Abstract

Dr. Nishchal Sharma*, Prof. Sunita Kumari, Dr. Arvind Kumar, Dr. Ajay Kumar Yadav

ABSTRACT

Background: Janu Sandhi Marma is described by Acharya Sushruta as a Vaikalyakara Marma, the injury of which may result in functional impairment and disability. The anatomical description of Janu Sandhi can be correlated with the modern knee joint complex, which comprises bones, ligaments, menisci, muscles, capsule and other supporting structures. Objective: To establish an anatomico-clinical correlation between Janu Sandhi Marma and the modern knee joint using clinical examination and radiological investigations, and to evaluate the classical Viddha Lakshana of Janu Marma injury. Materials and Methods: An observational, cross-sectional, hospital-based study was conducted at Balrampur District Hospital, Lucknow. Twenty-five patients aged 20–55 years presenting with knee joint trauma were evaluated. Clinical assessment included pain, swelling, tenderness, instability, range of motion and functional impairment along with special tests such as Lachman, anterior drawer, McMurray and valgus stress tests. Radiological assessment included X-ray and MRI. Ayurvedic clinical manifestations were correlated with modern clinical and radiological findings. Results: Twenty-five patients were included, comprising 18 males (72%) and 7 females (28%), with a mean age of 37.2 ± 9.4 years. The maximum number of patients belonged to the 31–40-year age group. Among 17 patients with ACL tears, 13 (76.47%) had complete tears and 4 (23.53%) had partial tears. Proximal-third ACL involvement was most frequent (64.71%). Meniscal injuries were associated with 35.29% and MCL injuries with 17.65% of ACL tear cases. Bone contusions were observed in 70.59% of ACL tear cases. Clinical-radiological agreement was highest for joint effusion (κ = 1.00), followed by Lachman test (κ = 0.82), McMurray test (κ = 0.75), anterior drawer test (κ = 0.71) and valgus stress test (κ = 0.68). All 25 patients exhibited at least three classical Viddha Lakshanas of Janu Sandhi Marma injury. Conclusion: The findings demonstrate a clinically meaningful correlation between the classical description of Janu Sandhi Marma and the anatomical, clinical and radiological features of knee joint injuries. The classical manifestations such as Vedana, Shotha, Khanjata, Kriya Ashakti and Sparshasahyata show recognizable modern clinical correlates. Integration of Ayurvedic clinical assessment with modern radiological evaluation may provide a comprehensive approach to the assessment of Janu Sandhi Marma trauma.