Average Indian Glenoid Sizes Are Smaller than All Commercially Available Glenoid Components: A Systematic Review.

Background: Despite the variability in glenoid sizes geographically, most of the currently available commercial glenoid component designs are based on the glenoid parameters of the Caucasian population which may not be suitable for the Indian population due to a mismatch between the prosthesis and native anatomy. The aim of the present study is to systematically review the literature to determine the average glenoid anthropometric parameters in the Indian population. Methods: A comprehensive literature search was conducted using preferred reporting items for systematic reviews and meta-analyses guidelines in the PubMed, EMBASE, Google Scholar, and Cochrane Library databases from the date of inception to May 2021. Any observational study conducted on the Indian population measuring the glenoid diameters, glenoid index, version, inclination, or any other glenoid measurements were included in the review. Results: A total of 38 studies were included in this review. The glenoid parameters were assessed on intact cadaveric scapulae in 33 studies, on 3DCT in three studies, and 2DCT in one study. The pooled average of glenoid dimensions are as the following- the superoinferior diameter or height was 34.65 mm, anteroposterior1 diameter or maximum width was 23.72 mm, anteroposterior2 diameter or maximum width of the upper part of the glenoid was 17.05 mm, the glenoid index was 67.88, and the glenoid version was 1.75-degree retroversion. Males were having a mean height of 3.65 mm and maximum width of 2.74 mm larger than the females. A subgroup analysis revealed no significant difference between different parts of India in glenoid parameters. Conclusion: The glenoid dimensions in the Indian population are smaller compared to the average European and American populations. The average glenoid maximum width of the Indian population is 1.3 mm smaller than the minimum glenoid baseplate size available in reverse shoulder arthroplasty. Glenoid components specific to the Indian market need to be designed to reduce glenoid failure attributable to the above findings. Level of evidence: III.

Acute Primary Epiphyseal Osteomyelitis of Proximal Tibia - A Case Report and Review of the Literature.

Introduction: Acute pyogenic epiphyseal osteomyelitis is a rare condition, mostly affecting children. This case report discusses the importance of clinical suspicion and the role of adjuncts in the diagnosis of these cases. Case Presentation: A 12-year-old female presented with pain in the right knee for 1 week and difficulty in walking for 4 days. Diagnosis was made with the help of magnetic resonance imaging MRI and guided biopsy. Pseudomonas aeruginosa was isolated from culture. She was treated with intravenous antibiotics with a good response. Discussion: Despite being a rarely reported entity, primary epiphyseal osteomyelitis should be kept as one of the differentials of the painful swollen knee in a child. Early diagnosis with the help of proper radiological investigations is the key to prevent the sequelae of this disease.