Methods: A cross-sectional, self-administered online survey was carried out between 3 September and 15 October 2020.
Results: A total of 8393 complete responses were received from a nationwide sample. Poor sustainability in the practice of "new norm" was reported. Noteworthy disparities were observed in willingness to carry out "new normal" practices by gender, urban-rural locality, non-Han and Han Chinese and educational attainment. There was evidence of economic and social disruption associated with COVID-19 or "new normal" practices. The current mean (±standard deviation [SD]) happiness score (110.45 ± 17.55) was slightly lower than the mean happiness score before (111.12 ± 17.83) the COVID-19 pandemic (t= -9.01, p<0.001). Lower socioeconomic status and greater economic and social disruptions were associated with lower current happiness scores. Moreover, greater willingness to adapt to "new normal" practices was associated with higher levels of happiness.
Conclusion: There is a need to encourage sustainable practice of new norm post-pandemic. Segments of the public continue to experience significant economic and social effects and the post-pandemic 'new norms' remain at risk of leading to psychological consequences.
Methods: This was a cross-sectional study conducted among landscape workers at a public university in Kota Kinabalu, Sabah. Interviews were conducted due to low literacy of the participants, using structured questionnaires which consist of personal characteristics, work descriptions, ergonomic risk factors, as well as self-reported WRMSD symptoms using NORDIC questionnaire. Ergonomic risk assessment (ERA) using rapid entire body assessment (REBA) was then conducted.
Results: Fifty-five of 60 landscape workers agreed to participate (92% response rate). The overall prevalence of WRMSDs among landscape workers was 85.5%. The highest prevalence involving the shoulder (65.5%), followed by neck (23.6%), wrist/hand (23.6%), and lower back (20.0%) regions based on their self-reported WRMSD symptoms over the past 12 months. Awkward posture was the risk factor identified through ergonomic risk assessment (ERA) conducted by ERA trained personnel. None of the working postures during assessment was noted to be appropriate. Although no significant difference was associated with self-reported WRMSDs, majority of the landscape workers (71%) were classified as medium ergonomic risk group using REBA, with the remaining 29% considered to be high ergonomic risk group.
Conclusion: Improvement in awareness campaigns, modification of working tools, and enhanced administrative approaches are among the control and prevention measures recommended to delay or prevent the occurrence of WRMSDs.
Material and Methods: Professional sports persons aged between 16-50 years operated for ACL tear using BPTB, free STG and STGPI grafts with minimum follow-up of two years were identified from hospital records. Patients with associated knee injuries were excluded. Patients, divided in three groups according to graft used, were compared in terms of mechanical stability (arthrometric examination KT-1000 score), functional outcome (Lysholm Score), return to sports activity (Tegner score and difference in thigh circumference) and degenerative changes (KL grading).
Results: BPTB graft group was found to be better than free STG and STGPI graft groups in terms of KT-1000 score. There was no statistically significant difference among the groups in terms of Lysholm score, Tegner score, difference in thigh circumference and KL grading.
Conclusion: BPTB graft is better than free STG and STGPI grafts in terms of knee stability. When compared for patient reported outcome, return to sports activity, osteoarthritic changes and graft failure there is no significant difference among the three types of grafts.
Material and Methods: The present study was a hospital based prospective, single centre study. One hundred and two geriatric patients who had sustained hip fracture and had been managed surgically, having no cognitive dysfunction, living independently, having unhindered walking capability before the fracture, were included in the study. They were called for follow-up at 3rd, 6th, and 12th month after the hip surgery. Psychological assessment was done by the Hospital Anxiety and Depression Scale (HADS) and functional outcome by using the Harris hip score (HHS).
Results: Our study did not show association between psychological status and functional outcome except in one sub-group. Significant correlation was observed between the psychological status and functional outcome in most of the patients in the extra-capsular group. We have identified improvement in the depression, anxiety and functional scores during the follow-up.
Conclusion: We conclude that psychiatric disturbances in a geriatric patient after undergoing a surgery for hip fracture may lead to poor recovery. We recommend that all such geriatric patients should undergo a psychological assessment and proper therapy should be instituted to achieve good functional recovery.
