Scientific Program

Conference Series Ltd invites all the participants across the globe to attend 4th International Conference on Orthopedics & Rheumatology Baltimore, Maryland, USA.

Day 1 :

Keynote Forum

Joseph Purita

Institute of Regenerative and Molecular Orthopedics, USA

Keynote: Cutting edge concepts in the use of stem cell and PRP injections in an office setting

Time : 09:00-09:35

OMICS International Orthopedics-2015 International Conference Keynote Speaker Joseph Purita photo
Biography:

Purita is director of Institute of Regenerative and Molecular Orthopedics (www.stemcellorthopedic.com) in Boca Raton, Florida. The Institute specializes in the use of Stem Cells and Platelet Rich Plasma injections. Dr. Purita is a pioneer in the use of Stem Cells and Platelet Rich Plasma. The Institute has treated some of the most prominent professional athletes from all major sports in both the U.S.A. and abroad. He received a B.S. and MD degree from Georgetown Univ. Dr. Purita is board certified in Orthopedics by ABOS. He is a Fellow American College of Surgeons, Fellow American Academy Orthopedic Surgeons, and a Fellow American Academy of Pain Management. He is also certified in Age Management Medicine. He has lectured and taught extensively throughout the world on the use of Stem Cells and Platelet Rich Plasma. He has been instrumental in helping other countries in the world establish guidelines for the use of Stem Cells in their countries. He has been invited to lecture on these techniques throughout the world as a visiting professor.

Abstract:

The presentation concerns PRP and Stem Cell (both bone marrow and adipose) injections for musculoskeletal conditions in an office setting. Indications are given as to which type of cell and technique to use to accomplish repair. Stem cells, both bone marrow derived (BMAC) and adipose, are used for the more difficult problems. PRP injections are utilized for the less severe problems. Indications are given when to use Stem Cells verses PRP and when to use both. The newest concepts in stem cell science are presented. These concepts include the clinical use of MUSE cells, exosomes, and Blastomere like stem cells. Basic science of both PRP and stem cells are discussed. This presentation defines what constitutes an effective PRP preparation. Myths concerning stem cells are dispelled. One myth is that mesenchymal stem cells are the most important stem cell. This was the initial interpretation of Dr. Arnold Caplan the father of mesenchymal stem cell science. Dr. Caplan now feels that MSCs have an immunomodulation capacity which may have a more profound and immediate effect on joint chemistry and biology. We now learn in the talk that the hematopoietic stem cells are the drivers of tissue regeneration. Also discussed are adjuncts used which enhance the results. These therapies include supplements, LED therapy, lasers, electrical stimulation, and cytokine therapy. The scientific rationale is presented for each of these entities as to how they have a direct on stem cells.

OMICS International Orthopedics-2015 International Conference Keynote Speaker Douglas E Garland photo
Biography:

Garland received his medical degree from Creighton University (1969) and orthopedic surgery residency at Tulane University (1976). He serves on the editorial board of Orthopedics Today, and has been on the clinical faculty at the University of Southern California for over 35 years. Dr. Garland has published more than 100 peer-reviewed scientific articles and chapters. He’s an internationally recognized expert in bone metabolism and his fracture surveys of locations, treatments, and outcomes within orthopedics are considered benchmarks in the field today. Since 2011, Dr. Garland has been the Medical Director for the Joint Replacement Center at Long Beach Memorial.

