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Paul D, Ghoshdastidar S, Halder S, Sarkar DK. Are Women Finally Joining Orthopedics in India? A Study of the Causes Limiting the Number of Women in Orthopedics in India with Steps for Furthering Progress. Indian J Orthop 2023; 57:586-595. [PMID: 37006728 PMCID: PMC10050455 DOI: 10.1007/s43465-023-00834-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 01/23/2023] [Indexed: 02/10/2023]
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Campbell DG, Poonnoose PM, Oommen AT, Natesan R. Perception of Perioperative Risk for Arthroplasty Patients: A Poll of Indian Orthopedic Surgeons. J Arthroplasty 2023:S0883-5403(23)00095-5. [PMID: 36773665 DOI: 10.1016/j.arth.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 02/01/2023] [Accepted: 02/03/2023] [Indexed: 02/13/2023] Open
Abstract
BACKGROUND A survey of the American Association of Hip and Knee Surgeons (AAHKS) reported that 95% of respondents attempted to modify risk factors prior to arthroplasty. This study investigated Indian arthroplasty surgeons' approach to patients who have modifiable risk factors. METHODS The AAHKS survey tool was adapted for Indian surgeons and distributed to the membership of the Indian Society of Hip and Knee Surgeons and Indian Arthroplasty Association via a Survey Monkey. A total of 92 survey responses were received, representing a response rate of 12%. RESULTS Overall, 87% of respondents restricted access to arthroplasty surgery for patients who have modifiable risk factors, but only 51% of respondents reported delays or restricted treatment because of risk factors. Respondents reported that financial implications were more likely to delay or restrict treatment in 97% and social/family reasons in 66%. Poor diabetic control (81%), previous infection (57%), and malnutrition/hypoalbuminemia (47%) were the most frequent modifiable risk factors. There were 82% of surgeons reporting that the patient's socioeconomic status influenced treatment including: 71% of patients who have low socioeconomic status, 57% who do not have insurance, and 45% who have limited social supports. Most surgeons (92%) reported that funding influenced the type of care provided and the choice of implants. CONCLUSION Over 97% of Indian arthroplasty surgeons thought socioeconomic factors impaired access to orthopaedic treatment. Only half the surgeons restricted access for comorbidities and these were more often related to infection risks and diabetes. These findings contrast dramatically to the practice patterns of American AAHKS members.
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Affiliation(s)
- David G Campbell
- Centre for Orthopaedic and Trauma Research, University of Adelaide, Adelaide, Australia
| | - Pradeep M Poonnoose
- Department of Orthopaedics, Christian Medical College Hospital, Vellore, Tamil Nadu, India
| | - Anil T Oommen
- Unit 2, Department of Orthopaedics, Christian Medical College Hospital, Vellore, Tamil Nadu, India
| | - Rajkumar Natesan
- Department of Joint Replacement Surgery, Ganga Hospital, Coimbatore, Tamil Nadu, India
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Iyengar KP, Jain VK, Nallakumarasamy A, Jeyaraman M. Virtual Fracture Clinic Model in India: A Technological Innovation. Indian J Orthop 2023; 57:1-6. [PMID: 36660488 PMCID: PMC9789262 DOI: 10.1007/s43465-022-00763-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/10/2022] [Indexed: 02/04/2023]
Abstract
Background Virtual Fracture Clinics (VFCs) are an alternative to the conventional model of fracture and minor injuries care. It is a new, evolving service designed to speed up patient access to orthopaedic care introduced in the United Kingdom in 2011 and has been increasingly used in the management of certain musculoskeletal injuries. Methods This observational, pilot study evaluates the possibility of combining telemedicine technology and a virtual fracture clinical assessment pathway to remotely assess patients supported by radiology imaging in India. Results Piloting and developing a virtual fracture clinical assessment pathway model in India is faced with many challenges including regulations, internet, and data connectivity issues, and concerns of medico-legal implications. Conclusion Recent studies have reported Virtual Fracture Clinics (VFCs) to be able to provide a safe, cost-effective model of patient care in a subset of musculoskeletal injuries. Limitations and shortcomings of Virtual Fracture Clinics (VFCs) in India can be mitigated with effective communication, enhanced documentation, appropriate training, and information governance. This pathway is not a replacement for conventional 'face-to-face' evaluation but a credible option to complement the delivery of trauma and orthopaedic care in the future in India.
