Displaying publications 161 - 180 of 600 in total

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  1. Saturveithan C, Premganesh G, Fakhrizzaki S, Mahathir M, Karuna K, Rauf K, et al.
    Malays Orthop J, 2016 Jul;10(2):35-40.
    PMID: 28435559 MyJurnal DOI: 10.5704/MOJ.1607.007
    Introduction: Intra-articular hyaluronic acid (HA) is widely utilized in the treatment of knee osteoarthritis whereas platelet rich plasma (PRP) enhances the regeneration of articular cartilage. This study analyses the efficacy of HA and PRP in grade III and IV knee osteoarthritis. Methodology: This is a cross sectional study with retrospective review of 64 patients (101 knees) which includes 56 knees injected with HA+ PRP, and 45 knees with HA only. Results: During the post six months International Knee Documentation Committee (IKDC) evaluation, HA+PRP group showed marked improvement of 24.33 compared to 12.15 in HA group. Decrement in visual analogue score (VAS) in HA+PRP was 1.9 compared to 0.8 in HA group. Conclusion: We propose intra-articular HA and PRP injections as an optional treatment modality in Grade III and IV knee osteoarthritis in terms of functional outcome and pain control for up to six months when arthroplasty is not an option.
    Study site: Melaka General Hospital, Malaysia
  2. Sath S
    Malays Orthop J, 2020 Nov;14(3):184-187.
    PMID: 33403084 DOI: 10.5704/MOJ.2011.031
    Complications in the form of esophageal injury, tracheal injury, injury to carotids, implant failure, loosening of screws, etc do occur after anterior cervical surgeries. Although intra-operative esophageal injuries are as such rare, there have been few reports of delayed esophageal perforation as well after anterior cervical surgeries. We report a very rare case of migration of missing screw from anterior cervical plate after anterior cervical corpectomy and plating, which had ultimately migrated down to colon and had to be removed via colonoscopy. Along with removal of migrated screw from colon, revision of failed anterior cervical surgery was done wherein plate and screws were removed with mesh cage left in-situ as it was snug-fit while pharyngeophageal perforation was explored and was found to be spontaneously healing, with addition of posterior Bohlman's interspinous wiring for added stability. Migration of screw from the anterior cervical plate into the colon although very rare, should be always kept in mind and its potentially serious complications. We also conclude that particular attention should be given to elderly people with poor bony quality who have high chances of implant failure, along with attention to proper cage size, screw position and proper locking of the screw to further lessen the chances of implant failure.
  3. Sara Ahmad, T.
    Malays Orthop J, 2011;5(3):35-37.
    MyJurnal
    The Mahmood Merican Award is an annual award for the best original scientific or clinical study submitted by young trainees in orthopaedic surgery in Malaysia, for presentation during the annual scientific meeting of the Malaysian Orthopaedic Association (MOA). This award was initiated in 1997 to encourage high standard of research and scientific presentations among young trainees.A cash prize of RM 1,000 was donated by Dato Dr Mahmood Merican. All Award finalists will represent MOA as ambassadors to regional orthopaedic association meetings, a duty that will be fully sponsored by MOA.
  4. Santy JE, Kamal J, Abdul-Rashid AH, Ibrahim S
    Malays Orthop J, 2015 Jul;9(2):13-16.
    PMID: 28435603 MyJurnal DOI: 10.5704/MOJ.1507.006
    Percutaneous pinning after closed reduction is commonly used to treat supracondylar fractures of the humerus in children. Minor pin tract infections frequently occur. The aim of this study was to prevent pin tract infections using a rubber stopper to reduce irritation of the skin against the Kirschner (K) wire following percutaneous pinning. Between July 2011 and June 2012, seventeen children with closed supracondylar fracture of the humerus of Gartland types 2 and 3 were treated with this technique. All patients were treated with closed reduction and percutaneous pinning and followed up prospectively. Only one patient, who was a hyperactive child, developed pin tract infection due to softening of the plaster slab. We found using the rubber stopper to be a simple and inexpensive method to reduce pin tract infections following percutaneous pinning.
  5. Santoso A, Utomo P, Im CJ, Park KS, Yoon TR
    Malays Orthop J, 2018 Nov;12(3):53-56.
    PMID: 30555649 DOI: 10.5704/MOJ.1811.010
    Hip geometry abnormalities found in patients with hereditary multiple exostoses (HME) could promote premature hip joint degeneration which needs treatment. We report the case of a 45-year old male with right hip arthrosis who underwent two-incision minimally invasive (MIS-2) total hip arthroplasty (THA), with satisfactory outcome. This technique could be an alternative approach for performing THA in patients with hereditary multiple exostoses.
  6. Santoso A, Ingale PS, Park KS, Yoon TR
    Malays Orthop J, 2017 Nov;11(3):56-58.
    PMID: 29326770 DOI: 10.5704/MOJ.1711.006
    Migratory bone marrow edema syndrome (BMES) of the hip is a rare entity. We report the case of a 41-year old male with migratory BMES of the hip with eight months interval period between onset of the pain and consultation. This patient was successfully treated non-surgically. It is important to always inform the patient with unilateral BMES of the hip regarding the possibility of future involvement of the contralateral hip.
  7. Santoso A, Yoon TR, Park KS, Anwar IB, Utomo P, Soetjahjo B, et al.
    Malays Orthop J, 2020 Mar;14(1):18-23.
    PMID: 32296477 DOI: 10.5704/MOJ.2003.003
    Introduction: Periprosthetic joint infection (PJI) of the hip due to methicillin-resistant bacteria is difficult to treat and remain a challenge for arthroplasty surgeon.