Abstract:

Background: Joint replacements (JRs) constitute the greatest single cost to Medicare. The majority of JRs in the U.S. are performed by low volume surgeons with a wide variability in clinical and financial outcomes. Joint Replacement Centers of Excellence (JRC) are proliferating, their mission: to provide best/predictable clinical outcomes while reducing cost through efficient/standardized care. It is generally accepted that high volume institutions and surgeons have superior outcomes; however, less is known about the outcomes of participants in JRC. We quantified the effects of surgeon case volume and/or compliance within a JRC program on key hip/knee replacement outcomes with significant financial impact. rnrnMaterials and Methods: During the 2012 calendar year, data of key outcomes for cases performed by two orthopedic surgeon groups performing total hip/or knee replacements at one large community hospital were analyzed: Group I (JRC) includes surgeons who joined the JRC program and Group II (non-JRC) those who did not. Group I was divided into Group IA (JRC >5O) and Group IB (JRC <50) based on surgeons' case volume being more or less than 50 annually. Group I was also divided into Group IC (JRC-Active), comprised of surgeons who regularly attended JRC meetings (>90% attendance) and Group ID (JRC-Passive; <10% attendance). No surgeons in Group II performed more than 50 annual cases. To compare the groups, we chose key outcome variables which have major clinical and financial impacts: blood transfusion rate, discharge to rehabilitation facility versus home, hospital bed days, complications, 30-day readmission, and mortality. rnrnResults: There was a significant decrease in blood transfusion, discharge to rehabilitation facility, and hospital bed days when comparing Group I (N=499) versus Group II (N=96) (p<.001; p<.001; p<.001). Group lA (N=341) versus Group IB (N=158) (p=.001; p<.001; p=.005), Group IC (N=202) versus Group ID (N=297) (p=.007; p=.003; p<.001), and Group IB (N=341) versus Group II (p<.001; p=.004; p<.001). Rates of complications, 30-day readmission, and mortality did not significantly differ among all groups. rnrn Conclusion: Participation in JRC was the major determinant for reduction in blood transfusion, discharge to rehabilitation facility versus home, and hospital bed days. Active/high volume JRC surgeons had the best outcomes. JRC/low volume JRC surgeons far outperformed non-JRC/low volume surgeons. This study is particularly revealing in that low volume surgeons (who perform the majority of joint replacements in the U.S.) can significantly improve certain clinical outcomes and cost savings to the hospital by participating in a well-functioning JRC programrn

Break: Coffee Break - 10:10-10:30 @ Foyer
  • Orthopedic Degenerative Diseases
    Arthritis - Types and Treatment
    Connective Tissue Disorders and Soft Tissue Rheumatism
    Physiotherapy

Session Introduction

Joseph R Purita

Institute of Regenerative and Molecular Orthopedics, USA

Title: The use of supplements and cytokines in platelet rich plasma injections and stem cell treatments

Time : 10:30 -10:55

Speaker
Biography:

Purita is director of Institute of Regenerative and Molecular Orthopedics (www.stemcellorthopedic.com) in Boca Raton, Florida. The Institute specializes in the use of Stem Cells and Platelet Rich Plasma injections. Dr. Purita is a pioneer in the use of Stem Cells and Platelet Rich Plasma. The Institute has treated some of the most prominent professional athletes from all major sports in both the U.S.A. and abroad. He received a B.S. and MD degree from Georgetown Univ. Dr. Purita is board certified in Orthopedics by ABOS. He is a Fellow American College of Surgeons, Fellow American Academy Orthopedic Surgeons, and a Fellow American Academy of Pain Management. He is also certified in Age Management Medicine. He has lectured and taught extensively throughout the world on the use of Stem Cells and Platelet Rich Plasma. He has been instrumental in helping other countries in the world establish guidelines for the use of Stem Cells in their countries. He has been invited to lecture on these techniques throughout the world as a visiting professor.

Abstract:

The success of stem cell and PRP treatments depends many times on the condition of the extra cellular matrix. The condition of the matrix can have has enormous implications on success or failure on Regenerative Medicine procedures. The matrix is many times a hostile environment of the stem cells. This hostility results in a large percentage of the stem cells (sometimes greater than 97%) perishing. This matrix can many times be manipulated to allow a greater percentage of stem cells surviving. This manipulation can be accomplished by the judicious use of certain supplements, cytokines and other modalities such as micro electrical stimulation and laser use. This talk will center on the use supplements, antioxidants and other modalities. The discussion will also center on free radicals and their mechanisms of causing damage on a cellular level. Also discussed will be certain cytokine pathways which have adirect effect on many orthopedic conditions.

