESULTS: 13 (93%) of 14 patients showed bony union on plain/oblique radiographs versus 7 (50%) on CT scan. The mean Oswestry Disability Index was 28 (good to excellent). The high incidence of nonunion shown on CT scanning did not correlate well with clinical results. CONCLUSION: Bony nonunion is more difficult to visualise on plain radiographs than reverse gantry CT. CT demonstrates more clearly the presence or absence of the bridging bone. Clinical results do not correlate with bony union, indicating that bony union is not required to achieve good results.

Adolescent↗
PubMed2003

A rare cause of irreducible dislocation of a total hip prosthesis.

This report describes a patient with an anterior dislocation of the total hip arthroplasty, which was irreducible using described techniques of closed reduction. It required an open reduction using a direct lateral approach with the release of the rectus femoris.

Aged↗
PubMed2003

Fractured neck of femur in the mobile independent elderly patient: should we treat with total hip replacement?

PURPOSE: To report the outcome of displaced sub-capital neck of femur fractures in the independent elderly (>70 years) managed with total hip arthroplasty through a modified Hardinge approach. METHODS: Between 1998 and 2000, a surgeon performed a cemented hip replacement using a modified lateral approach in 36 consecutive patients in the Hawke's Bay Regional Hospital, Hastings. Medical charts and out-patient follow-up clinic records were reviewed with respect to outcomes, with particular reference to complications. Independent review of functional outcome was completed at one year postsurgery using a questionnaire. RESULTS: At an average follow-up of 1.8 years (range, 1-3 years), no patient needed further surgery. One patient had died, giving a mortality rate at one year of 2.9%. All other medical complications were successfully treated. The overall prevalence of early medical complications was 43%. There were no dislocations, and 80% of patients had a good clinical outcome at their first follow-up. CONCLUSION: The modified lateral approach of Hardinge minimises the incidence of postoperative dislocation. However, there was a high incidence of medical complications and aggressive treatment of such complications was necessary, both preoperatively and postoperatively. The number of pre-existing medical conditions was a significant factor influencing patient morbidity.

Activities of Daily Living↗
PubMed2002

A modified direct lateral approach in total hip arthroplasty.

A modified lateral approach of Hardinge allows adequate access for orientation of the implant was described. Although this approach is more difficult than the posterior approach, there is a learning curve, when mastered, it ll definitely reduce the incidence of dislocation. In the Author s opinion, this approach should be used routinely for total hip arthroplasty for fractured neck of femur where the incidence of dislocation is unacceptably high using the posterior approach.

Arthroplasty, Replacement, Hip↗
PubMed2001

Rare case of sciatic nerve palsy in a modular total hip arthroplasty.

A rare case of sciatic nerve palsy in an uncemented modular hip arthroplasty is described. We believe that a delay in recognizing liner dissociation causing granuloma was responsible for the nerve palsy. Delay in diagnosis can be avoided by a careful inspection of prereduction and postreduction radiographs.

Arthroplasty, Replacement, Hip↗
PubMed2000

Persistent back pain in adults: Four case reports.

The author describes 4 cases of thoracic back pain. All 4 had significant night pain, and 3 of the 4 presented with an upper motor neuron lesion of the lower limbs subsequestly diagnosed as a primary vertebral tumor. All lesions were well demonstrated on CT examination and were proved to be chordoma, lymphoma, solitary plasmacytoma or aneurysmal bone cyst. Awareness of primary thoracic tumours is important, as early recognition may prevent irreversible damage to the cord.

Journal Article↗
PubMed1999

Recurrence of gout after total knee arthroplasty.

The existence of gout in a total knee arthroplasty (TKA) may be more common than is currently recognized. We report 2 cases of acute recurrence of gout in knees after TKA, 1 with coexistent infection.

Arthroplasty, Replacement, Knee↗
PubMed1997

A comparison of three lateral approaches in primary total hip replacement.

Three different lateral approaches for a Charnley total hip replacement were studied in 264 operations. The transtrochanteric approach was used in 94, the Liverpool in 88 and the Hardinge in 82. The mean follow up was 2.6 years (range 2 to 3 years). The clinical result was the same in each group. Radiographs showed that alignment of the femoral stem was significantly better in the transtrochanteric group. Grade III socket demarcation was more frequent with the Liverpool approach. There was no difference in cement distribution between the 3 groups, except the acetabular cement distribution was poor with the Hardinge approach. There was no increase in Trendelenburg gait after the Hardinge or Liverpool approach compared with the transtrochanteric approach. Dislocation was a problem after the transtrochanteric approach and risk factors were retroversion of the acetabular cup and detachment of the trochanter. Severe heterotopic bone formation was 5 times more common after the Liverpool, compared with the other two, approaches.

Arthroplasty, Replacement, Hip↗
PubMed1996

Significance of the Trendelenburg test in total hip arthroplasty. Influence of lateral approaches.

The effects of lateral approaches to total hip arthroplasty on abductor weakness and limp were studied in 264 patients with primary osteoarthritis. The Hardinge approach was used in 82 patients, the transtrochanteric approach in 94, and the Liverpool approach in 88. There was no difference in functional level, range of movement, and limp among three lateral approaches. There was no increase in Trendelenburg gait after the Hardinge or Liverpool approach compared with the transtrochanteric approach. It is evident that the Trendelenburg test is a useful part of clinical examination if performed and interpreted correctly.

Aged↗
PubMed1996

Compartment syndrome of the buttock following a total hip arthroplasty.

An elevation of the interstitial pressure in a closed osseofascial compartment results in compartment syndrome. This may be caused by a decrease in compartment volume or an increase in compartment contents. The gluteal compartment syndrome is rare. Because the gluteal region has a large volume, this compartment requires a massive increase in content to cause a compartment syndrome. Also, this compartment blends anatomically with the muscles of the thigh, allowing extravasation of blood outside the compartmental envelope. This case report is of a patient whose medial circumflex femoral artery was severed during a total hip arthroplasty through a posterior approach leading to compartment syndrome of the buttock. Although this clinical presentation has not been described as compartment syndrome, one similar presentation was described in the literature.

Aged↗
PubMed1995

A rare complication of pectoralis major rupture.

Pectoralis major rupture is an uncommon injury. Only 85 cases have been reported in the literature. Rupture may be partial or complete. The treatment of partial rupture is conservative, whereas in cases of total rupture surgical repair is advocated, particularly in young active patients. Complications are few. We describe a case of infection of the haematoma following a partial rupture. To the best of our knowledge it is the first case to be reported in the English literature.

Adult↗
PubMed1994

Heterotopic ossification in total hip arthroplasty. The influence of the approach.

The effects of lateral approaches for total hip arthroplasty on heterotopic bone formation were studied in 264 patients with primary osteoarthritis. The Hardinge approach was used in 82 patients, the transtrochanteric approach in 94, and the Liverpool approach in 88. The incidence of heterotopic ossification was 42%. A severe form of bone formation occurred five times more in the Liverpool approach than in other two approaches.

Aged↗