Joint Preservation and Replacement

Saturday, 9 November 2024

ACL reconstruction 5 years failure

Anterio-superior femoral tunnel leading to failure. Tibial tunnel was 18 mm so 2 stage revision with 1st stage grafting

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20 years post acetabular fracture

Only interfering screws were removed. Intraop frozen sections and cultures were negative. Global and acetabular offset increased by 5 mm. Will this help in abductor efficiency or lurch/ pain time will tell. Usually they take an year to be happy if offset is increased

Friday, 8 November 2024

Recurrant dislocation of Rt THR in a 55 year old lady- one year post thr for secondary osteoarthritis due to AVN

the poly (Bubble) is sen on the lateral aspect of the ilium as a ring. Even a dual mobility cannot salvage this vertical cup

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Essentially revised the cup and COC bearing used The stem taper was protected with a plastic cap made from the cut suction tube

Saturday, 2 November 2024

ACL repair with MCL proximal repair at 3 weeks post injury both acl and mcl looks near noraml at 14 months

Acute repair of ACL and MCl is the way to go today to get the best results.Clinically and radiologically knee looks normal. Both scopic and MRI visually looks more like normal acl unlike a reconstruction. The recent data on clearing the the knee haematoma to reduce the inflammatory metabolites might decrease the long term incidence of osteoarthritis

Monday, 23 September 2024

Elbow instability of one year duration in a rt handed nurse.

pivot shift was painful. lift off from chair was painful. mri and xray revealed a non union conoid and ? mcUCL thickening. EUA and scopy revealed a conoid fracture as the cause. Arthroscope assisted freshening of fracture surface and fixation cured the instabilty

SIF/ SPONK 6 month post partial menisetomy

The risk of menisectomy is not just wear. the effects of SPONK over time is variable depending on the sixe and location

Tuesday, 13 August 2024

Tuesday, 14 November 2023

10 yrs post latarjet asymptomatic and played badminton

the bonegraft broke off while sleeping after 10 yrs post op. Did the grqft ever incorporate or did it break off being avascular. increasing attempts at latarjet and its modifications will definitely raise similar complications and osteoarthritic even after ? healing. we migth reduce dislocation rates at best , rest time will tell. div class="separator" style="clear: both;">

Intraop fracture in a prior fixed and healed distal femoral fracture

salvage of a porotic intraop fracture ina RA pt thru the cyst poorly stabilised by the plate, revised by the rotating hinge link knee with distal femoral replacement