Speaker
Biography:

Garland received his medical degree from Creighton University (1969) and orthopedic surgery residency at Tulane University (1976). He serves on the editorial board of Orthopedics Today, and has been on the clinical faculty at the University of Southern California for over 35 years. Dr. Garland has published more than 100 peer-reviewed scientific articles and chapters. He’s an internationally recognized expert in bone metabolism and his fracture surveys of locations, treatments, and outcomes within orthopedics are considered benchmarks in the field today. Since 2011, Dr. Garland has been the Medical Director for the Joint Replacement Center at Long Beach Memorial.

Abstract:

Background: Patients undergoing joint replacement surgery have higher risk for complications at hospitals with low surgical volume1. Surgeons who perform more than 50 surgeries annually have fewer complications2, 3. The Long Beach Memorial Joint Replacement Center (JRC) is a Destination Center of Superior Performance® created by Marshall Steele/Stryker Performance Solutions® that has a comprehensive course of treatment for persons undergoing elective joint replacement surgery. JRC surgeons have strived for standardization of practice through surgical and post-surgical evidence-based protocols. A retrospective study comparing outcomes of the JRC surgeons and non-JRC surgeons was conducted. Results: In 2012, 11 JRC surgeons performed 584 surgeries compared to 9 non-JRC surgeons who performed 137 surgeries. Four JRC surgeons performed >50 surgeries compared to none of the non-JRC surgeons. A review of specific clinical, operational, and financial outcome measures for elective/non-elective joint replacement surgeries in 2012 demonstrated that there were significant and positive differences between JRC surgeons and non-JRC surgeons in length of stay, discharge home, blood transfusion rates, complication rates, and 30-day readmission rates. Lower direct costs and higher contribution margins were noted for the JRC comparatively. Additionally, JRC surgeons with volumes of less than 50 demonstrated improved clinical outcomes. Conclusion: Strong, collaborative physician leadership in the JRC and establishing evidence-based protocols had positive influences on the clinical outcomes of patients and operational/financial performance of the hospital in JRC surgeons with less than 50 surgeries per year as well as JRC surgeons with more than 50 surgeries per year while non-JRC surgeon outcomes remained unchanged.

Margaret Wislowska

Centralny Szpital Kliniczny MSW, Poland

Title: Antiphospholipid antibody syndrome

Time : 12:10-12:35

Speaker
Biography:

Margaret Wisłowska, Head of the Department of Internal Medicine and Rheumatology CSK MSW, the specialist in internal medicine, rheumatology, rehabilitation medicine, hypertention, the author of over 190 scientific papers and books. She has participated in numerous scientific meetings. Promoter of 10 PhD theses. She took trainings at Guy and St Thomas' Hospitals in London, Charity Hospital in Berlin, Rheumatology Institutes in Prague and Moscow. In 2003 she created the Department of Internal Medicine and Rheumatology, and in 2010 Clinic of Internal Medicine and Rheumatology CSK MSW. Prof Margaret Wisłowska is the professor lecturer at the Medical University of Warsaw.

Abstract:

