balasubramanian Balakumar

balasubramanian Balakumar
The Royal Orthopaedic Hospital NHS Foundation Trust · Department of Orthopaedics

MRCS

About

49
Publications
3,718
Reads
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125
Citations
Additional affiliations
April 2012 - July 2014
Christian Medical College & Hospital
Position
  • Professor (Assistant)
July 2009 - July 2011
Christian Medical College Vellore
Position
  • Fellow
March 2005 - April 2008
Madras Medical College
Position
  • Medical Doctor

Publications

Publications (49)
Article
Full-text available
Background Anterior Decompression and Fusion (ACDF) is a common surgery recommended for symptomatic cervical degenerative disc disease after failed conservative care. There is no consensus on the choice of implants, and it varies between surgeons. This study aims to analyse the early complications following ACDF performed using a standalone cage ve...
Article
Full-text available
Aims It is imperative to understand the risks of operating on urgent cases during the COVID-19 (SARS-Cov-2 virus) pandemic for clinical decision-making and medical resource planning. The primary aim was to determine the mortality risk and associated variables when operating on urgent cases during the COVID-19 pandemic. The secondary objective was t...
Article
Full-text available
Due to advancing age, neck of femur fractures is becoming increasingly more common. As the population continues to age, the rate of hip fractures with other associated injuries is also increasing. This case report is of a patient with an ipsilateral concomitant fracture of the proximal and distal femur and we discuss the importance of accurate hist...
Article
Introduction Traumatic hip dislocation is a rare injury in the paediatric population. It can occur after high energy trauma, but also after lower energy injuries especially in younger children. Posterior dislocation is the most common pattern of hip dislocation. In most cases, closed reduction is successful, but occasionally open reduction is requi...
Article
Full-text available
This report contains 2 acute fractures of the Exeter V40 stem with 2 different types of neck fracture, one at the subcapital level and another at the base of the neck. A review of relevant literature provides an insight into a similar pattern of failures reported in a certain subset of cases. We hypothesize that for high-BMI cases, attention to pro...
Article
Full-text available
Objective This study tested the long-term efficacy of two synthetic scaffolds for osteochondral defects and compare the outcomes with that of an established technique that uses monolayer cultured chondrocytes in a rabbit model.Methods Articular cartilage defect was created in both knees of 18 rabbits and divided into three groups of six in each. Th...
Conference Paper
Background: This study aims to look at early complications following Anterior decompression and fusion (ACDF) performed using standalone cages versus cages-crew (Zero-P) construct for patients with cervical degenerative disc disease. Methods: A total of 162 patients had undergone ACDF in between Aug 2016 to July 2018. There were 83 patients (111 l...
Conference Paper
Background: The guidelines at the time of this audit states that caudal epidural steroid injection should be considered for acute and severe sciatica and not for neurogenic claudication from spinal canal stenosis. We evaluated the compliance with the NICE guidelines (NG59) at our hospital. Methods: All consecutive patients who underwent caudal epi...
Article
Full-text available
Introduction: The fracture burden of the UK utilises a vast proportion of National Health Service (NHS) resources. Subsequent complications in healing result in poor patient outcomes (indirect costs) and increased demand on healthcare services (direct costs). Inadequate education regarding risk factors for poor outcomes provides a target for interv...
Article
Full-text available
Case: An 11-year-old child who presented with a postseptic gap nonunion of 4 cm in the proximal humerus was treated with a customized hydroxyapatite-tricalcium phosphate-tricalcium silicate composite (HASi) scaffold loaded with culture-expanded autologous bone marrow–derived mesenchymal stem cells (MSCs) primed into osteogenic lineage. Union occur...
Article
Magnetic resonance imaging (MRI) of knee has become the integral part of knee evaluation, hence any MRI based study adds more value if it helps in the decision-making process, especially for surgery in treating patellofemoral pain. We tried to determine normal patellar indices using knee MR images and the correlation between them and also compared...
Chapter
Slipped capital femoral epiphysis (SCFE) is a common paediatric orthopaedic problem that attracts substantive research and debate. The understanding of the pathophysiology of this disorder and its subsequent treatments are evolving at a slow pace. Some forms of treatments have become obsolete while new surgical techniques have emerged which have be...
Conference Paper
Abstract Text: Background: Management of AVascular Necrosis (AVN) of femoral head in Slipped Capital Femoral Epiphysis (SCFE) is difficult. We proposed to ascertain if staged hip distraction could prevent the collapse and recover the femoral head. Methods: A retrospective review of hip database retrieved 16 children with unstable SCFE and AVN. Al...
Poster
We detail a modified single incision approach to perform the Tonnis triple pelvic osteotomy by a minimally invasive approach. PATIENTS AND METHODS: 12 children underwent minimally invasive Tonnis Osteotomy. There were five boys and seven girls in this study group. Average age was 11 years (9-15 years) at the time of surgery. Mean follow-up was 20....
Article
Background:: Management of avascular necrosis (AVN) of the femoral head in slipped capital femoral epiphysis (SCFE) is difficult. We proposed to ascertain if staged hip distraction could prevent collapse and recover the femoral head. Methods:: A retrospective review of the hip database retrieved 16 children with unstable SCFE and AVN. All underw...
Presentation
This presentation looks at a classic paper and compares it with the current trends in practice
Chapter
Slipped capital femoral epiphysis (SCFE) is common paediatric orthopaedic problem that attract substantive research and debate. Understanding and subsequent treatments is evolving at a high pace. Some forms of treatments have become obsolete and a new surgical techniques have emerged and widely adopted without clear evidence of the long term outcom...
