Browsing by Author "Pokharel, Sabin"
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Publication Anterior Cruciate Ligament Injury among Patients with Knee Injury Visiting the Out-patient Department of Orthopaedics of a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Pokharel, Sabin; Thapa, Sunil Singh; Lamichhane, Arjun PrasadAbstract Introduction: Anterior cruciate ligament injury diagnoses are often missed at initial presentation. Though better diagnosed by physical examinations when done by orthopaedics surgeons, proper history is also important in diagnosing it. This study aimed to find the prevalence of anterior cruciate ligament injury among patients with knee injury visiting the out-patient Department of Orthopaedics of a tertiary care centre. Methods: This descriptive cross-sectional study was conducted on patients visiting the out-patient Department of Orthopaedics of a tertiary care centre within the study period from 31 January 2019 to 1 February 2020, after obtaining clearance from the Institutional Review Committee [Reference number: 321(6-11-E)2/075/076]. The anterior cruciate ligament injury diagnosis was made using a Magnetic Resonance Imaging scan. They were inquired about the specific history features at the time of injury: leg giving way, inability to continue the activity, massive swelling of knee joint within 6 hours, and ‘pop’ heard or felt. Point estimate and 95% Confidence Interval were calculated. Results: Among 127 cases of knee injury, anterior cruciate ligament injury was found in 109 (85.83%) (79.76-91.89, 95% Confidence Interval). History of the leg giving way, inability to continue the activity, massive swelling of the knee and ‘pop’ heard or felt were present in 90 (82.60%), 92 (84.40%), 91 (83.50%), and 86 (78.90%) cases of anterior cruciate ligament injury respectively. At least two history features were present in 104 (95.41%) cases. Conclusions: The prevalence of anterior cruciate ligament injury was found to be similar to the published studies.Publication Correlation Between Radiological Grading and Clinical Scoring in Knee Osteoarthritis Patients(Nepal Health Research Council, 2024) Sapkota, Kshitiz; Gautam, Sandesh; Luitel, Prajjwol; Sapkota, Radhika; Pokharel, SabinBackground: Osteoarthritis is characterized by mechanical joint abnormalities, primarily involving articular cartilage and subchondral bone degradation. Diagnosis of knee osteoarthritis relies on American College of Rheumatology criteria, and severity assessment utilizes the Western Ontario and McMaster Universities Osteoarthritis Index score and Kellgren and Lawrence grading. Despite reported associations, discrepancies persist in the correlation between Western Ontario and McMaster Universities Osteoarthritis Index and Kellgren and Lawrence grade. Methods: Descriptive cross-sectional study was conducted at the National Trauma Centre, over six months with consecutive convenience sampling. Demographic and clinico-radiological data were collected. Mean, SD and correlation coefficient was calculated. Results: Consecutive convenient sampling yielded 80 participants meeting American College of Rheumatology criteria, aged 52-81 years, predominantly female (67.50%). Significant positive correlations were identified between age, Western Ontario and McMaster Universities Osteoarthritis Index score, and KL grade. Results showed most cases with Kellgren and Lawrence grade III and strong correlations (r=0.73, p=0.00) between total Western Ontario and McMaster Universities Osteoarthritis Index scores and Kellgren and Lawrence grading. Notably, pain, stiffness and physical functions individually exhibited a significant possitive correlation with Kellgren and Lawrence grading. The study affirms age-related influences on osteoarthritis, emphasizes female predilection, and underscores the importance of assessing both clinical and radiological parameters. Conclusions: In conclusion, this study supports Western Ontario and McMaster Universities Osteoarthritis Index efficacy in dynamic disease assessment and management, especially in settings where radiological examinations may be impractical, thus establishing Western Ontario and McMaster Universities Osteoarthritis Index as a versatile tool for systematic monitoring and intervention in knee osteoarthritis. Keywords: knee osteoarthritis; radiology; rheumatology; scoring; X-Ray.Publication Missed T8-T9 translational fracture with intact neurology: A Case report(Nepal Medical Association, 2025) Sharma, Niraj Kumar; Banjade, Rishi Ram; Pokharel, Sabin; Ghimire, SharmilaAbstract Translational fracture of the thoracic spine, though rare due to its stability, is often associated with spinal cord injury and neurological deficits. Few cases present with intact neurology. We report a case of a 28-year-old woman who, after a road traffic accident, had persistent back pain with intact neurology. The initial chest radiograph showed a subtle deformity that was missed, likely because a lateral view was not done, and the patient was discharged. Persistent back pain led to CT imaging, revealing a T8–T9 translational fracture, left 4th and 5th posterior rib fractures near the costovertebral junction, and a T7 transverse process fracture. MRI confirmed these findings. She underwent posterior instrumentation and decompression, with symptom relief, and remained asymptomatic on follow-up. Translational thoracic spine fractures, typically associated with neurological deficits, can be missed when neurology is intact. Timely imaging and intervention are crucial for optimal outcomes.