Antiphospholipid syndrome [APS] is the autoimmune disease characterized by vascular thromboses and/or pregnancy loss associated with persistently positive antiphospholipid antibodies (aPL; measured with lupus anticoagulant [LA] test, anticardiolipin antibody [aCL] enzyme-linked immunosorbent assay [ELISA], and/or anti-beta2-glycoprotein-I antibody [alfabeta2GPI] ELISA). Determining significant APS depends on: persistent (at least 12 weeks apart) aPL positivity excluding transient aPL positivity which is common during infections; 2/ a positive LA test is a better predictor of aPL-related thrombotic events compared with other aPL tests; 3/ the specificity of aCL and alfabeta2GPI ELISA tests for aPL-related clinical events increases with higher titers; 4/ 50% of the APS patients with thrombosis present with at least one non-aPL thrombosis risk factor at the time of their vascular event; 5/ IgM isotype is lesse commonly associated with clinical events compared with IgG isotype; 6/ in patients with aPL-related clinical events and no other thrombosis risk factors and have IgAaCL and IgAalfabeta2GPI positivity; 7/triple aPL positivity (LA, aCL, and alfabeta2GPI) can be clinically more significant than double or single aPL positivity. Clinical manifestation related to aPL represent a spectrum: 1/ aPL positivity without clinical events; 2/ aPL positivity solely with non – criteria manifestations (e.g. thrombocytopenia, hemolytic anemia, cardiac valve disease, aPL nephropathy); 3/ APL based on arterial / venous thrombosis and/or pregnancy morbidity; 4/ catastrophic antiphospholipid syndrome.

Eran Maman

Tel Aviv University, Israel

Title: New treatment modality for massive Rotator Cuff tears

Time : 13:25-13:50

Speaker
Biography:

Eran Maman, Medicine Doctor (M.D), now is a Head of the Shoulder Surgery Unit at Tel Aviv Medical Center. After finishing medical school; Dr.Maman completed his residency in orthopedics. Furthermore, he did a Clinical fellowship in shoulder surgery at Toronto University, Canada. Dr. Maman's research focuses on tendon biology and tendon to bone healing. He aims at finding an optimal biological treatment that is capable of improving tendon-bone interface and promotes healing. He has been working on rat models rotator cuff tears and the influence of many different drugs/material (PRP, steroid, NSAID, statins) on tendon to bone healing in terms of histology and biomechanics. Our group has pioneered on the influence of statins with or without NSAID on the tendon to bone healing on repaired RC.

Abstract:

The treatment of full-thickness massiverotator cuff tears (MRCT) is challenging and associated with a high treatment failure and re-tear rate.As there is no current consensus or definitive guidelines concerning the treatment of this devastating condition, there is a need to evaluate potential alternatives for this patient’s population.The InSpace™ device is a novell treatment modality of an inflatable biodegradable implant, made of a copolymer of Poly Lactic acid and Caprolactonethat degrades within12 months.The spacer is deployed arthroscopically into the sub-acromial space and allows smooth gliding of the humeral head against theacromion. The temporary lowering of the humeral head during spacer inflation in patients with full thickness massive RCTsmay additionally provide improved balance between the subscapularis anteriorly and the infraspinatus posteriorly, permitting better deltoid activation and compensation. The device is approved for use in the EU (since July 2010) and has been tested in several clinical trials as well as implanted in over 4000 commercial cases. The gained clinical experience showed low risk and good safety profile along with a promising effectiveness results, which includesclinically and statistically significant improvementin shoulder functionality, that maintained for a long term (of up to 5 years) in the majority of the treated patients. The use of the InSpace device may be a simple and less invasive alternative that has the potential to provide comparable safety and effectiveness profile to otheravailable surgical options such as arthroscopic partial repair, tendon transfer rotator cuff allograft or arthroplasty.

Speaker
Biography:

Rui Shi has completed his MD at the age of 24 years from Southeast University and is now a Ph.D. candidate of Medical School of Southeast University.

Abstract:

