Browsing by Author "Thapa, Sunil Singh"
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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 Prediction of Hamstring Autograft sizes for Anterior Cruciate Ligament Reconstruction using Preoperative Magnetic Resonance Imaging(Nepal Health Research Council, 2023) Shrestha, Prakash; Thapa, Sunil Singh; Mahara, Deepak Prakash; Paudel, Sharma; Lamichhane, Arjun; Saud, TejendraAbstract Background: The purpose of this study is to determine whether preoperative magnetic resonance image measurements can predict the hamstring tendon autograft diameter during anterior cruciate ligament reconstruction. Methods: We prospectively evaluated Forty-two patients with anterior cruciate ligament injury who underwent reconstruction using hamstring tendon autograft. Preoperative diameters and cross-sectional areas of the hamstring tendons were estimated using magnetic resonance imaging of the knee. Intraoperative diameters of the hamstring tendon graft were measured using a cylindrical graft sizer. We used Pearson's correlation test to compare the Preoperative and intraoperative graft size measurements. A possible cutoff value for the hamstring graft size was determined using Receiver operating characteristic analysis. Results: The mean age of the patient in the study was 27.5 ± 8.5 years. There were statistically significant correlations between preoperative and intraoperative hamstring tendon graft measurements (P < 0.001). Our study found 13.3 mm² cross-sectional area as the cutoff for predicting 7mm of quadrupled hamstring graft size with both sensitivity and specificity of 85.7 %, respectively. Conclusions: We can conclude that preoperative magnetic resonance imaging measurements can predict the intraoperative graft size. This study can help in preoperatively planning for the graft choice. Keywords: Anterior cruciate ligament (ACL), Hamstring graft, Magnetic resonance imaging (MRI), Prediction