Article
Full-text available
Aims: We describe surgical dislocation with capital realignment as an option for management of failed in-situ pinning in children with severe unstable slipped capital femoral physis. Patients and methods: A retrospective data collection from our hospital hip database retrieved 7 patients with severe unstable slipped capital femoral physis who ha...
Chapter
Pathomechanics and Radiology of Aseptic Loosening in Total Hip Arthroplasty
Article
Aim We intend to compare the outcomes of arthroscopic osteoplasty with open neck osteotomy for correction of the hip impingement and improvement of hip function in children with moderate to severe healed Slipped Capital Femoral Epiphysis (SCFE). Our aim is to verify if arthroscopic osteoplasty could achieve the same outcome as open procedures. Pat...
Preprint
Background Total knee arthroplasty (TKA) has been proved to be a successful and cost-effective treatment for improving pain and function in patients with knee arthritis. Total knee arthroplasty (TKA) is one of the most common orthopaedic surgeries performed worldwide and advancement in surgical techniques and prosthetic designs have improved the pa...
Article
Aims: We detail a modified single incision approach to perform the Tonnis triple pelvic osteotomy by a minimally invasive approach. Patients and methods: 12 children underwent minimally invasive Tonnis Osteotomy. There were five boys and seven girls in this study group. Average age was 11 years (9-15 years) at the time of surgery. Mean follow-up...
Research
Full-text available
https://online.boneandjoint.org.uk/doi/abs/10.1302/1358-992X.99BSUPP_11.BSCOS2017-010
Article
Full-text available
Background Assessment of bone graft substitute incorporation is critical in the clinical decision making process and requires special investigations. We examined if the pixel value ratio (PVR) obtained in routine follow-up digital radiographs could be used for such assessment. Material/Methods Radiographic images were acquired using either compute...
Article
Objective: Salmonella osteomyelitis in immunocompromised individuals with sickle cell anaemia is well documented. Its occurrence in immunocompetent children is rare. Methods: All pus culture positive cases of salmonella typhi between the period 2009 to 2014 were reviewed and only those children without sickle cell disease or trait were considere...
Article
Full-text available
Background & objectives: Human bone marrow is rich in various growth factors which may support the chondrocyte growth. This study was conducted to compare the culture characteristics of human growth plate chondrocyte in foetal bovine serum (FBS) and human autologous bone marrow extract (BME) in monolayer culture. Methods: Iliac crest apophyseal car...
Article
Purpose: Contemporary methods for the management of neck deformity following a healed severe slipped capital femoral epiphysis (SCFE) include subcapital neck osteotomy. Methods: 18 patients with chronic severe SCFE in the oblique plane (mean slip angle = 70°) constituted the study group. 6 patients with an open physis underwent modified Dunn cap...
Conference Paper
Full-text available
shown to be a safe and effective treatment for severe hip dysplasia. More recently a minimally invasive approach has been described by Soballe et al. in an attempt to reduce complications while still achieving effective acetabular re-orientation. In this study we report the radiological corrections achieved and complication profile of PAO procedure...
Article
Full-text available
Unlabelled: Slipped capital femoral epiphysis (SCFE) may lead to symptomatic femoroacetabular impingement (FAI). We report our experience of arthroscopic treatment, including osteochondroplasty, for the sequelae of SCFE. Data were prospectively collected on patients undergoing arthroscopy of the hip for the sequelae of SCFE between March 2007 and...
Article
Full-text available
We present an adolescent with distal radius nonunion following an open fracture and failed surgery which eventually united when the length and stability was restored for eight weeks duration. The intact periosteal sleeve at the nonunion site formed new bone when its tension was restored by gradual differential distraction. This case report highligh...
Article
We evaluated novel triphasic hydroxyapatite tricalcium phosphate calcium silicate scaffold (HASi) in the management of paediatric bone defects. Their main advantage is considered to be adequate strength and stimulation of bone formation without resorting to autograft. A total of 42 children younger than 16 years of age were recruited over a period...
Article
Full-text available
Abstract Purpose The correction obtained in the coronal plane knee deformity using guided growth was assessed in children with sick physes (Height<1SD of the normal children) to define the limits of this technique in sick physis Methods We retrospectively assessed deformity correction following guided growth using 8 plates in children with corona...
Article
Paediatric femur fractures are managed with the titanium elastic nail system (TENS) in the 5-16-year age group. TENS is costly and not easily available in public hospitals. This study compares TENS nailing with stainless-steel Ender's nail fixation of paediatric femur fractures. A retrospective analysis of patient records from 2006 to 2008 yielded...
Article
Full-text available
Loss of reduction following closed or open reduction of displaced supracondylar fractures of the humerus in children varies widely and is considered dependent on stability of the fracture pattern, Gartland type, number and configuration of pins for fixation, technical errors, adequacy of initial reduction, and timing of the surgery. This study was...
Article
Patients with Sjögren-Larsson syndrome, an autosomal recessive syndrome characterized by ichthyosis, spastic diplegia/quadriplegia, mental retardation and ocular features that include pigmentary changes in the retina, rarely present to the orthopaedic surgeon. We detail a rare and unusual presentation of Sjögren-Larsson syndrome in an adolescent bo...
Article
Complex reconstruction after calcaneal excision for aggressive or malignant tumors has been advocated. In this report we describe a 7-year-old child who underwent chemotherapy followed by total calcanectomy for a primitive neuroectodermal tumor of the calcaneum. The near-normal function achieved after the operation leads us to believe that complex...

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