Aashish Gulati

Sandwell and West Birmingham Hospitals NHS Trust · Department of Orthopaedics

Objectives This abstract provides an update on the Open Ankle Models being developed at the University of Bath. The goal of this project is to create three fully open-source finite element (FE) ankle models, including bones, ligaments, and cartilages, appropriate musculoskeletal loading and boundary conditions, and heterogeneous material property d...

Objectives The fidelity of a 3D model created using image segmentation must be precisely quantified and evaluated for the model to be trusted for use in subsequent biomechanical studies such as finite element analysis. The bones within the ankle joint vary significantly in size and shape. The purpose of this study was to test the hypothesis that th...

Background Acute Achilles tendon rupture is a common injury and when missed leads to the development of a chronic Achilles tendon rupture. Studies suggest surgical treatment (either repair or reconstruction) for most patients with a chronic Achilles rupture due to the functional deficit caused by the lack of an intact Achilles tendon. Numerous auto...

Background: Biomechanical simulation of the foot and ankle complex is a growing research area but compared to simulation of joints such as hip and knee, it has been under investigated and lacks consistency in research methodology. The methodology is variable, data is heterogenous and there are no clear output criteria. Therefore, it is very diffic...

Aim: To determine the influence of gap distance and its location on clinical and radiological outcomes in patients with acute rupture of Tendo-Achilles (TA) treated non-operatively with functional rehabilitation. Methods: Twenty-six patients with acute complete TA rupture underwent ultrasound (US) scanning within a week of their injury. The meas...

Aim Hip fracture fixation surgeries are one of the most common surgeries that every trauma unit does regularly. Surgical training and expertise to fix these fractures properly are quite crucial for every orthopaedic surgeon. Therefore, orthopaedic training programmes all over the world consider significant focus on this and teach trainee surgeons e...

Introduction : Pain after lower limb orthopaedic surgery can be severe. Poorly controlled pain is associated with adverse outcomes. Peripheral nerve blocks (PNB) have become popular in foot and ankle surgery for their effective pain control and low complication rates. It has always been assumed that hindfoot procedures are more painful than midfoot...

Background On the 11th March 2020, the World Health Organization declared the COVID-19 outbreak a pandemic. Multiple new guidelines were proposed and existing models of social, domestic and hospital care altered. Most healthcare systems were largely unprepared for this, and the pandemic has tested their adaptability. This study aimed to assess the...

Aim: This UK based multi-centre study reports clinical characteristics, early outcomes and predictors of mortality in 34 consecutive COVID-19-positive hip fractures so that the lessons learnt could be utilised in other parts of World who are at a different phase of the pandemic. Methods: This study analysed patient admitted with hip fractures wi...

Foot osteoarticular tuberculosis is uncommon. Late diagnosis and sub-optimal management can lead to significant morbidity, deformity and even death. Preservation of life, limb and function can be achieved with prompt diagnosis and treatment. In 1882, Robert Koch published his discovery of mycobacterium tuberculosis as the causative agent of tubercu...

Our aim in this paper was to investigate the guidelines and laws governing informed consent in the English-speaking world. We noted a recent divergence from medical paternalism within the United Kingdom, highlighted by the Montgomery v Lanarkshire Health Board ruling of 2015. We investigated the situation in the United Kingdom, Australia, New Zeala...

Background A previous prospective observational study investigated the influence of knee and ankle position on Achilles tendon edge apposition following acute rupture using dynamic ultrasound (Qureshi et al, JBJS Am 2011; 93: 2265-70). Twenty six patients with acute complete TA ruptures underwent ultrasound (US) within a week of injury. Measurement...

Category Other Introduction/Purpose Several variables are thought to have an effect on the post-operative pain relief after reconstructive foot and ankle surgery. In the past decade, the role of regional nerve blocks in the management of post-operative pain has become established. The technique(s) of regional blocks varies between centers and the...

Background: This prospective randomised controlled trial was performed to determine whether the incidence of local infection is reduced in patients who are administered prophylactic antibiotics for lesser toe fusion surgery. Methods: 100 adult patients undergoing toe fusion surgery that required K-wires to be left in situ for 4-6 weeks were rand...

Background Complex symptomatic ganglion cysts arising from the proximal tibio-fibular joint (TFJ) are not an uncommon presentation in specialist knee clinics and can be managed by aspiration or excision. There is however a high rate of recurrence and often there is progressive involvement of the common peroneal nerve (CPN) and its branches, and per...

Background The rate of bearing dislocation with the domed lateral Oxford Unicompartmental Knee Replacement (OUKR) in different series varies from 1% to 6% suggesting that dislocation is influenced by surgical technique. The aim of this study was to identify surgical factors associated with dislocation. Methods Aligned post-operative antero-posteri...

