European Journal of Orthopaedic Surgery & Traumatology

Article : Bilateral simultaneous total knee arthroplasty in severely deformed knees: use of an evidence-based rehabilitation programme

Authors : Vijay D. Shetty and Bhushan Shitole

Link : http://www.springerlink.com/content/850g127q637lw063/

PUBLICATIONS IN SOARD, APRIL 2010

Article : 1.Effectiveness of laparoscopic sleeve gastrectomy on glycemic control in obese Indians with type 2 diabetes mellitus

Authors : Poonam S. Shah, Jayashree S. Todkar, Shashank S. Shah
pages 138-141

Link : http://www.soard.org/article/S1550-7289%2809%2900529-2/abstract

Article : 2.Long-term effects of laparoscopic sleeve gastrectomy in morbidly obese subjects with type 2 diabetes mellitus

Authors : Jayashree S. Todkar, Shashank S. Shah, Poonam S. Shah, Jayashri Gangwani
pages 142-145

Link : http://www.soard.org/article/S1550-7289%2809%2900530-9/abstract

Article : 3.Prospective controlled study of effect of laparoscopic sleeve gastrectomy on small bowel transit time and gastric emptying half-time in morbidly obese patients with type 2 diabetes mellitus

Authors : Shashank Shah, Poonam Shah, Jayashree Todkar, Michel Gagner, S. Sonar, S. Solav
pages 152-157

Link : http://www.soard.org/article/S1550-7289%2809%2900776-X/abstract

Article : BILATERAL SIMULTANEOUS TOTAL KNEE ARTHROPLASTY IN SEVERLY DEFORMED KNEES :
Use of an evidence-based rehabilitation programme

Authors : Vijay D Shetty, Consultant Orthopaedic Surgeon and Bhushan Shitole, Fellow, Hiranandani Orthopaedic Medical Education (HOME)

Journal : European Journal of Orthopaedics and Trauma. February 2010

Abstract : Post-operative rehabilitation after staged total knee arthroplasties (TKAs) in severely deformed bilateral knee disease can be a very difficult task. At the same time, the safety of simultaneous (one stage) bilateral TKA remains controversial and highly debatable. We wish to report our experience with simultaneous bilateral conventional TKAs for all severely deformed knees, followed by a carefully planned, evidence-based rehabilitation programme. Simultaneous bilateral TKA in severely deformed knees is safe and very effective, provided attention to details of rehabilitation and overall multidisciplinary medical care is exercised.

Link : http://www.springerlink.com/content/850g127q637lw063/



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Article : 15th IAPQA CONFERENCE AT MEXICO CITY - 8th OCTOBER 2009
Controlling Nosocomial Infections –The Dr L H Hiranandani Hospital Experience

Authors: Uday Tewary - AGM Pharmacy, V M P Thomas - General Manager Operations & Projects,Suvin Shetty - Consultant Pathologist, Sheena Binu - Infection Control Nurse 

ABSTRACT

Dr L H Hiranandani hospital manages a vibrant and effective infection control program. The hospital infection control committee (HICC) has a multidisciplinary constitution. The surveillance of nosocomial infections is the foundation for organizing and maintaining an infection control programme. Hence, the infection control data collected and analysed include surgical site infections, catheter-related bloodstream infections, urinary tract infections and ventilator-associated infections.

The analysis involves comparing the data with the national and international benchmarks. The isolated microorganisms in the clinical specimens and their antibiogram are discussed to assess the trends and prevalence of antibiotic resistance and emergence of multidrug resistant bug. The measures taken after analysis help in taking corrective actions to reduce the average length of stay of patients and associated morbidity and mortality.

The infection control programme has helped to preempt any outbreaks in the high dependency areas of the hospital. It has also reduced the overall stay of the patient in hospital as evinced by a decreasing Average Length of Stay (ALOS), there by decreasing cost of treatment to the patient and a faster turnover for the hospital a win – win situation for all.

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Article :15th IAPQA CONFERENCE AT MEXICO CITY - 8th OCTOBER 2009
Energy and Resource Conservation - Simple Measures Big Savings

Authors : Dr Akash Rajpal - Assistant General Manager  - Hospital Operations, Anil Dhamdhere - Manager – Engineering Services

ABSTRACT

Dr L H Hiranandani Hospital pioneered some measures to conserve energy and also water in the daily hospital operation. It has been able to save energy from the state allocated quota and return some to the National power grid. The hospital conforming to ASHRAE standards for the environment within.   India is heavily dependant on rain and other natural sources for water. At the design stage ‘Rain water harvesting’ was planned. This has paid rich dividends. It helps reduce the water intake from the Government and at the same time accrues hospital savings

This paper will highlight the planning and benefits that has been derived from the forward thinking and planning

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Article: Arthroscopic view of transient synovitis of the hip joint : a case report.

Authors: Vijay D. Shetty, M.S Orth., Dr Gautam M. Shetty, M.S Orth.

