Indrajeet Kumar

Introduction: Total hip arthroplasty (THA) remains one of the most effective surgical interventions for advanced hip pathology, providing reliable pain relief and functional restoration. Despite widespread use, outcomes from different regions and clinical settings continue to be valuable for benchmarking the quality of care. Materials and Methods: A prospective observational study was conducted in the department of orthopedics at a tertiary care center in eastern India. Thirty adult patients undergoing uncemented THA for various hip pathologies were enrolled. All procedures were performed using a porous press-fit acetabular cup through the modified Hardinge approach. Perioperative parameters, radiographic findings, and functional outcomes, including the Harris Hip Score (HHS), were recorded. Patients were followed at 1, 3, 6, and 12 months. One patient was lost to follow-up. Results: Among the 30 patients, 24 (80%) were male, and 6 (20%) were female. Primary indications included osteoarthritis secondary to avascular necrosis (16; 53.33%), post-traumatic arthritis (10; 33.33%), rheumatoid arthritis (3; 10%), and corticosteroid-induced arthritis (1; 3.33%). The mean pre-operative HHS was 43.33 ± 10.8, categorized as poor. The average operative duration was 87.23 min (range: 60–135), with a mean intraoperative blood loss of 388.67 mL (range: 220–820). Radiographically, none of the 29 evaluated patients demonstrated component loosening in either the acetabular or femoral zones at any follow-up interval (1, 3, 6, or 12 months). Functional outcomes showed statistically significant improvement: mean HHS increased to 80.97 ± 5.1 at 1 month, 86.07 ± 4.0 at 3 months, 90.42 ± 2.9 at 6 months, and 92.59 ± 2.7 at 12 months (P < 0.001 for all comparisons). Conclusion: Uncemented THA using a porous press-fit acetabular cup demonstrated excellent early outcomes, with no evidence of component migration or osteolysis during 1-year follow-up. Patients experienced significant and sustained improvement in functional scores, with no major complications reported. Keywords: Press-fit acetabular cup, uncemented total hip arthroplasty, screwless fixation, avascular necrosis, osteoarthritis hip, eastern India, modified Hardinge approach.

Total hip arthroplasty is an effective procedure for improving mobility and quality of life, but the comparative functional outcomes of cemented and uncemented techniques remain debated. In this prospective randomised study of 50 patients divided into two equal groups, clinical and radiological assessments were performed preoperatively and at regular intervals up to 4 years. Cemented THR demonstrated superior early outcomes, with significantly better pain relief and Harris Hip Scores at 6 weeks and 3 months. By 6 months, functional outcomes between cemented and uncemented THRs converged, with both groups achieving good-to-excellent results and minimal complications. Cemented implants provide faster early recovery, while the long-term advantages of uncemented implants require further investigation to guide individualised implant selection.

Introduction: Bone cementation has various effects on hemodynamics including potentially fatal bone cement implantation syndrome (BCIS). Most of the studies on BCIS are from developed countries. We have studied the effect of bone cement on hemodynamics in hip arthroplasty in the eastern Indian population and compared it with the available literature. Materials and Methods: This prospective study was done by a team of orthopedic surgeons and anesthesiologists in a tertiary center in eastern India between March 2020 and December 2022. Result: Seventy-two patients (Male 38: and Female 34) of age between 25 and 100 years fulfilling the inclusion criteria were included. In 43 patients (28/72, 38.88%) systolic and diastolic blood pressure fell in the range of 10 mmHg, in 22 patients (22/72, 30.56%) fall in blood pressure was in the range of 10–20 mmHg, and more than 20 mmHg fall in blood pressure were seen in seven patients (7/72, 9.72%). SPO2 decreased from 97–100% to 94–96% in 28 patients and 90–93% in six patients, which began to rise after 5 min of cementing and returned to normal after 10 min. Arrhythmias were seen in 16 patients with multiple comorbidity. Two patients had a cardiac arrest and one patient died after 6 h in the intensive care unit. Conclusion: Pre-operative evaluation, perioperative monitoring of hemodynamic parameters during cementing especially in high-risk patients with multiple comorbidities, and taking essential precautions during cemented arthroplasty are the key to preventing complications like BCIS. Keywords: Total hip arthroplasty, hemiarthroplasty, bone cement, bone cement implantation syndrome, hemodynamics, Eastern India.

There is scarce data on demography and different surgical treatment modalities for giant cell tumor of bone (GCTB) from eastern India. In light of this, the present study aimed to examine the demographic characteristics, different surgical treatment modalities, and recurrence rate of GCTB at a tertiary care institute in Bihar. A retrospective audit of 52 GCTB patients who were treated at the center from January 2016 to December 2020 was conducted. The minimum follow-up period was one year. GCTB patients underwent surgical procedures ranging from extended intralesional curettage with bone graft or bone cement with or without fixation to wide local excision to resection with or without reconstruction or amputation depending on the stage and site of the tumors. The mean age of patients was 31.86 years (range: 13-67 years). The distal femur (20 patients, 38.46%) and proximal tibia (11 patients, 21.15%) were the most common sites of the tumor. Sixty-eight confirmed cases (male: 32, female: 36) of GCTB were operated on, with a male-to-female ratio of 1:1.125. Sixteen patients (four males and 12 females) were lost to follow-up. So, the final study consisted of 52 patients with a median age of 28 years (first quartile: 24 years, third quartile: 38 years). The majority of patients (32 patients, 61.53%) were in the third and fourth decades of life. Based on this retrospective audit, it is concluded that the knee region is the most common site of GCTB. Surgery is the mainstay of management. Most of the patients came under Campanacci Grade 3 with low compliance with follow-up and adherence to the treatment. Hence, educational programs, the establishment of early detection centers, and timely referral to expert treatment are necessary.