    Material and Methods: Retrospective review was done to the patients who received two-stage revisions with an antibiotic loaded cement-spacer for PJI of the hip between January 2010 to May 2015. We found 65 patients (65 hips) with positive culture findings. Eight patients were lost to follow-up and excluded from the study. Among the rest of the 57 patients, methicillin-resistant infection (MR Group) was found in 28 cases. We also evaluate the 29 other cases that caused by the other pathogen as control group. We compared all of the relevant medical records and the treatment outcomes between the two groups.

    Results: The mean of follow-up period was 33.7 months in the methicillin-resistant group and 28.4 months in the control group (p = 0.27). The causal pathogens in the methicillin-resistant group were: Methicillin-resistant Staphylococcus aureus (MRSA) in 10 cases, Methicillin-resistant Staphylococcus epidermidis (MRSE) in 16 cases and Methicillin-resistant coagulase-negative Staphylococcus (MRCNS) in two cases. The reimplantation rate was 92.8% and 89.6% in the methicillin-resistant and control group, respectively (p= 0.66). The rates of recurrent infection after reimplantation were 23.1% (6/26) in the methicillin-resistant group and 7.6% (2/26) in the control group (p= 0.12). The overall infection control rate was 71.4% (20/28) and 89.6% (26/29) in the methicillin-resistant and control group, respectively (p = 0.08). Both groups showed comparable baseline data on mean age, BMI, gender distribution, preoperative ESR/CRP/WBC and comorbidities.

    Conclusions: Two-stage revision procedure resulted in low infection control rate and high infection recurrency rate for the treatment of methicillin-resistant periprosthetic joint infection (PJI) of the hip. Development of the treatment strategy is needed to improve the outcome of methicillin-resistant periprosthetic joint infection (PJI) of the hip.

  8. Sanjeevan R, Prabu S, Azizul A, Abdul-Halim Y
    Malays Orthop J, 2018 Jul;12(2):56-58.
    PMID: 30112131 MyJurnal DOI: 10.5704/MOJ.1807.011
    Being a rare clinical entity, discal cyst presents indistinguishably from other causes of lower back pain and radiculopathy. It is an extremely rare pathology with unclear pathogenesis, indeterminate natural history with no consensus on the ideal management of the condition. We report a rare case of discal cyst in a patient who presented to our centre with localised low back pain and subsequently left sided radicular pain. With the aid of MRI and with clear surgical indication we proceeded with endoscopic removal of the cyst and intraoperatively confirmed its origin from the adjacent disc. The patient had immediate relief of his symptoms and no postoperative complications. We recommend that endoscopic surgery can be an effective alternative to conventional open surgery for discal cyst of the lumbar spine.
  9. Samal P, Mohapatra NC, Mishra J, Mylarappa A, Das P
    Malays Orthop J, 2020 Mar;14(1):84-87.
    PMID: 32296488 DOI: 10.5704/MOJ.2003.014
    Giant cell tumour of tendon sheath is a benign soft tissue lesion most commonly found in the flexor aspect of hand and wrist. However, it is uncommon in foot and ankle and rare in bilateral achilles tendon. We report a case of 17-year-old female who presented with progressive enlargement of bilateral achilles tendon for six months. MRI findings showed that most of the tumour had intermediate to low signal intensity. Histopathology confirmed the diagnosis of giant cell tumour of tendon sheath. To help the patient regain the strength of the achilles tendon and walking abilities, a large area of tendon tumour was excised, followed by reconstruction with transfer of the peroneus brevis (PB) and posterior tibial (PT) tendon autograft. At two years follow-up, functional result was satisfactory.
  10. Sam CX, Anwar AZ, Ahmad AR, Solayar GN
    Malays Orthop J, 2021 Mar;15(1):119-123.
    PMID: 33880158 DOI: 10.5704/MOJ.2103.018
    Introduction: Reverse total shoulder arthroplasty provides a surgical alternative to standard total shoulder arthroplasty for the treatment of cuff tear arthropathy, arthritis and fracture sequelae. This study aimed to assess the short-term outcomes following reverse total shoulder arthroplasty for patients in a large public hospital in Malaysia.