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Affiliation(s)
| | - Vijay Kumar Jain
- Department of Orthopaedics, Atal Bihari Vajpayee Institute of Medical Sciences, Dr Ram Manohar Lohia Hospital, New Delhi, 110001 India
| | - Arulkumar Nallakumarasamy
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, 751019 Odisha India
| | - Madhan Jeyaraman
- Department of Orthopaedics, Faculty of Medicine-Sri Lalithambigai Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai, 600095 Tamil Nadu India
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Kandwal P, Barik S, Maini L. Orthopedic Undergraduate Education in India: Need for a Change. Indian J Orthop 2022; 56:1843-1846. [PMID: 36310557 PMCID: PMC9561498 DOI: 10.1007/s43465-022-00735-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 08/24/2022] [Indexed: 02/04/2023]
Affiliation(s)
- Pankaj Kandwal
- All India Institute of Medical Sciences, Rishikesh, India
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Singh A, Das S, Chopra A, Danda D, Paul BJ, March L, Mathew AJ, Shenoy P, Gotay C, Palmer AJ, Antony B. Burden of osteoarthritis in India and its states, 1990-2019: findings from the Global Burden of disease study 2019. Osteoarthritis Cartilage 2022; 30:1070-1078. [PMID: 35598766 DOI: 10.1016/j.joca.2022.05.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 04/19/2022] [Accepted: 05/02/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe the burden of osteoarthritis (OA) in India from 1990 to 2019. DESIGN Data from Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 were used. The burden of OA -knee OA, hip OA, hand OA, and other OA- was estimated for India and its states from 1990 to 2019 through a systematic analysis of prevalence, incidence, years lived with disability (YLD), and disability-adjusted life years (DALY) using methods reported in GBD 2019 study. RESULT Around 23.46 million individuals in India had OA in 1990; this increased to 62.35 million in 2019. The age-standardised prevalence of OA increased from 4,895 (95% uncertainty interval (UI):4,420-5,447) in 1990-5313 (95%UI:4,799-5,898) in 2019, per 100,000 persons. Similarly, DALYs due to OA increased from 0.79 million (95%UI:0.40-1.55) to 2.12 million (95%UI:1.07-4.23); while age-standardised DALYs increased from 164 (95%UI:83-325) to 180 (95%UI:91-361) per 100,000 persons from 1990 to 2019. OA was the 20th most common cause of YLDs in India in 2019, accounting for 1.48% (95%UI:0.88-2.78) of all YLDs; increasing from 23rd most common cause in 1990 (1.25%(95%UI:0.74-2.34)). Knee OA was the most common form of OA, followed by hand OA. The prevalence, incidence, and DALYs for OA and knee OA were consistently higher in females than males. CONCLUSION The burden and impact of OA in India are substantial and is increasing. Adopting suitable control and preventive community measures to reduce modifiable risk factors (obesity, injuries, occupational stress) are needed to reduce the current and future burden of OA in India.
