A collection of complex joint preservation and replacement case studies and random thoughts of a orthopedic surgeon essentially aimed at knowledge dissemination.
Thursday, 22 October 2026
ACL healing is time dependant or patient dependant. do we need better imaging before return to sport
3 year post acl rec clinically intact acl. Patient is asymptomatic and for all practical purpose doing well. not allowed return to contact sports .MRI shows acl graft intensity ?still to mature. why?
Is this more prone to rerupture?
Tuesday, 20 October 2026
23 yrs post THR is old acetabular fracture
Did this in 2002 when he came with failed acetabular reconsteuction. The RTA claim is still going at 23 years and wanted to know the cost of revision when he needs. This was biolox ceramic on poly with CLS stem and I think sportono cup(Sulzer) which was the only ceramic cup for me to use then. Donot have the preop xray. Inspite of the increased offset and varus stem the wear is neglgible.
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Sunday, 11 October 2026
Radial and complex tears heal. did the augmentation with BMAC make the difference
6 weeks rescope for 2nd stage ACI proves it. Then one case cannot be the evidence. Difficult to scope everyone even with our new nanoscope. Mri evidence is too tricky to differentiate fibrous tissue for tear unless there is fluid leaking into the tear and narrow slices.
CHRONIC DISLOCATED PATELLA IN TKR - A SOLUTION USING SYNTHETICS
THIS WAS A CASE REFERED WITH MALROTATED IMPLANT WITH MCL LAXITY AND PATELLAR SUBLUXATION. THE RHK HELPED WITH WALKING BUT 40 DEGREE EXT LAG PERSITED DUE TO PATALLAR DISLOCATION DUE TO LAX MEDIAL TISSUES WITH WEAK VMO. WE DID A LATERAL PATELLAR VY LIMITED LENGTHENING, A XIROS SYNTHETIC LIGAMENT WAS USED OUTSIDE IN AND INSIDE OUT WITH A ONE INCH GAP RESULTING IN A STRONG INTRARTICULAT LATRRAL LOOP WITH A TO PULL THE PATELLA WITH OUT A CUT OUT PASSED INSIDE OUT THROUGH THE PATULOUS MEDIAL VMO AND SOFT TISSUE AND TIED TIGTH TO REDUCE THE PATELLA AND THE MEDIAL TISSUES REEFED AS DEMONSTRATED IN FIG BELOW AND ELIMNATED HER LAG IN 4 MONTHS WITH HELP FROM THE BEST PHYSIOTHERAPY FROM ARUN.
PATELLA WAS NOT DRILLED DUE TO POROSIS AND SOME ILLDEFINED EARLY ATTEMPT ELSEWHERE
REV
Thursday, 8 October 2026
HYBRID FIXATION ON RT HIP
CEMENTING THE DISTAL HALF OF STEM WITH PROXIMAL POROCOAT FOR ETO HEALING AND IMMIEDIATE WT BEARING IN A 90 YEAR OLD LADY. DONT WE NEED A SIMILAR STEM IN PEROPROSTHETIC FRACTURE WITH POOR BONE AND GENERAL CONDITION TO MOBILISE IMMEDIATE POSTOP
Sleeve and. MBT tray done in 2008
was allograft needed
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OCD WITH ICRS STAGE 1 WITH OPEN PHYSIS
2 YEARS SYMPTOMATIC OCD WITH A FAILED CONSERVATIVE TREATMENT IN A LEVEL 1 ATHLETE
TRANS ARTICULAR DRILLING DONE IN VIEW OF LOCATION AND OPEN PHYSIS with intact cartilage
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