    Materials and Methods: We identified and performed five primary reverse total shoulder arthroplasties between 1 May 2019 and 1 June 2020. All patients were contactable and available for analysis. Assessment of functional outcomes was performed using the Constant-Murley score, the patient satisfaction score (PSS), and imaging studies. The mean follow-up from operation to the time of reporting was 9.6 months (range, 3 to 14 months).

    Results: The median age for our patients was 58 years (±11.91). The most common indication for surgery was post-traumatic arthritis, followed by rotator cuff arthropathy and osteoarthritis. The mean Constant score improved from 9.0 pre-operatively to 52.3 post-operatively at a mean of 9.6 months. The majority of the patients were satisfied with the surgery as the post-operative range of motion, especially anterior elevation and abduction, improved in four of our patients and there were no short-term complications, for example, of infection or revisions, reported at the last follow-up.

    Conclusion: This study has shown that reverse total shoulder arthroplasty can yield good short-term outcomes for the treatment of complex shoulder problems in addition to cuff tear arthropathy. It should be considered a treatment for rotator cuff tears, severe arthritis and ≥ 3 parts proximal humeral fractures.

  11. Sallehuddin, A., Saw, A., George, J., Sengupta, S.
    Malays Orthop J, 2008;2(1):12-16.
    MyJurnal
    Purpose: To evaluate the usefulness of ultrasound guidance in percutaneous needle biopsy for musculoskeletal tumours.
    Methods: Forty-five consecutive patients underwent ultrasound-guided needle biopsy. An additional group of 50 patients who underwent needle biopsy without ultrasound guidance was retrospectively selected as historical control. The sample was considered adequate when a diagnosis can be made, and diagnostic when the diagnosis is similar to the final report based on the excised tumour.
    Results: Adequacy of the biopsy samples was 84% in ultrasound-guided group as compared 76% in the group with no ultrasound guidance. Diagnostic accuracy was 64% in the ultrasound-guided group and 52% in the group without ultrasound guidance. Both of these differences were not statistically significant.
    Conclusions: Ultrasound guidance did not provide a significant advantage in the biopsy of musculoskeletal tumours. Diagnostic accuracy seems to improve with the use of larger 14 gauge biopsy needle but further evaluation is necessary.
  12. Sakai Y, Nakashima H, Takatsu T, Imagama S
    Malays Orthop J, 2023 Mar;17(1):117-123.
    PMID: 37064635 DOI: 10.5704/MOJ.2303.014
    INTRODUCTION: Spinal osteochondroma is rare. The purpose of this study is to examine the clinical characteristics and surgical treatment outcomes of 11 patients with spinal osteochondroma.

    MATERIALS AND METHODS: The study included 11 patients with spinal osteochondroma. In these patients, we examined the onset level, onset site, initial symptoms, surgical procedure, outcomes and complications.

    RESULTS: Of the 11 patients, 9 presented with solitary tumours, and 2 had multiple. The mean post-operative observation period was six years and two months. The onset level was the cervical spine in eight patients, thoracic in two, and lumbar in one. The most common onset site was the posterior elements. The initial presentation was myelopathy in seven patients, radiculopathy in two, neck pain in one and feeling of mass in one. All patients underwent excision of the tumour, and depending on the tumour onset site, additional posterior or anterior decompression with or without fusion was performed. There was no recurrence in all patients. Intra-operative complications included dura tear and oesophageal injury in one patient with cervical onset, while post-operative complications included C5 palsy in one patient.

    CONCLUSIONS: In this study, surgical excision for osteochondroma of the spine were excellent with no recurrence of the tumour.

  13. Sahoo PK, Sahu MM
    Malays Orthop J, 2023 Mar;17(1):133-141.
    PMID: 37064638 DOI: 10.5704/MOJ.2303.016
    INTRODUCTION: Harvesting peroneus longus for ACL reconstruction is thought to create ankle instability which could add to postural instability from an ACL injury. This apprehension prevents its use as a graft of primary choice for many surgeons. To date, there is no evidence available describing changes in postural control after its use in ACL reconstruction. The purpose of the study was to analyse the changes in postural control in the form of static and dynamic body balance after ACL reconstruction with Peroneus Longus Tendon Graft and compare it with the unaffected limb at different time intervals.