Material and Methods: We conducted a retrospective study of children with angular deformity of the knee treated by the guided growth technique from January 2010 to December 2015 in a tertiary centre. The guided growth technique was done using either the flexible titanium plate (8-plate) or the 2-hole reconstruction plate. Correction of deformity was assessed on radiographs by evaluating the mechanical axis deviation and tibiofemoral angle. The implants were removed once deformity correction was achieved.
Results: A total of 17 patients (27 knees) were evaluated. Twenty-two knees (81.5%) achieved complete correction of the deformity. The median age was 4.0 (interquartile range 3.0-6.0) years and the median Body Mass Index (BMI) was 26.0 (25.0-28.0). There were 7 unilateral and 10 bilateral deformities with different pathologies (14 tibia vara, 3 genu valgus). The median rate of correction was 0.71° per month. One patient (1 knee) had screw pull-out and two patients (4 knees) had broken screws in the proximal tibia. Three patients (5 knees) failed to achieve complete correction and were subsequently treated with corrective osteotomies. Out of five patients (8 knees) who were followed-up for at least 12 months after removal of hardware, two had rebound deformities. No permanent growth retardation occurred in our patients.
Conclusion: Our outcome for guided growth to correct knee angular deformity was similar to other studies. Guided growth is safe to perform in children below 12 years old and has good outcome in idiopathic genu valgus and Langeskiold II for tibia vara. Patients should be observed for recurrence until skeletal maturity following implant removal.
Material and Methods: This is a level 2 prospective cohort study, recruiting 20 volunteers between 40 to 80 years old. Participants underwent 3 stations in 3 point crutch gait: straight line ambulation of 20m, timed-up-and-go-test, and computerised dynamic posturography. Participants also answered a subjective questionnaire on their crutch preferences.
Results: Axillary crutches demonstrated a faster speed of ambulation compared to forearm crutches (Axillary crutch v=0.5m/s, Forearm crutch v=0.44m/s, p=0.002). There was a lower increase in heart rate post activity for axillary crutches. For the timed-up-and-go test, completing the circuit with Axillary crutches was faster (t=63.06, p<0.001) versus the forearm crutch (t=75.36, p<0.001). For computerised dynamic posturography, participants recorded lower effort scores for backward tilts when using axillary crutches (39.13, p=0.0497) versus forearm crutches (42.03, p=0.0497). Subjectively, majority of participants felt that axillary crutches had an easier learning curve and were superior in the areas of ambulation, balance and stability.
Conclusion: Our study demonstrated that axillary crutches were superior to forearm crutches for 3-point crutch gait; axillary crutches had a faster ambulation speed, required less effort during use, provided superior stability and were the preferred choice subjectively. This study would be helpful for clinicians and therapists when prescribing mobility aids to individuals with impaired gait.
Material and Methods: This is a cross-sectional descriptive study measuring the isometric strength values using the handheld IDO isometer of dominant and non-dominant shoulder of healthy Filipino individuals aged 20 to 30 years old.
Results: There is no significant difference in the mean isometric shoulder strength between the dominant and non-dominant arm for both sexes. The male gender scored higher values compared to the female gender and is statistically significant.
Conclusion: There is no difference in isometric shoulder strength between the dominant and non-dominant shoulder. Strength differences favour the male gender.
Material and Methods: Thirty five patients with closed proximal humerus fractures, above 18 years old, admitted in our tertiary care hospital during the study period were enrolled. Patients underwent open reduction internal fixation with proximal humerus locking plate under general anaesthesia. Post-operative patients were assessed using Constant and DASH scores. Complications were recorded.
Results: In our study the absolute Constant score of the study population increases at three months and six months and was found to be significant. Mean Constant score for 4-part fractures was 45.6 which were inferior as compared to 2-part and 3-part fractures (43.1 and 44.6, respectively). The mean Constant score at six months was 51.80 +/- 6.71. All three types of proximal humerus fractures showed significant improvement in the mean DASH score over our study period of six months and was found to be significant. Mean DASH score at six months was 27.97+/-12.84. Out of the 35 cases in the study two had complications. One had implant failure (Neer's type 3, 60-year-old female) and one had varus collapse (Neer's type 3, 45-year-old male).
