Joint Preservation and Replacement

A collection of complex joint preservation and replacement case studies and random thoughts of a orthopedic surgeon essentially aimed at knowledge dissemination.

Saturday, 11 April 2026

MOM METASUL 23 YEARS POSTOP RT

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   23 YEARS POST RT HIP REPLACEMENT WITH MOM HIP ANDS 10 YEARS POST LT HIP COC , NOW CAME WITH PAIN LT HIP.  NO SYMPTOMS WITH 28 MM METASUL ...

Atypical femoral fracture Lt femur

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Sudden onset thigh pain? Fall reported as intermedius tear.  20 days later comes with Atypical sub trochanteric fracture, not on bisphosphon...
Friday, 20 February 2026

ACI Vs UNI in 54 year uni-compartmental arthritis

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 We debated about ACI vs Unicompartment replacement. Weighing the options the patient opted for ACI.  Did not do HTO as there was grade 2 we...

unstable periprosthetic fracture post TKR in an octogenarian caregiver

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 one week old injury awaiting fixation. Decided to do a distal femoral replacement so that he can full wt bear and been the caregiver  he is...
Friday, 12 December 2025

22 years post bilateral revision in a spondyloepiphyseal dysplasia

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This was a bil revision done in 2002 for failed bil MOP surface replacament with MOP. came with groin pain and pain on wt bearing . bone sca...
Friday, 5 December 2025

MYSTERY WRIST

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 Presents 3 months after a twisting injury preventing a bike from falling. .Pain after splinting by a doc in Mumbai. one week after injury. ...
Thursday, 4 December 2025

ULNO CARPAL IMPINGEMENT WITH CENTRAL TEAR OF TFCC TREATED WITH A SCOPIC WAFER PROCEDURE

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  Stage 3 ulnocarpal impingement    ARTHROSCOPIC RESECTION OF THE DISTAL ULNA THROUGH THE DEBRIDED CENTRAL TEAR ROTATING THE WRIST TO MOVE T...

22 years after bil revision hip in a spondyloepiphyseal dysplasia

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Painful lt hip( groin )  negative  bone scan  stress shielding. metal head starting to impinge in this  reg poly over 28 MOP bearing Plan.A ...

rheumatoid elbow post elbow replacement

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   ROM  30 to 100@ 4 weeks active flexion and passive extension to protect triceps repair till 6 weeks
Saturday, 22 November 2025

Instabilty post TKR due to MCL injury

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Repeated falls 5 monthspost TKR with mcl laxity and mild recuravtum n a Mobile bearing knee. Delayd  Progreesive ligamentous laxity of MCL  ...

Malunited childhood proximal femoral fracture with SUFE and OAhip and valgus knee,anke and degenerate spine

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 Type 2 valgus degenerate  spine with painful malunited proximal femur with old SCFE hip, Lt.  hip was replaced  4 years ago. CT  revealed a...

Periarticular fracture of femur and patella i

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 RTA in a pt with  10 year old conservative  treated  tibial fracture with osteopenia  Attempted fixation by surgeon revealed no hold for  f...
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Dr Jacob Varghese
VPS lakeshore Hospital, Kochi, Burjeel Hospital Muscat oman, kerala, India
orthopedic surgeon - with interests in sports injuries, joint preservation, primary and revision joint replacement
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