1.Does Femoral Intercondylar Notch Volume Differ in Anterior Cruciate Ligament-Injured Adult Patients Compared to the Uninjured?: A Meta-Analysis
Vivek JHA ; Md. Quamar AZAM ; Prathmesh JAIN ; Shivakumar A BALI
Clinics in Orthopedic Surgery 2022;14(1):76-89
Background:
Stenotic femoral intercondylar notch is considered as a risk factor for anterior cruciate ligament (ACL) injury and three-dimensional notch volume is used as a marker for the injury. The primary purpose of this study was to assess the difference in notch volume between the ACL-injured and uninjured in men and women combined or stratified by sex. The secondary purpose was to assess the difference in notch volume between the ACL-intact men and women.
Methods:
A search of PubMed/Medline, Scopus, Google Scholar, and Cochrane databases from inception to December 9, 2020, was conducted without restrictions using the following terms: ACL, notch, volume, notch volume, femoral notch volume, and intercondylar notch volume. Studies that compared the ACL-injured with uninjured controls were included. Independent extraction of articles by two authors using predefined data fields including study quality indicators was done. All pooled analyses were based on the inverse-variance weighted random effects model and mean difference was chosen as the effect measure.
Results:
Nine studies (1,169 knees) qualified for overall analysis (both sexes combined) and significant heterogeneity was observed, which disappeared after pooling studies with age-sex matched controls and those without. Notch volume in the ACLinjured was 0.75 cm3 (95% confidence interval [CI], 0.53–0.96 cm3 ), which was smaller than that in the age- and sex-matched controls. Six studies qualified for analysis in men. Notch volume in the ACL-injured men was smaller, especially when non-contact ACL injury was considered (1.40 cm3 ; 95% CI, 1.08–1.73 cm3 ). Five studies qualified for analysis in women and ACL-injured women had smaller notch volume irrespective of the mechanism of injury (0.38 cm3 ; 95% CI, 0.18–0.59 cm3 ). Notch volume of the uninjured men was larger than that of the uninjured women (1.86 cm3 ; 95% CI, 1.54–2.18 cm3 ).
Conclusions
ACL-injured adults have smaller notch volume than the age- and sex-matched controls. Non-contact ACL-injured males have smaller notch volume compared to ACL-intact males. ACL-injured females have smaller notch volume irrespective of the nature of injury. Men have higher notch volume than women. The quality of evidence is very low to low.
2.Posterior dislocation of the hip with ipsilateral displaced femoral neck fracture.
Vivek TRIKHA ; Tarun GOYAL ; Ram-K JHA
Chinese Journal of Traumatology 2011;14(2):104-106
Traumatic posterior dislocation of hip associated with ipsilateral displaced femoral neck fracture is a rare injury. Moreover, the management of such patients evokes strong views regarding primary replacement or preserving the femoral head. We presented a case of young adult with such an injury. He was operated upon with reduction of the dislocation and fixation of femoral neck fracture with the help of cancellous screws. Two years later, the fracture had united and the patient was asymptomatic. We further proposed the mechanism of injury for such a fracture and discussed the management in the changing trauma scenario of the developing world.
Adult
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Femoral Neck Fractures
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complications
;
surgery
;
Fracture Fixation, Internal
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Hip Dislocation
;
complications
;
surgery
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Humans
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Male