Conclusion: Due to angular stability and effective maintenance of the intraoperative fracture reduction during follow-up period, early post-operative mobilisation is possible which helps the patient to attain better shoulder range of motion and return to activity faster.
Material and Methods: Patients with shoulder pain for more than three months not responding to NSAIDs or physiotherapy with a diagnosis of rotator cuff tendinitis, confirmed by MRI, were included in the study. Patients with rotator cuff tear or any other shoulder pathology were excluded. We included a total of 30 patients who received 5ml of landmark guided PRP injection in the subacromial space followed by a six-week exercise program. Patients were followed-up at 3, 6 and 12 weeks. and were assessed clinically using the VAS, SPADI and Constant and Murley Score.
Results: VAS score of patients improved from a pre injection score of 7.4 to a score of 1.9 in the 12th week. The mean SPADI score and Constant score improved from a pre injection score of 73.33 and 39.57 to a post injection score of 18.1 and 86.47, respectively.
Conclusion: Platelet Rich Plasma injections showed good to excellent early results, in patients with rotator cuff tendinopathy with improvement in VAS, SPADI and Constant scores.
Material and Methods: A total of 55 patients who had undergone conventional surgery (Group A) are compared with 45 patients of UBS (Group B) in TSS. The primary outcome measure of Modified Japanese Orthopaedic Association score (m JOA) with neurological complications and dural injury were assessed. Secondary outcome measures of total blood loss (TBL), time duration of surgery (ORT) and length of hospital stay (LHS) were analysed.
Results: The pre-operative mJOA score 5.00(4.00-6.00) in the group A and 5.00(4.00-6.00) in the group B improved to 7.00(7.00-8.00) in the group A and 9.00(9.00-10.00) in the group B, respectively (P<0.001) at final average follow-up of 117.55 months for group A and 75.69 months in group B. More significant grade of myelopathy improvement and mJOA recovery rate (RR) were noted in group B. The TBL, ORT and LHS were more favourable in group B as compared to group A (p<0.0001). The group A had 9 (16.36%) neurological deficits compared to 2 (4.44%) in group B (p<0.001). Dural tears occurred in both groups (A=11, B=9). It was more frequent and not repairable in group A but without significant statistical difference.
Conclusion: UBS can reduce neurological deficits and improve outcomes in TSS. Secondarily, reduced blood loss, lesser surgical time and reduced LHS are significant added advantages of this new technology.
Material and Methods: This experimental study involved 225 bone specimens prepared from discarded bone fragments during a series of 45 knee and hip arthroplasty surgeries. The bone fragments were cut into five identical cubes and were randomly assigned to either control (positive or negative), or experimental groups (0.5% chlorhexidine, 10% povidone-iodine or 70% alcohol). The control negative was to determine pre-contamination culture. All bone specimens, except the control negative group were uniformly contaminated by dropping on the operation theatre floor. Subsequently, the dropped bone specimens except for the control positive group, were disinfected by immersing in a respective antiseptic solution for 10 minutes, before transported to the microbiology laboratory for incubation.
Results: The incidence of a positive culture from a dropped bone fragment was 86.5%. From the 37 specimens sent for each group, the incidence of positive culture was 5.4% (2 specimens) after being disinfected using chlorhexidine, 67.6% (25 specimens) using povidone-iodine and 81.1% (30 specimens) using alcohol. Simple logistic regression analysis demonstrated that chlorhexidine was significantly effective in disinfecting contaminated bones (p-value <0.001, odd ratio 0.009). Povidone-iodine and alcohol were not statistically significant (p-value 0.059 and 0.53, respectively). Organisms identified were Bacillus species and coagulase negative Staphylococcus. No gram-negative bacteria were isolated.
Conclusion: A total of 0.5% chlorhexidine is effective and superior in disinfecting contaminated bones.
Material and Methods: A cross-sectional study was conducted on 131 OA patients in Rehabilitation Health Organisation, Terengganu. Socio-demographic, clinical, lifestyle histories, 24-hour dietary intake and HRQOL were assessed using a structured questionnaire.