A population-based database was analyzed to identify the causes, characteristics of reoperations and associated risk factors after microendoscopic discectomy(MED) to treat lumbar disc herniation(LDH).A series of 952 patients who underwent MED for single-level LDH between 2005 and 2010 were included in this study. Out of this series, 58 patients had revision spinal surgery. The causes and clinical parameters including the intervals between primary and reoperations, grade of disc degeneration, and surgical findings in the revisions were retrospectively assessed. The possible risk factors including age, sex, weight, occupation, duration of surgery, blood loss and radiological findings were evaluated by multivariate logistic regression analysis. In total, 76 disc herniations were excised in revision discectomies with or without interbody fusion for the most common reason-recurrent disc herniation or epidural scar. The overall mean interval between primary and revision surgeries was 39.05 months(range, 2 months to 95 months ). Cumulative overall reoperation rate at 1, 3, 5 years were 1.56%, 2.74%, 5.23% respectively, and gradually increased to 8.17% after near 10 years. Compared to the non-reoperated patients, re-operated patients had older age, higher level of lumbar degeneration, with severe Modic change(Grade Ⅰ 17.2%, Grade Ⅱ 34.5%, compared with Grade Ⅰ 1.5%, Grade Ⅱ 30.6% in single-operated patients) and obvious adjacent disc degeneration(81.1%, higher than single-operated patients’ 48.1%). By logistic regression analysis,adjacent segment degeneration and Pfirrmann grading for disc degeneration were identified as significant risk factors related to reoperation after primary MED(OR 2.448, 1.510 respectively).Our study presented a relatively low incidence of reoperation after primary MED. Adjacent segment degeneration, Pfirrmann grading for disc degeneration seem to be the most important risk factors for reoperations after MED to treat LDH. The treatment options for patients with these factors at first visit should be carefully measured.

Speaker
Biography:

Neven Mahmoud Taha Fouda is a Professor of Physical Medicine, Rheumatology and Rehabilitation, Ain Shams University hospitals .She did her M.D degree in November 2003 in Ain Shams University-Cairo-Egypt. She has license to practice medicine in Egypt and worked as consultant of Physical Medicine, Rheumatology and Rehabilitation in many hospitals in Saudi Arabia. She has experience in intra-articular and extra-articular injection and diagnosis by nerve conduction and electromyography.She is also active member in the Egyptian society of Rheumatology and Rehabilitation and Egyptian society of joint disorders and arthritis.

Abstract:

Aim of the work:To assess obstructive sleep apnea (OSA) as one of common primary sleep disorders in patients with rheumatoid arthritis (RA) and its correlation to disease activity and pulmonary function tests. Patients and methods:This study included 30 female patients with RA fulfilled the modified American college of Rheumatology (ACR) criteria.All the patients were subjected to full medical history,thorough clinical examination with evaluation of the disease activity using Disease Activity Score 28(DAS28),laboratory assessment of highly sensitive C reactive protein (hsCRP), pulmonary function tests (FVC- FEV 1 and FEV 1/FVC) and one night polysomnography (PSG) at the sleep laboratory. Results: Polysomnographic data revealed OSA in 14 RA patients ( 46.7%) . Patients with OSA showed longer disease duration (mean 7.0±1.94 y) ,higher BMI (mean 30.8±2.48), higher hsCRP(6.7+0.6 mg/L)and higher DAS28 (4.9 ±1.85) than patients with no OSA (mean 4.0 ±1.72 y, 20.3 ±1.55, 4.9+0.3mg/L and 3.7± 1.28 respectively).While there was statistically non significant difference between both groups as regards results of pulmonary function tests (p>0.05).The study showed statistical significant correlation between AHI (apnea- hypopnea index) and BMI ,hs CRP and DAS 28 (r=0.45 ,0.43 and 0.51 respectively p<0.05), Conclusion: OSA is commonly associated with patients with RA .This possibly suggest common underlying pathological mechanisms which may be linked to chronic inflammation Co-existence of OSA in RA patients will influence the disease activity and the level of circulating inflammatory markers in these patients .Diagnosis and treatment of OSA in RA patients may help in improved clinical care,better prognosis and avoid rheumatoid-associated morbidities.