Background and purpose Adequate restoration of femoral offset (FO) is critical for successful outcome after hip arthroplasty or fixation of hip fracture. Previous studies have identified that hip rotation influences the projected femoral offset (FOP) on plain anteroposterior (AP) radiographs, but the precise effect of rotation is unknown. Patients...

Purpose: Elderly patients with bone cancer are thought to have poorer access to specialist treatment and therefore suboptimal outcome. The aim of this study was to review the clinical course, outcome and survivorship in geriatric patients with primary bone tumours. Methods: We analysed 66 consecutive patients aged 60 years or older who were surg...

Hip fractures are common and the incidence is expected to increase. Systemic analgesics, often prescribed to relieve pain after hip fractures, have huge side effects and can delay surgery. We analyse the role and efficacy of alternative forms of analgesia like fascia-iliac blocks (FIB) and assess the feasibility of a service delivered by junior doc...

The Exeter femoral stem is a double-tapered highly polished collarless cemented implant with good long-term clinical results. In order to determine why the stem functions well we have undertaken a long-term radiostereometric analysis (RSA) study. A total of 20 patients undergoing primary Exeter total hip replacement for osteoarthritis using the Har...

Unlabelled: Background: Cast bracing (CB) has been a well established method of treating tibial shaft fractures. Majority of the recent literature on treatment of tibial shaft fractures have upheld intramedullary nailing (IMN) as the treatment of choice. Most of these studies are from the west, in public funded health set ups and in hospitals wi...

Purpose Pediatric fractures are common and are often managed by manipulation under general anesthesia (MUA). This study’s aim was to assess the changing pattern of pediatric fractures over 6 years and use this data to perform a workload forecast and estimate cost implications of treatment under general anesthesia. Methods The Emergency Department (...

It is recommended that in medial compartment osteoarthritis (OA) unicompartmental knee replacement (UKR) should not be undertaken unless there is bone on bone. This recommendation is not evidence based and it is important to know if it is correct as there are many patients with pain and partial thickness cartilage loss (PTCL) who could potentially...

Retrospective cohort study. To describe functional outcome and discharge destination of elderly patients with traumatic spinal cord injuries. National Spinal Injuries Unit, Glasgow, UK. We collected data for 5 years on all patients >65 years old with a traumatic spinal cord injury treated at the National Spinal Injuries Unit. We identified 39 patie...

Introduction: This study investigates the current practice of surgeons in the United Kingdom with regards to their usage of prophylactic antibiotics for percutaneous orthopaedic procedures. Methods: An electronic sur-vey of 10 questions was devised and sent to all members of the British Orthopaedic Association. Three hun-dred and three replies were...

This study's aim was to determine the patterns of osteoarthritis (OA) in both unicompartmental medial and lateral OA of the knee. Forty patients with medial and 20 with lateral unicompartmental knee osteoarthritis were studied to determine the location of full-thickness cartilage lesions. Intraoperatively, the distance between margins of the lesion...

Narrow, well-defined radiolucent lines commonly observed at the bone-implant interface of unicompartmental knee replacement tibial components have been referred to as physiological radiolucencies. These should be distinguished from pathological radiolucencies, which are poorly defined, wide and progressive, and associated with loosening and infecti...

Balancing service provision and surgical training is a challenging issue that affects all healthcare systems. A multicentre prospective study of 1501 total hip replacements was undertaken to investigate whether there is an association between surgical outcome and the grade of the operating surgeon, and whether there is any difference in outcome if...

Unexplained pain is an important complication of both total knee replacement and unicompartmental knee replacement. After unicompartmental knee replacement the most common site for the pain is antero-medial over the proximal tibia. The reason for this is not clear; however it may be due to high bone strain. A validated finite element model of a pro...

Varus malalignment after total knee replacement is associated with a poor outcome. Our aim was to determine whether the same was true for medial unicompartmental knee replacement (UKR). The anatomical leg alignment was measured prospectively using a long-arm goniometer in 160 knees with an Oxford UKR. Patients were then grouped according to their m...

As implants are made in incremental sizes and usually do not fit perfectly, surgeons have to decide if it is preferable to over or undersize the components. This is particularly important for unicompartmental knee replacement (UKR) tibial components, as overhang may cause irritation of soft tissues and pain, whereas underhang may cause loosening. O...

This study's aim was to assess the effect of component mal-alignment on outcome of Oxford Unicompartmental Knee Replacement (UKR). Two hundred and eleven knees implanted with a medial UKR, using a minimally invasive approach, were followed up at a minimum of 4 years. Sagittal and frontal plane femoral and tibial component alignments were determined...

The optimal approach for total hip arthroplasty is hotly debated. We analysed 121 consecutive patients who underwent primary total hip arthroplasty during the first three years of practice of a newly appointed consultant. Patients were analysed for pain scores (1-6), function scores (1-6) and satisfaction levels (1-5). All complications, during and...