    MATERIALS AND METHODS: Thirty-one participants with ACL injury were selected and subjected to an assessment of static and dynamic balance before and after ACL reconstruction using the HUMAC balance system. Outcome measures for Centre of Pressure (COP) assessment were average velocity, path length, stability score, and time on target. Comparison of scores was done pre-operatively as well as at three- and six-months post-reconstruction with Peroneus longus tendon graft.

    RESULTS: Static balance of the affected limb showed significant improvement with a decrease in average velocity (F=4.522, p=0.026), path length (F=4.592: p=0.024) and improvement of stability score (F=8.283, p=0.001). Dynamic balance measured by the time on the target variable also showed significant improvement at six-month follow-up (F=10.497: p=0.000). There was no significant difference between the affected and non-affected limb when compared at the different time intervals.

    CONCLUSION: The static and dynamic balance, which is impaired after ACL injury, improves with ACL reconstruction with PLT autologous graft. Hence PLTG can be safely used as a graft for ACL reconstruction without affecting postural control and body balance.

  14. Sahin K, Demirel M, Turgut N, Arzu U, Polat G
    Malays Orthop J, 2019 Mar;13(1):45-48.
    PMID: 31001384 DOI: 10.5704/MOJ.1903.009
    Aneurysmal bone cysts rather than local aggressive lesions of the bone which may arise in any part of the axial or appendicular skeleton. Although several theories are available in the literature, the pathogenesis is still conflicting. We report an exceptional case of an aneurysmal bone cyst in the distal femur of a female cerebral palsy patient who underwent bilateral distal femoral derotational osteotomy and plate-screw fixation operations when she was 11 years old. Twenty-four months after the operation, radiographs showed a cystic lesion in the distal portion of the right femur around the osteotomy site. The diagnosis of Aneurysmal Bone Cyst (ABC) was made and the lesion was treated by curettage with cement application. After 36 months of follow-up, there was no recurrence. This is the first case reported in literature which raises the possibility that an osteotomy could be a cause in the development of an aneurysmal bone cyst.
  15. Sahin K, Kendirci AS, Kocazeybek E, Demir N, Saglam Y, Ersen A
    Malays Orthop J, 2022 Nov;16(3):44-49.
    PMID: 36589385 DOI: 10.5704/MOJ.2211.008
    INTRODUCTION: Bigliani classification is used for determination of acromial morphology, but poor inter-observer reliability has been reported on conventional radiographs. This study aims to assess inter- and intra-observer reliability using magnetic resonance imaging (MRI).

    MATERIALS AND METHODS: Forty consecutive patients diagnosed with subacromial impingement syndrome were included to study. All subjects underwent standard shoulder MRI scan and acromial shape was evaluated by nine observers of different level of expertise (three attending surgeons, three senior orthopaedic residents and three radiologists). A second set of evaluation was performed in order to assess intra-observer reproducibility. Kappa (κ) coefficient analyses both for interobserver reliability and intra-observer reproducibility were then performed.

    RESULTS: Overall inter-observer agreement among nine observers was fair (κ=0.323). κ values for all 4 individual types ranged from 0.234 to 0.720 with highest agreement for type 4 and lowest agreement for type 3. Second evaluation did not result with an increase of inter-observer agreement (κ=0.338, fair). The κ coefficients for intra-observer reproducibility of nine observers ranged from 0.496 to 0.867. Overall intra-observer reproducibility was substantial. Comparison of inter- and intra-observer reliability among three groups showed no significant difference (p=0.92 and 0.22, respectively).

    CONCLUSION: Results showed that MRI did not show superior reliability compared to conventional radiographs. Moreover, inter- and intra-observer agreement did not differ between observers of different level of expertise. Findings of present study suggest that despite a sophisticated imaging modality like MRI, Bigliani's classification apparently lacks accuracy and additional criteria, or different assessment methods are required to assess acromial morphology for clinical guidance.