Speaker
Biography:

Shoaib Khan has completed his M.B.B.S from Dow Medical College, Karachi, Pakistan in 2005 and his M.R.C.S from Royal College of Surgeons of Edinburgh, UK in 2013. He is working as a Research Fellow for Spine in University Hospital of North Tees, Stockton on Tees, United Kingdom

Abstract:

Background Anterior cervical discectomy and fusion (ACDF) is considered to be the gold standard treatment for cervical degenerative disease. Different modalities and instrumentation have been used to achieve fusion. The objective of our study was to evaluate the rate of fusion in patients who underwent Anterior Cervical Discectomy and Fusion without the use of cervical plate. Methods and materials The study involved retrospective radiographic analysis of patients who underwent ACDF using cages without plate from August 2005 to February 2014. The radiographs were assessed for fusion independently by a Consultant Radiologist and Consultant Spinal Surgeon using Brantigan-Steffee fusion criteria. The criteria include a denser and more mature bone fusion area than originally achieved at the time of operation, no interspace between the cage and the vertebral body, and mature bony trabeculae bridging the fusion area. The procedures were performed in our unit. Results Thirty nine patients underwent ACDF without plating. Out of 39, 21 were females and 18 were males. Average age for our patients was 62.03 with an average follow up of 25.8 months. Five patients were excluded from study as they had inadequate follow up to comment on fusion. 10 patients had fusion performed at one level, 27 at two levels, one each at 3 and 4 levels. The operated levels for one level patient was C3/4, 4/5, 5/6 and 6/7, for two levels were C3/4 and 4/5, C4/5 and 5/6, C5/6 and 6/7, for three levels was C3/4,4/5,5/6 and for four levels was C3 to C7. Independent analysis by Radiologist and Spinal surgeon showed that fusion was achieved in 28 patients (82%) at all levels, non union was observed in 3 patients(9%), one level (C4/5 and C5/6) was fused out of two levels (C4/5, 5/6 and C5/6, 6/7) in 3 patients(9%). Conclusion ACDF using cages without instrumentation has revealed excellent rate of fusion (82%) which shows that plating is not necessary to attain a better outcome from ACDF.

Sagaram Uday Shanker

Maruthi Rheumatology Research Center, India

Title: Sjogrens syndrome and Hyperlipoproteinemia (a) A detrimental association

Time : 15:50-16:15

Speaker
Biography:

Uday Shanker received medical degree from Gandhi Medical College, Hyderabad, India in 1978. He then worked as a Sr. Intern in Cardiology in Gandhi Hospital, Hyderabad. In 1984 he worked as a Research associate in Dpt. Nephrology at Thomas Jefferson University Hospital, Philadelphia. He returned to India to do extensive clinical work in Cardiology and Nephrology and started his own Cardiac emergency ICCU where he treated over 10,400 Myocardial Infarctions. He worked in Cardiac Catherization unit, Apollo Hospital, Hyderabad where he produced a paper on Hibernation Myocardium and won fellowship in American College of Angiology. In 2005, he won his first national award, Bharatiya Chikitsak Ratan in New Delhi. Subsequently he won 14 awards including a felicitation and award in London and Bangkok. His passion to serve the rural India made him travel extensively as a consultant Rheumatologist treating around 13000 patients.

Abstract:

INTRODUCTION:
In my 30 years of experience in the field of Cardiology and Rheumatology, I have come across several cases of Dyslipidemia, Hyperlipoprotienemia (a) and inflammatory arthritis. Dyslipidemia not responding to regular treatment with statins, were investigated further and found to have higher levels of lipoprotein (a) which is detrimental to the arthritis patients. On further investigations, few patients were found to have an uncommon combination of Sjogrens syndrome and hyperlipoprotienemia. Such association may lead to sudden / early death. :
OBJECTIVE: Identification of the Association of Hyperlipoprotienemia (a) with Sjogrens syndrome and Vasculitis in autoimmune arthritis diseases.:
METHOD USED: Clinical OP basis: Identified seven cases of Inflammatory arthritis like RA, SLE, MCTD, Enteropathic Arthritis, Psoriatic Arthritis etc. and their association with Hyperlipoprotienemia (a) and associated Sjogrens syndrome ( period 2009 –2015 ):
MEDICAL TREATMENT: - Inflammatory arthritis – DEMARDS and Deflazacort - Hyperlipoprotienemia (a) - Niacin NF 1 gm. per day and Omega fatty acids 500mg per day - Associated dyslipidemias - Statins - Associated diabetes (if required) - Oral Hypoglycemics - Associated hypothyroidism (if required) - Thyroxine tablets
RESULT: Sjogrens syndrome: There was symptomatic relief, such as correction of Dryness of Oral Cavity, Dyspepsia Retroorbital pain, Preauricular Glandular enlargement, lubricant eye drops to dry Palpebrae
- Lipoprotein (a) levels reduced to optimum values in 3 to 6 months:
CONCLUSION:Though very rare, the association of Hyperlipoprotenemia (a) with Sjogrens syndrome and Vasculitis in autoimmune inflammatory arthritis does exist, and the incidence is more in rheumatoid arthritis when compared to SLE, MCTD, Scleroderma and Psoriatic arthritis.

