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Background: Inadequate pain relief during the early post-operative stages following arthroscopic shoulder procedures may lead to patients having poor functional and satisfaction outcomes. The goal of our study is to evaluate the effect of Eperisone in patients undergoing arthroscopic rotator cuff repair, with regards to post-operative pain and functional outcomes. Methods: All patients who underwent arthroscopic rotator cuff repair between January to September 2022 were assessed. Patients eligible for the prospective study were separated based on their analgesia regimes. Group 1 received baseline analgesia (Paracetamol and Arcoxia). Group 2 patients had Eperisone prescribed as an additional adjunct. For breakthrough pain, oral tramadol was administered. Outcome measures inclusive of: Visual Analog Scale (VAS) pain score, morphine milligram equivalent (MME) values, University of California Los Angeles (UCLA) shoulder score and range of motion measurements were collated. Results: 40 patients were included in our study, of which 17 patients were in group 1 and 23 patients were in Eperisone group. There were no statistical difference in pain scores, UCLA scores and ROM in the first six weeks following surgery, between the control group and Eperisone group. The average amount of breakthrough opioid usage based on MME were slightly lower in the Eperisone group in the first two weeks, however this was not statistically significant. Conclusion: Addition of muscle relaxants such as Eperisone to post-operative analgesia regime did not significantly lead to improvement of pain scores or early functional outcome, in patients undergoing arthroscopic rotator cuff repair. However, Eperisone could still be offered on a case-by-case basis.

Lumbosacral transition vertebra (LSTV) is a common occurrence and its prevalence ranges from 2.6% to 35.6%. Our aim is to study this phenomenon in the adult Singaporean population and assess the level of degeneration of the suprajacent disc in those with LSTV. Retrospectively, 545 patients (Age = 57.6 ± 18.3 years; Male = 277; Female = 268) who underwent radiographic evaluation of the lumbar spine for lower back pain or radicular symptoms were shortlisted. LSTV was found to be present in 106 patients (19.4%) with sacralization of L5 and lumbarization of S1 occurring in 96 patients (17.6%) and 10 patients (1.8%), respectively. The most common form of LSTV was Castellvi type IIA (46 patients; 43.4%). Based on Pfirrmann grading, Grade IV disc degeneration was most common in both the LSTV level (63%) and the unfused suprajacent level (77%) in those with LSTV. There was a significantly higher number of patients with grade IV and above degeneration in the suprajacent disc level among those with LSTV when compared to the last unfused (L5-S1) disc level in those without LSTV (84% vs. 65%; p = 0.0001). This suprajacent disc degeneration seen in patients with LSTV may contribute to low back pain and related problems in these patients.

Study Design A systematic review. Purpose This study aimed to evaluate the prevalence of coexisting lumbar spondylosis (LS) and knee osteoarthritis (KOA), which has clinical implications on the screening, diagnosis, and management of orthopedic patients. Overview of Literature Due to current global health trends, the number of affected patients is expected to increase substantially. However, no prior systematic reviews have discussed this topic. Methods A systematic literature search was conducted in June 2021 in the PubMed, Embase, Scopus, CINAHL, and Cochrane CENTRAL databases. Clinical and epidemiological studies that reported quantitative data on the prevalence of coexisting LS and KOA were included. Studies which reported data on only LS or KOA alone were excluded. Odds ratios (ORs) and 95% confidence intervals (CI) for LS or KOA were retrieved or calculated for meta-analysis. Fixed-effects and random-effects models were used, and statistical significance was considered when p

Abstract Purpose This study aims to assess the significance of post‐operative change in limb length in medial opening wedge high tibial osteotomy (MOWHTO), and evaluate the correlation between correction angles and changes in limb length. We hypothesize that opening wedge height and correction angles directly correlate to changes in limb length. Methods The medical records and radiographs of 91 MOWHTO patients were retrospectively evaluated for relevant radiographical parameters both pre‐ and post‐operatively. The exclusion criteria are: (i) concurrent distal femur osteotomy in the same setting, (ii) other previous unilateral lower limb surgeries prior to MOWHTO and (iii) failure to follow‐up with post‐operative radiographs. A linear regression model was performed and a line of best fit, Pearson's correlation coefficient (r) and coefficient of determination (R2) were computed. Chi‐squared test was also performed, and results with P 8 mm) and smaller (

Abstract Purpose To qualitatively evaluate the current evidence reporting outcomes of intra‐articular injection of orthobiologics in patients undergoing high tibial osteotomy (HTO) for osteoarthritis of the knee. Methods A systematic search methodology of the PUBMED, EMBASE, and CINAHL databases was conducted in July 2021. The search workflow was in adherence to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA). The following inclusion criteria were adopted: clinical trials of any level of evidence, reporting outcomes following intra‐articular injection of orthobiologics during high tibial osteotomy for knee osteoarthritis, with a minimum number of 10 patients treated. Duplicate data, studies on implanted orthobiologics and articles not written in English were excluded from this review. Results Eight studies were included in this review, with a total of 585 patients. Outcomes were discussed based on the types of orthobiologics used: (i) Platelet‐Rich Plasma (PRP), (ii) Bone Marrow Aspirate Concentrate (BMAC), and (iii) Injected Mesenchymal Stem Cells (MSCs). Two studies utilised PRP, 4 studies utilised BMAC and 4 studies utilised injected MSCs.. Three studies provided Level II evidence and five studies provided Level III evidence. Statistically significant improvements in outcomes were documented in multiple trials, with few patients experiencing adverse events. Conclusion Intra‐articular injection of orthobiologics in patients undergoing HTO is safe and effective with good outcomes reported. Due to the lack of high‐level evidence, further research is required before this can be considered standard of care. Level of evidence III