Journal : Knee Surgery Sports Traumatology and Arthroscopy; August 2009

ABSTRACT

We present a case of a 13-year-old male patient with hip pain and limp. Inconclusive investigations and persistent symptoms resulted in the patient undergoing hip arthroscopy. At arthroscopy, a large focal cartilaginous defect of the femoral head with synovitis was seen and synovial biopsy confirmed the diagnosis. Arthroscopic debribement of the lesion, synovectomy and non-weight bearing for 6 weeks resulted in relief of symptoms. Transient synovitis is a common diagnosis in young children, but the extent of damage to the femoral head has not been previously described. Transient synovitis may not always respond to symptomatic treatment and hip arthroscopy may be useful in detecting the actual lesion and plan the treatment.

Key words : Arthroscopy; transient synovitis; hip joint

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Article: Anterolateral incision in total knee arthroplasty: is there a role for a longer incision in this day-and-age of minimal invasive surgery?.

Authors: Vijay D Shetty, Gautam M Shetty

Journal: European Jouranl of Orthopaedics and Traumatology (EJOST). Published online: 22 February 2009. http://www.springerlink.com/content/243315r41nnm44w4/

Affiliation: Hiranandani Othopaedic Medical Education (HOME)

ABSTRACT

Study design Prospective randomised study on the early clinical outcome of anterior midline versus anterolateral incision for total knee arthroplasty (TKA). Purpose To assess the early clinical outcome of anterior midline versus anterolateral incision for TKA in terms of wound dehiscence, time for wound healing, lateral flap numbness and knee range of movements. Method A total of 40 consecutive patients randomly received either anterior midline (midline group; 20 patients, 25 TKAs) or anterolateral skin incision (anterolateral group; 20 patients, 24 TKAs) followed by anteromedial arthrotomy. Postoperatively, the patients were assessed for wound dehiscence, time for wound healing, lateral flap numbness and range of movements. Results Midline group demonstrated more wound dehiscence, longer healing time and lateral flap numbness compared to anterolateral group. Although the incision was shorter in midline group(P < 0.0001), better flexion was achieved in anterolateral (P < 0.0001). Conclusion Anterolateral incision may be superior in terms of wound healing, lateral flap numbness and knee range of movements and may be a good alternative to the routine anterior midline incision especially in patients who want to kneel, for religious reasons, in the early postoperative period.

For more details please visit : http://www.springerlink.com/content/243315r41nnm44w4/

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Articles: Low Intensity Pulsed Ultrasound: Fracture Healing.

Authors: Vijay D. Shetty and Co-authors

This is the first joint publication between McMaster University, Canada and Dr L H Hiranandani Hospital, Mumbai, India. It is a symposium on fracture healing.

ABSTRACT

Background: Annually, millions of people across the world are inflicted with bone fracture injuries. Untimely healing is a significant burden in terms of socioeconomic costs, personal costs, and patient quality of life. Low intensity pulsed ultrasound (LIPUS) has gained much attention as a potential adjunctive therapy for accelerating fresh fracture healing, but its efficacy remains controversial. This paper is presented in two parts—a literature review followed by a systematic review. The literature review highlights the physiology of fracture healing and the influence LIPUS exerts on cells and molecules involved in this healing process. In part two, we present a systematic review of randomized controlled trials (RCTs) assessing the clinical effectiveness of LIPUS in accelerating the time to fracture healing.

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Persistent bilateral anterior hip pain in a young adult due to meralgia paresthetica: a case report

Vijay D. Shetty 1 * , Gautam M. Shetty 1

Address: 1 Department of Orthopaedic Surgery,

L.H Hiranandani Hospital, Powai,

Mumbai 400076, India.

Email: VDS - * vijaydshetty@gmail.com,

GMS - gautams10@gmail.com

Additional file 1: cover letter for revision.doc, 27K

http://www.casesjournal.com/imedia/9408052412419668/supp1.doc

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Complete Wellbeing articles written by doctors from L H Hiranandani hospital.

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Articles: Cervical screening for all OPD patients to detect and treat conservatively at risk patients for pre cancer/early cancer.

Authors: Surg. Cdr. Dr S. Chatterjee, M.D., (Principal Worker), Surg. Capt. Ms P. Tarneja, M.D., D.G.O. (Co-Worker) and Lt. Col. (AMC) S. Bhattacharya, M.D. (Co-Worker)

Final Report, Armed Forces Medical Research Committee (Project No. 2128/96)

ABSTRACT

The study was carried out at INHS Asvini (Dept. of Obstetrics & Gynaecology), i.e., the hospital catering to the needs of service personnel and their families. In the study the uterine cervix was evaluated using a colposcope. 315 women who had come to the OPD with some gynaecological complaint were evaluated. 250 were evaluable as they completed the study protocol. Cervical smears were taken and stained with Papanicolaou stain to ascertain inflammatory lesions, dysplasia or malignancy. The patients were also examined through a colposcope wherein the cervix was cleaned with 5% acetic acid and also Schiller’s test was performed. The patients “at risk” were treated with medical therapy and minimal invasive surgical techniques which results in a high cure

Persistent bilateral anterior hip pain in a young adult due to

 rate.