Results: Knee and/or hip OA patients recruited consisted of 19.1% of men and 80.9 % of women collectively with a mean age of 61.81 (9.28) years ranging from 38 to 83 years. The percentages of underweight, normal, overweight, and obese patients were 1.5%, 12.2%, 36.7%, and 49.6%, respectively. Further assessment of HRQOL showed that the highest mean score was obtained by the social functioning (SF) domain of 41.25 (27.16), while the mental domain scored the least mean score of 21.15 (20.92). In terms of gender breakdown, the males had significantly greater weight and height but lower body fat (BF) compared to their female counterparts, as well as a significantly higher energy, carbohydrate and protein intake. According to the age group, patients aged < 60 years had significantly greater weight, height, and BF than those aged ≥ 60 years.
Conclusion: This study is an important baseline reference for proper OA management and prevention by providing crucial nutritional status and HRQOL information.
Material and Methods: A retrospective observational study from September 2013 to August 2015 was conducted at a tertiary level medical teaching institution. The clubfeet were classified according to the Harold and Walker classification. Radiographic parameters assessed were the talocalcaneal angle (AP, lateral), talus-first metatarsal angle (AP, lateral) and calcaneal-fifth metatarsal angle. The scar and the functional score, according to Laaveg and Ponseti, were evaluated as outcome measures at the final follow-up.
Results: Twenty-four children with a mean age of 43.7 ± 24.7 months were enrolled in the study. There was a total of 36 clubfeet: 21 (65.6%) with a poor functional outcome; 12 (37.4%) with excellent to good scar in both horizontal and vertical components. There was a statistical significance between the pre-operative and post-operative radiological parameters (p<0.05). None of the patients presented with any limitation of activities of daily living despite the poor functional outcome in many of the children. There was no significant association between the qualities of scar (horizontal, vertical) and the functional outcome with age at presentation, pre-operative Harold and Walker classification and pre-operative radiographic angles.
Conclusion: Surgical intervention in terms of ala carte posteromedial soft tissue release could not produce a good outcome over four years in CTEV. The threshold for surgery in CTEV should be high, given the poor results.
Material and Methods: This is a retrospective study of patients with soft tissue injury who underwent PRP therapy between 2015 and 2018 at an orthopaedic and traumatology hospital. The study collected demographic data including the type of soft tissue injury and Visual Analog Scale (VAS) before and after the PRP injection. Those data were statistically analysed to identify the significance of PRP.
Results: Seventy-six patients were included, predominantly female, middle aged (40-69 years old) and class one obesity. Most of the complaints (61.8%) were in the lower extremity region. Pain improvements measured with mean VAS score were observed in both acute (3.06±1.28 to 0.8±0.65) and chronic (4±1.75 to 0.97±0.62) cases. There was a significant decrease of VAS score before and after the PRP injection (p < 0.000).
Conclusion: PRP injection is able to alleviate both acute and chronic pain in soft tissue injuries without additional analgesic.
Material and Methods: We retrospectively analysed radiographic data of 300 patients from a tertiary hospital's geriatric hip fracture database who underwent either hip hemi-arthroplasties or total hip arthroplasties. Proximal femur morphological measurements were recorded, analysed and compared to that of commonly used femoral stems. Subgroup analysis was performed to compare age and gender related differences.
Results: A total of 18.3% of the study population had a medial femoral offset (MFO) of less than 30mm, which is the smallest available offset for the implants studied. 22.6% of female and 3% of male subjects had MFOs that were less than 30mm. In our subgroup analysis, males had significantly larger femoral head diameters, MFO and vertical femoral offsets compared to females. Older subjects (75-90 years old) had significantly smaller femoral head diameters, vertical femoral offsets and neck shaft angles compared to younger subjects (60-75 years old).
Conclusion: Commonly used femoral stem implants have measurements that do not suit our Chinese population with small medial femoral offsets. In addition, elderly males have significantly larger femoral head diameters, medial and vertical femoral offsets whereas older subjects have significantly smaller femoral head diameters, vertical femoral offsets and neck shaft angles.