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Affiliation(s)
- A Singh
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - S Das
- Era's University, Lucknow, India
| | - A Chopra
- Centre for Rheumatic Diseases, Apollo Jehangir Hospital, Pune University, Pune, India
| | - D Danda
- Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India
| | - B J Paul
- Department of General Medicine, KMCT Medical College, Calicut, Kerala, India
| | - L March
- Institute of Bone and Joint Research, Kolling Institute of Medical Research, University of Sydney, Sydney, Australia; Florance and Cope Professorial Rheumatology Department, University of Sydney Royal North Shore Hospital, St Leonards, Sydney, Australia
| | - A J Mathew
- Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India; Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Copenhagen University Hospital - Rigshospitalet Glostrup, Denmark
| | - P Shenoy
- Centre for Arthritis & Rheumatism Excellence, Kochi, Kerala, India
| | - C Gotay
- University of British Columbia, Vancouver, BC Canada
| | - A J Palmer
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - B Antony
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
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Runu R. Postgraduate orthopedic training – Where are we today? JOURNAL OF ORTHOPAEDIC DISEASES AND TRAUMATOLOGY 2022. [DOI: 10.4103/jodp.jodp_70_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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John AT, Madhuri V. A Preliminary Survey of Women Orthopaedic Surgeons on Awareness of Radiation Safety Practice and Breast Cancer Risk in India. Indian J Orthop 2021; 56:452-456. [PMID: 35251509 PMCID: PMC8854465 DOI: 10.1007/s43465-021-00524-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 09/13/2021] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To assess women surgeons' awareness of radiation protection protocols, cumulative dose, safety measures, radiation exposure, and breast cancer risk in India. METHODS The data were acquired through a survey monkey questionnaire circulated to women orthopaedic surgeons across the country through the WOICE group, e-mails and phone. The questionnaire assessed the respondents' awareness of radiation protection measures and level of exposure. Medical history on breast cancer during their professional life, time of diagnosis, and radiation exposure were collected. Data were analysed and expressed as percentages. RESULTS Fifty-one women orthopaedic surgeons responded. These were sub-grouped into early and late-career group based on whether they had worked in orthopaedics for less than 10 years (n = 33) or 10 or more years (n = 18). The mean number of years of practice of the respondents was 8.1 years, and for the group with 10 or more years was 18.7 years. 90.2% reported compliance to the lead shield, while 9.8% (n = 5) were non-compliant because of the shield's weight. Of the included respondents, 88.8% are currently working. Among all the respondents, only 13.7% (n = 7) use a radiation dosimeter. Not surprisingly, 88.2% (n = 45) of all respondents were unaware of the total radiation exposure received. Two surgeons in the more than 10-year practice category reported a history of breast carcinoma. CONCLUSIONS This preliminary report suggested a need for more awareness of radiation protection measures among women orthopaedic surgeons. Hence, along with the practice of wearing a lead gown, use of lightweight shield, awareness on exposure measure and use of radiation dosimeter should be encouraged.
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Affiliation(s)
- Ansu Thankam John
- Department of Orthopaedics, Christian Medical College, Vellore, 632 002 Tamil Nadu India
| | - Vrisha Madhuri
- Department of Paediatric Orthopaedics, Christian Medical College, Vellore, 632 002 Tamil Nadu India
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Kaidi AC, Hellwinkel JE, Rosenwasser MP, Ricci WM. The history of orthopaedic surgery in India: from antiquity to present. INTERNATIONAL ORTHOPAEDICS 2021; 45:2741-2749. [PMID: 34406432 DOI: 10.1007/s00264-021-05174-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 07/28/2021] [Indexed: 10/20/2022]
Abstract
Indian orthopedists have a legacy dating back more than 4000 years. Starting with the Harappan civilization, ancient orthopaedic surgeons reduced fractures and conducted therapeutic trepanations. Since then, Indian physicians have pioneered many of the orthopaedic techniques still used today - including the use of prosthetics, fracture tables, and rehabilitative physical therapy. Today, orthopaedic surgeons coexist with traditional Indian bonesetters. Although bonesetting practices can have complication rates as high as 40%, bonesetters still handle a majority of fractures in India and are often culturally preferred. Importantly though, bonesetters are often the only expedient option available in both rural and urban settings.