• The study it is concluded that

  · Pap smear should be performed on all sexually active women regardless of age coming to gynaecological OPD.

  · Examination of the external genitalia is important prior to taking a pap smear to exclude incidental vulval lesion and to exclude multicentric origin of disease.

  · Normal morphology of the cervix does not always indicate a healthy cervix.

  · Surgical treatment is most effective where medical therapy has failed.

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Articles: Persistent anterior hip pain in young adults : current aspects of diagnosis.

Authors: Dr Vijay D. Shetty, Department of Orthopaedic Surgery,

Dr L H Hiranandani Hospital, Powai, Mumbai - India

ABSTRACT

Persistent anterior hip pain, in young adults, presents a diagnostic and treatment challenge to hip surgeons. Diagnosis, in some cases, is difficult because available diagnostic tools are not very reliable, resulting in a difficult decision making process. This article discusses the possible causes, current knowledge of the condition and outlines a method to approach this difficult problem. (Hip International 2008; 18:)

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Articles: Clinical Diagnosis of Medial Plica Syndrome of the Knee: A Prospective Study.

Authors: Shetty VD, Vowler SL, Krishnamurthy S, Halliday AEG.

The Journal of Knee Surgery 2007;20:277-280

ABSTRACT

Clinical diagnosis of symptomatic medial plica that causes anteromedial knee pain is poorly defined in the literature; therefore, arthroscopy is considered to be the gold standard for diagnosing this condition. We report our system of clinical diagnosis for medial plica syndrome that is based on patient history and our criteria for clinical examination. This prospective study included 48 symptomatic patients (66 knees) with clinical suspicion of pathological medial plica based on five essential and four desirable criteria. All patients underwent arthroscopic examination to confirm or disprove the clinical diagnosis and also treatment. Arthroscopy confirmed the clinical diagnosis of medial plicae in 44 patients (62 knees) for a diagnostic accuracy of 91.7% (95% confidence interval [CI]: 80% to 97.7%) and sensitivity of 100% (95% CI: 92% to 100%). The 44 patients with pathological medial plicae at arthroscopy were treated by arthroscopic resection. Thirty-nine patients (55 knees) showed satisfactory outcome after arthroscopy (95% CI: 75.4%, 96.2%). Our method of clinical diagnosis of pathological medial plica is simple, inexpensive, noninvasive, and reliable. We conclude arthroscopy is successful in treating this condition.

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Articles: Factors influencing length of stay after primary total hip replacement: role of anaesthesia and the anaesthetist.

Authors: Shetty VD, Vowler SL, Villar RN.

HIP INTERNATIONAL 2007; 17: 64 - 69

ABSTRACT

We studied 121 consecutive total hip replacements (THRs) in 109 patients in order to establish the influence of anaesthetic technique, anaesthetist concerned, age of the patient, and body mass index (BMI) on the length of hospital stay after primary total hip replacement. Patients received either general anaesthesia alone (50 THRs) or a combination of general and local anaesthesia (lumbar plexus block; 71 THRs) from three separate anaesthetists. Our analysis showed that those patients who received a combination of anaesthesia showed shorter median length of hospital stay (three days) than those who received general anaesthesia alone (five days; p < 0.0001). The age of the patient was also critical (p = 0.003) as was the anaesthetist concerned (p = 0.01). BMI was unimportant.

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Articles: Hip Arthroscopy: Current concepts and review of literature.

Authors: Shetty VD, Villar RN.

British Journal Of Sports Medicine 2007;41:64-68.
 

ABSTRACT

Diagnosis and treatment of intra-articular hip problems in young patients present a challenge to hip surgeons. Previous studies have shown that non-invasive investigations such as radiography, computed tomography and magnetic resonance imaging provide limited help. Non-operative treatment is likely to result in persistent symptoms, and surgical options for intra-articular hip problems involve open arthrotomy of the hip joint, which carries potential risks associated with joint dislocation. Arthroscopy of the hip joint, therefore, seems to be an attractive option. It was once thought that introduction of a straight arthroscope into the ball-and-socket hip joint was almost impossible. Hip arthroscopy has seen several advances since then, and the speed at which it developed in recent years directly corresponded to the rate at which the conditions affecting the hip joint were identified. Athletes and other young individuals with hip injuries are increasingly being diagnosed with an ever evolving series of conditions. Many of these conditions were previously unrecognised and thus left untreated, resulting in premature ends to the patients’ competitive careers. Hip arthroscopy, as with any procedure, is not without risks. The procedure is not widely available as it requires specialist equipment and takes a long time to learn. Complications are few, occurring in <5% of patients.

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