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
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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

Dynamic mri in PF instability caused by increased femoral anteversion

17 yrs post bil one stage Ceramic on ceramic THR

28 mm Alumina head and liner with no issues to date. SROM stem was used then to cover for any ceramic fracture and taper damage and in case for easier revision.

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

Periprosthetic fracture in a Octagenerian

afe and aortic stenosis narrow canal 10.5. bowed femur absence of curved 10 inch 10.5 mm dia porocqt stem made us use this cemented long wxeter stem z10 mm dia and 240 mm and wired proxmily without cement. in the past a porocoat stem was cemented distally after removing the porocoat i trqop with a burr only distally to cemebt the proximal uncemented stem was witd to the periprosthetic fracture to facilqta e ingrowth or fracture heqling . It make for a quick surgwry in these unfit pts and can mobikise full wt bearing stwt.

Patella dislocation with osteochondral fracture of medial facet

14 yr old male with genu valgum open physis and grade 3 b troclea and osteochondral fracture patella underwent medial epiphysidesis by paeds team, fixqtion on oc peice with suture tape and biopins and teochleplasty and mpfl repqir rather than recon. div class="separator" style="clear: both;">

Saturday 16 September 2023

Hypointense ACL

we still do not have a a clear cut correlation between clinical and radialogical data to make an informed decision for return to sport like in fracture union