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Affiliation(s)
- Austin C Kaidi
- Department of Orthopedic Surgery, Columbia University Medical Center, 622 W. 168th St, PH-11, New York, NY, 10032, USA.
| | - Justin E Hellwinkel
- Department of Orthopedic Surgery, Columbia University Medical Center, 622 W. 168th St, PH-11, New York, NY, 10032, USA
| | - Melvin P Rosenwasser
- Department of Orthopedic Surgery, Columbia University Medical Center, 622 W. 168th St, PH-11, New York, NY, 10032, USA
| | - William M Ricci
- Orthopedic Trauma Service, Hospital for Special Surgery, 535 East 70th St, New York, NY, 10021, USA
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James D, Gajendran M, Paraseth T. Epidemiological determinants of children's orthopedic care in rural central India. JOURNAL OF ORTHOPEDICS, TRAUMATOLOGY AND REHABILITATION 2021. [DOI: 10.4103/jotr.jotr_36_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Goyal ND, Chavan RK, Pahwa A, Gautam VK, Mishra N, Tripathi PK. "OPD TRIAGE" - A novel concept for better patient management in heavily loaded orthopaedic OPDs. J Clin Orthop Trauma 2020; 11:S472-S478. [PMID: 32774014 PMCID: PMC7394801 DOI: 10.1016/j.jcot.2020.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 04/04/2020] [Accepted: 04/06/2020] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND A heavily loaded subsidized government run OPD at tertiary care hospital normally caters 200-300 patients daily. Constant improvement in management of OPD through new policies are essential for better patient management and for proper utilization of skill, expertises and time of senior faculty. We designed a new concept of OPD TRIAGE for the same. MATERIAL AND METHODS Study was carried out on 1800 randomly selected patients, 950 each on triage & non triage interventional day.Patients were interviewed and changes in their satisfaction level were noted through a questionnaire. Senior treating faculty were also questioned about their changes in behaviour towards patient due to the intervention. RESULTS On triage days around 91% patients are satisfied with professional care, depth of relationship, doctor's attitude, counselling from doctor. While on non triage days, this figure is only 51%. Regarding treating doctors, around 93% percent of the time, the consultants were more happy and enthusiastic to consult patients on OPD triage days. While on non triage days it was only 32%. CONCLUSION The concept of OPD Triage can very efficiently be applied for better management of patients in heavily loaded government OPD setup, which will also help in proper data maintenance, increase patients satisfaction and for efficient utilization of time, skills and expertise of the treating consultant.
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Affiliation(s)
- Nishant D. Goyal
- Department of Orthopaedics, ShriVasantrao Naik Medical College and Hospital, Yavatmal, Maharashtra, India,Corresponding author. Vrudavan Nagar, Kandli Paratwada, Dist-Amrawati, Maharashtra, India, Pin-444805.
| | - Rajesh kumar Chavan
- Dept of Orthopaedics, ShriVasantrao Naik Medical College and Hospital, Yavatmal, Maharashtra, India
| | - Anshul Pahwa
- Department of Obstetrics and Gynaecology, ShriVasantrao Naik Medical College and Hospital, Yavatmal, Maharashtra, India
| | | | - Neeraj Mishra
- Dept of Orthopaedics, Rajawadi General Hospital, Mumbai, India
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11
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Madhuri V, Khan N. Orthopaedic Women of India: Impediments to Their Growth. Indian J Orthop 2020; 54:409-410. [PMID: 32549957 PMCID: PMC7270374 DOI: 10.1007/s43465-020-00130-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 04/27/2020] [Indexed: 02/04/2023]
Affiliation(s)
- Vrisha Madhuri
- Department of Pediatric Orthopedics, Christian Medical College, Vellore, India
| | - Nabila Khan
- Department of Pediatric Orthopedics, Christian Medical College, Vellore, India
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12
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Iyengar KP, Jain VK, Vaish A, Vaishya R, Maini L, Lal H. Post COVID-19: Planning strategies to resume orthopaedic surgery -challenges and considerations. J Clin Orthop Trauma 2020; 11:S291-S295. [PMID: 32367999 PMCID: PMC7196552 DOI: 10.1016/j.jcot.2020.04.028] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 12/15/2022] Open
Abstract
The Coronavirus SARS-CoV-2 (COVID-19) pandemic has had a substantial effect on the health care systems around the world. As the disease has spread, many developed and developing countries have been stretched on their resources such as personnel as well as adequate equipment. As a result of resource disparity, in a populous country like India, the elective orthopaedic surgeries stand cancelled whilst trauma and emergency services have been reorganised following Indian Orthopaedic Association and recent urgent British Orthopaedic association guidelines. Though these guidelines provide strategies to deal with trauma and orthopaedic surgery management in the present scenario, once the COVID-19 pandemic stabilizes, restarting elective orthopaedic surgery and managing delayed trauma conditions in evolving health care systems is going to be a profound task. We look at the future challenges and considerations of re-establishing trauma and orthopaedic flow during the post-COVID-19 phase and suggest an algorithm to follow (Fig. 1).
