medial patellar facet chondral defect

grade 4 medial patella r defect 3 cm circumference in a 19 year old male student. Normal TT:TG diatance. MPFL intact. No history of injury.

cartilage mapping at 6 months. this was done in 2010 has good function till date 10 years followup.

ceramic on metal cleared by FDA

It was anounced that FDA approved ceramic on metal bearing by depuy for use recently. We have been using this bearing couple over the last 2 years with no untoward problems( 11 cases with 2 year follow up). Ever since J. fishers article in j of biomechanics(2004) suggesting decrease in metal debris as well as decrease chances of liner fracture, this was an option to look forward to.

Does this reduced metal debris cause problems

will this evolve to other new bearing Viz; ceramic on oxinium bearings.

anterior column fracture with posterior hemitransverse in an 82 year old male

anterior column is displaced with an essentilly undispalced hemitransverse fracture as described by letournel.

would you fix it or treat him conservatively

or fix and repalce it ?

He was advised PTH for severe porosis 2 years before> it was deferred by the patient due to percieved immediate cost.

This patient was advised antiresorptive therapy 2 years ago. He refused and paid the price. We fixed the posterior column and used a ganz cage to cement a cup.. the trochanrteric flip was used to improve exposure. A single screw was used to stabilse the anterior column thru the cage . He was mobilised on day 3 PWB. Awaiting for the six week review.