Garima Gupta

Saaii College of Medical Science and Technology, India

Title: Impact of osteoarthritis on balance, perceived fear of fall and quality of life

Time : 16:15-16:40

Speaker
Biography:

Garima Gupta is result oriented physiotherapist. She is presently working as a Head of Department, Researcher and Assistant Professor in Saaii College of Medical Science and Technology, India. She has done her graduation from super specialty HOSMAT Hospital, Bangalore. In 2010 she completed her Masters in Physiotherapy (Neurology) from Indian Spinal Injury Center, New Delhi. She is actively involved in various ongoing research projects and has multiple international books and research publications in the field of physiotherapy. She actively contributes as reviewer for many international journals. She has also presented two papers in international conferences

Abstract:

Background: Osteoarthritis is the commonest form of joint disease. Reviews suggest presence of balance deficits in osteoarthritic population but in most of the studies expensive force platform, or balance master were used . In the present study we aimed to study the impact of knee OA on balance using cost effective “postural sway-meter”. Present study also aimed to study the coreleation of severity of knee disabilities with perceived fear of fall, previous number of falls and quality of life in OA population. We also aimed to study the affect of balance deficits on quality of life. Methods: 60 people of 50-70 years were taken. Assessment of postural sway was done by sway-meter, quality of life by arthritis impact measurement scale 2 short form, severity of OA by osteoarthritis index of severity and perceived fear of fall by fall efficacy scale was done. Results: The result of the unpaired ‘t’ test analysis showed that people with OA have significant balance deficits when compared to the control group under both eyes open and closed on floor condition. Degrees of knee disability have significant impact on fear of fall and quality of life. Balance deficits have significant impact on patient’s quality of life and their perceived fear of fall. Conclusion: While attending patients with osteoarthritis possible balance deficits should be kept in mind and equal importance should be given to the patient’s fear of fall, quality of life and their severity of knee osteoarthritis

Speaker
Biography:

Gurmeet Singh is presently Research Scholar in Mechanical Engineering Departmentat Thapar University, Patiala-Punjab, India. He is working on bone drilling during orthopedic surgery. He has completed his Masters of Engineering in Mechanical Engineering from PEC University of Technology, Chandigarh, India. He has publish 3 international journals and present paper at 4 international conferences. He is having 7 years teaching and research experience. His research area is modern manufacturing, non-conventional machining and bone drilling.

Abstract:

Orthopaedic bone surgery is a curious topic for research in present medical engineering. Machining to bone is very necessary action to treat some major bone fracture. Machining to bone includes through holes, blind holes and sometime just finishing to the bone edges. This machining to the bone can damage the bone and its surroundings if execution is not in a proper manner. This damage may lead to failure of bone joint after some time when human tries to do his daily work, so to maintain the bone joint for long time machining damage should be controlled at the time of machining only. Major problem initiates with machining of bones are crack initiation and thermal damage. This study mainly focuses to maintain the forces exerted and surface damage to the bone during bone drilling with variation of drilling parameters. Using L9 orthogonal array optimized combination of parameters are suggested which gives less damage to the bone surroundings. SEM images of bone drilling surfaces helps to get the micro level information of bone damage.