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Affiliation(s)
- Karthikeyan P. Iyengar
- Trauma and Orthopaedic Surgeon, Southport and Ormskirk NHS Trust, Southport, PR8 6PN, UK,Corresponding author.
| | - Vijay K. Jain
- Department of Orthopaedics, Atal Bihari Vajpayee Institute of Medical Sciences, Dr Ram Manohar Lohia Hospital, New Delhi, 110001, India
| | - Abhishek Vaish
- Trauma and Orthopaedic Surgeon, Department of Orthopaedics, Indraprastha Apollo Hospital, Sarita Vihar, Mathura Road, 110076, New Delhi, India
| | - Raju Vaishya
- Department of Orthopaedics, Indraprastha Apollo Hospital, Sarita Vihar, Mathura Road, 110076, New Delhi, India
| | - Lalit Maini
- Department of Orthopaedics, Maulana Azad Medical College, New Delhi, India
| | - Hitesh Lal
- Department of Orthopaedics, Sports Injury Centre, Safdarjung Hospital, New Delhi, India
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Abstract
The emergence of COVID-19 has impacted orthopaedic surgery worldwide. India, with
its large population and limited health resources, will be overwrought over the
coming days due to the number of cases of critically ill patients with COVID-19.
It is important to understand the challenges for orthopaedic (and other)
surgeons in India when dealing with patients during the COVID-19 pandemic. This
article highlights the challenges in the triaging of patients, care in dealing
with a patient with COVID-19 in orthopaedic surgery, and the effects on
academics and research activities; it also suggests immediate measures and
recommendations that also apply to other specialties.
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Affiliation(s)
- Vijay K Jain
- Associate Professor, Department of Orthopaedics, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Raju Vaishya
- Senior Consultant, Department of Orthopaedic, Joint Replacement and Arthroscopic Surgery, Indraprastha Apollo Hospitals, New Delhi, India
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Murlimanju BV, Krishnaprasad PR, Santosh Rai PV, Dinesh KVN, Prabhu LV. Current state of orthopedic education in India. Indian J Orthop 2017; 51:349-350. [PMID: 28566793 PMCID: PMC5439327 DOI: 10.4103/ortho.ijortho_475_16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- B V Murlimanju
- Department of Anatomy, Kasturba Medical College, Manipal University, Manipal, Karnataka, India,Address for correspondence: Dr. B V Murlimanju, Department of Anatomy, Kasturba Medical College, Manipal University, Mangalore - 575 004, Karnataka, India. E-mail:
| | - P R Krishnaprasad
- Department of Orthopedics, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - P V Santosh Rai
- Department of Radiodiagnosis, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - K V N Dinesh
- Department of Orthopedics, Srinivas Institute of Medical Sciences and Research Centre, Mukka, Mangalore, Karnataka, India
| | - Latha V Prabhu
- Department of Anatomy, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
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Jain AK. Author's reply. Indian J Orthop 2017; 51:350-351. [PMID: 28566794 PMCID: PMC5439328 DOI: 10.4103/ortho.ijortho_27_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Anil Kumar Jain
- Director Professor and Head, Department of Orthopaedic, University College of Medical Sciences and GTB Hospital, New Delhi, India,Address for correspondence: Dr. Anil Kumar Jain, Director Professor and Head, Department of Orthopaedic, University College of Medical Sciences and GTB Hospital, New Delhi, India. E-mail:
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