Journal of Orthopedic Education

This case study investigates the transformative impact of cognitive behavioural interventions on freezing of gait (FOG) in an 80-year-old female patient, Sharadha, diagnosed with Parkinson’s disease. Despite conventional treatments, Sharadha’s FOG persisted, hindering her mobility and diminishing her quality of life.1 Through a tailored treatment plan encompassing psycho education, cognitive restructuring, behavioural techniques, and stress management, Sharadha experienced remarkable improvements. She learned to challenge negative thought patterns, visualise fluid movement, and utilise external cues to overcome FOG episodes.2 As a result, Sharadha regained confidence, independence, and mobility, demonstrating the profound potential of non-pharmacological interventions in managing FOG in Parkinson’s disease. This study underscores the importance of holistic approaches in improving outcomes for individuals living with Parkinson’s disease and offers hope for enhanced quality of life through cognitive behavioural interventions. The implementation of the cognitive-behavioural intervention led to significant improvements in Sharadha’s mobility and overall quality of life. Within several weeks of beginning treatment, Sharadha reported a marked reduction in the frequency and severity of her FOG episodes. She became more confident in her ability to walk independently, even in challenging environments. The use of external cues, combined with her cognitive restructuring efforts, allowed Sharadha to break through the “freeze” moments, significantly reducing her risk of falls.

Introduction: Tibial plateau fractures are one of the common fractures that occur near the knee. These fractures are mainly due to high-velocity injuries. So, there is a high risk of ligamentous and meniscal injuries. It is always important to identify associated ligamentous and/or meniscus injuries in tibial plateau fracture that can change the treatment plan. This study aims to assess the association of ligamentous and/or meniscal injuries in patients with tibial plateau fractures. Materials and methods: This prospective observational study was conducted in the Department of Orthopaedics in B&B Hospital from September 2021 to May, 2022. 40 patients who meet the inclusion criteria were included in the study. All tibial plateau fractures were classified according to the Schatzker classification. MRI was reported by a single radiologist with a fellowship in musculoskeletal radiology. MRI findings were recorded and an association was studied with different types of tibial plateau fractures. Results: Out of 40 patients, 36(90%) patients had ligamentous and/or meniscal injuries. The mean age of the patients was 38.9 years. The majority of the cases were due to road traffic accidents. 40% of the cases had ligamentous injuries only, 15% had meniscal injuries only and 35% had both ligamentous and meniscal injuries. Among ligamentous injuries (isolated or combined), ACL injury was common (77%). Among meniscus injuries (isolated or combined), lateral meniscus injury was common (70%). Schatzker type II fracture had a high association with ligamentous and/or meniscal injuries.

Blood transfusion is often required during major orthopaedic surgery due to excessive blood loss, especially with joint arthroplasty, spinal fusion, and fracture repair. Despite the medical importance of transfusion in saving lives, new knowledge indicates that transfusion could have adverse effects on bone healing and bone regeneration. Physiological effects of blood transfusions on bone repair, particularly potential delays in inflammatory responses, impaired oxygen delivery, prolonged inflammation, and increased bone resorption, are the foci of this article. Understanding how transfusion-related immunomodulation and changed cytokine activity disrupt bone regeneration is essential for optimizing post-operative outcomes. Strategies to reduce the need for transfusion-inclusive blood-conserving techniques and pharmacological agents such as tranexamic acid and erythropoietin are presented. This article reviews the available literature to offer comprehensive understanding regarding how blood transfusions might influence bone healing in orthopaedic surgeries while simultaneously presenting potential alternative strategies to improve the outcomes for the patients.

When breast cancer cells spread from primary bone in the breast to the bones, they are called metastasis in the bone and this is considered advanced or stage 4 breast cancer and commonly affected bones are humerus, femur, spine, ribs, skull, pelvis. Patients with bone metastasis from breast cancer presents with pain, pathological fractures, spinal cord compression causing neurological symptoms, hypercalcemia. Bone scan detects metastasis. Treatment include radiation therapy, cryotherapy, bone modifying drugs to manage pain and prevent fractures1. One such case of proximal femur fracture due to metastasis secondary to breast cancer reported.

Using signs from the eye to understand what’s going on in the bones might sound unusual at first but it’s a line of thought that’s slowly gaining momentum. After all, a number of systemic diseases show up in the eye, and doctors have long relied on this connection. So, it’s not a big leap to consider whether eye health could also reflect bone health, especially in conditions like osteoporosis. In this work, we take a closer look at whether certain patterns things like how blood vessels look at the back of the eye, how stiff the cornea is, or changes around the optic disc might offer early clues about bone weakness. It’s not just guesswork; some of these features seem to share the same underlying causes as bone deterioration: inflammation, tiny vessel problems, and oxidative stress, to name a few. With tools like OCT and new ways to map the retinal vessels, clinicians might be able to pick up these signs well before bone loss becomes obvious. For orthopaedic doctors, that could mean acting earlier, perhaps even adjusting care plans based on what’s seen in the eye. And maybe just maybe this could shift the focus a bit. From reacting to fractures to trying to prevent them. That’s the bigger picture. Of course, a lot more research is needed. But the potential is there, and it’s worth paying attention to.