Joint Preservation and Replacement

had 3 attempts at union surgically with 2 scars. Decided to do distal femoral repalcement to get him back to his feet after 2 tears. nil infection. the risk of skin issues was discussed and had plastic backup which luckily was not needed .

Thursday, 13 January 2022

Infected activ motion plate in a HTO

Friday, 3 December 2021

2 months of dislocated Knee repalcement in an elderly lady with high BMI

Allleged history of fall 2 months back. Knee lying dislocated when reviewed by us TKR done 5 years ago with no issues till the fall Bloods and knee aspiration - - normal Options of RHKif frozen section was negative or Fusion if infected was discussed. 2 stage was ruled out by patientThe decision had to be one stage and no external fixation as per patients families request . So a fusion was done as frozen section showed probable infection as per fieldman's criteria, Survived the surgery and mobilised FWB day 2 day before discharge went into renal shutdown at day 12 and after a month of ICU and stay we lost her

mucinous cyst degeneration of ACL

Wednesday, 3 November 2021

squatting leading to dislocation in TKR

Conventional TKR is not designed for squatting. Even high flexion designs are reported to lead to earlier PF problems and wear.

Sunday, 5 September 2021

meniscal repair augmented with synovial to improve the healing in a complex degenerate tear

Menisectomy have been clearly shown to give poor long term results. Hence methods to augment and enchance repair by multiple sutures, BMAC, VGF's have been tried. we seemed to have some early good results so far with synovialaugmented repair. it is too early to be sure so we are following up the consented patients for the same.

Saturday, 4 September 2021

2 MONTH OLD DISLOCATED KNEE WITH CELLULITIS IN THE SHIN

fell 2 months after TKR and dislocated the knee. pt (BmI 35) with recurrant cellulitis on the ipsilateral tibial shin shin which is asymptomatic. esr was 110 with a crp of 20. Repeated knee aspiration was negative. incidently a gram negative UTI and large supraclavicular LN was found on admission planned for a supraclavicular biopsy, frozen section , HPE, cultures and Rotating hinge knee with arthrodesis back up. frozen section as per fieldmans criterioa showed too many PMNL in more than 5 power field, A modular titanium fusion nail and stimulan with antibiotic polymyxcin and vancomycin was inserted . Pt made to wt bear the same day evening and mobilised b haemolytic strep grew for which minimum 4 weeeks IV antibiotics is planned.

Tuesday, 24 August 2021

Greater tuberosity fracture ain’t benign

mri revealed a bankart"s lesion which was not suspected as the pt came 2 weeks post injury due to the pandemic. hence scopic bankarts reapir and suture bridge reapir of the cuff was done getting him full rom at 3 month with improving scapular rhythm. The key is do we need to look more into the tuberosity fractures for instabilty. so is mri mandatory in a tuberosity fracture to look for cuff, bankarts and SLAP tears

Sunday, 22 August 2021

Distal biceps tendon Rupture in an active persons dominant Arm

3 week old injury- Middle aged male injured rt elbow while batting sustained a bruise and swelling rt arm positive hook and squeeze tests. mri showed distal biceps tendon with retaction 8 cm above the elbow. the options of surgical treatment and conservative were discussed before repair and bracing was done distal bv class="separator" style="clear: both;">