  16. Sahdi H, Rasit AH, Khoo CS, Bojeng A, Nur-Alyana BA
    Malays Orthop J, 2019 Jul;13(2):52-55.
    PMID: 31467654 DOI: 10.5704/MOJ.1907.011
    Congenital humeroradial synostosis can occur as an isolated clinical entity or as part of a syndrome. Bilateral elbow fixed flexion deformity is very incapacitating and challenging to treat. Here we present the case of a boy with fixed flexion deformity of both elbows due bilateral humeroradial synostosis. Other characteristic features of multiple synostoses syndrome were also present in this child, his elder brother and mother. We elected to improve the position of the right elbow by adapting the modified French osteotomy described by Bellemore et al.
  17. Sahdi H, Chan WH, Dollah NB, Entri A
    Malays Orthop J, 2018 Nov;12(3):43-46.
    PMID: 30555646 MyJurnal DOI: 10.5704/MOJ.1811.011
    Acquired radial clubhand deformity can be a consequence of large bone gap left by premature extensive radius osteomyelitis sequestrectomy. Single-bone forearm reconstruction is a salvage procedure when other motion-preserving techniques are not feasible. Here we present a child who developed radial clubhand deformity after an untimely sequestrectomy of radius diaphysis. In view of limited microsurgical expertise in our centre, single-bone forearm procedure was done utilising simple Kirshner wires to achieve radio-ulnar fusion. The procedure resulted in pain-free stable wrist, restoration of hand function and improved cosmesis.
  18. Sadagatullah AN, Nazeeb MN, Ibrahim S
    Malays Orthop J, 2017 Nov;11(3):31-35.
    PMID: 29326763 MyJurnal DOI: 10.5704/MOJ.1711.013
    Introduction: Osteosynthesis of the femur using an interlocking nail is the gold standard for treating diaphyseal fractures of the femur. There are two established entry points for the antegrade interlocking nails which is the piriformis fossa or the greater trochanter. It has been reported that varus malalignment was frequently seen in proximal femur fracture which were treated with interlocking nail utilizing the greater trochanter entry point. The study was done to find out if the problem was of significance. Materials and Methods: This was a retrospective study which included 179 patients with femur fractures which were treated from January 2013 till September 2015 in one Hospital. They were treated with interlocking nail either by utilizing the piriformis fossa (PF) or the greater trochanter (GT) entry points. Post-operative radiographs of the femur were used to measure the varus deformity. Results: Out of 179 patients, there were 5 patients who were reported to have unacceptable varus malalignment (2.79%). These 5 patients were out of the 88 (5.68%) patients utilizing the greater trochanter as the entry point. The same 5 patients were out 90 patients that were diagnosed with proximal femur shaft fractures (5.55%). Analysis with logistic regression was statistically not significant. Conclusion: There was higher rate of varus malalignment seen in proximal femur shaft fractures treated with interlocking nails utilizing the greater trochanter entry point. The incidence of varus malalignment was not significant statistically.
  19. Sabran, M.N., Talha, A.J.M., Omar, M., Ibrahim, M.Y., Shahril, Y.
    Malays Orthop J, 2008;2(2):21-26.
    MyJurnal
    This is a prospective randomized clinical trial to compare use of a combination of periarticular drug injection with patientcontrolled analgesia (PCA) to PCA alone in post-total knee arthroplasty (TKA). Thirty patients who were admitted for unilateral total knee arthroplasty were selected randomly into an Injection group or a Standard group. The periarticular injection contained Ropivacaine, Ketorolac and Adrenaline, given intra-operatively. The mean amount of opioid used was 22.87 mmol/L in the Injection group as compared to 39.78 mmol/L in the Standard group (p = 0.026). The Injection group had lower pain score at rest and during exercise (p=0.021, p=0.041, respectively), as well as better return to function (p=0.026) and shorter hospital stay (6.1 days, Injection; 7.5 days, Standard, p=0.027). Overall, the group receiving periarticular drugs injection had less pain, less narcotic usage, earlier return to function, similar experience of adverse effects and shorter hospital stays.
  20. Saadon I, Amit B, Zolquarnian A, Muhamad F
    Malays Orthop J, 2017 Jul;11(2):64-67.
    PMID: 29021882 MyJurnal DOI: 10.5704/MOJ.1707.010
    Musculoskeletal tumours of the lower limbs especially malignant tumours are not common. The fibula is the site of primary bone tumours as reported in 2.4% of lower limb tumours with the proximal third being more frequently involved than the distal segment. Osteosarcoma is the most common primary malignant bone tumour of nonhaematopoietic origin, with distal fibular involvement in 0.47% of patients. The advances in imaging techniques and neo-adjuvant chemotherapy have now made it possible to accurately define the extent of tumour and plan limb salvage with tumour resection. The purpose of this case report is to highlight the successful outcome of limb salvage procedure with a five year follow up in an 11-year old boy with distal fibular osteosarcoma. Limb salvage surgery with distal fibulectomy and retention of the foot are a good alternative to radical amputation.
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