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
Monday, 27 July 2026
Saturday, 18 July 2026
Isnt BPT the best in revascularisation and RTS
Friday, 10 July 2026
type 3 Valgus in RA with incompetent acl
This was my first RHK in 2000 was difficult to get zimmer to supply RHK to kerala. Those were the days when the multinationals decided what we could do.
got our the PPS hood system which Amrita hospital imported for us from stryker us and jnj guys seeing it with us imported their lousy version and marketing surgeons with hood on in newspapers in mumbai and elsewhere.
2 Infected knee revison done with sleeves and stem done in 2009 where in we did not trust the sleeve alone
auto grafted the mataphyseal defect with particulate alligraft which we don not do now as far as I know
lt knee Type 3 valgus ie; deficient mcl rt knee Oa with med condyle 4 weeks old fracture
Finacially challenged was on bedrest for 4 weeks when she came to us. Could not afford RHK or even stems
Got out with one stage bil surgery to get her up in 6 weeks fused the valgus knee with a custom nail(compressed with charnley clamps and locked the custom nail and removed the clamp- did not write up the technique when I was in Amrita)) and fixed and replaced the rt after stabilising the sticky femoral fracture & the fracture and started wt bearing both sides @ 6 weeks. Costs sometimes conpromise surgery which could have been an RHK lt side and distal femoral replacement tkr as shown elsewhere here in this blog feb 20th
Sunday, 5 July 2026
Infected elbow replacement
Treated elsewhere with only iv and oral antibiotics for close to an year.
stage 1 revsion with stimulan and ball spacer inserted. at 4 month got 20 to120 rom can do most activities of daily living
clinically mild instabiity in varus and valgus. _Hope to revise to a long stem TER if the patient undestands the risk
Monday, 22 June 2026
Saturday, 11 April 2026
MOM METASUL 23 YEARS POSTOP RT
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 HIP MOM WITH POLYETHLENE SANDWICH IN 23 YEARS. THE IMPLANT WAS WITHDRAWN WHEN SULZER ORTHOPEDICS CLOSED DOWN. AWAITING CO AND CR LEVELS MRI IS NORMAL.
DISTAL TIP OF LT HIP WAS HOT OF BONE SCAN
Atypical femoral fracture Lt femur
Sudden onset thigh pain? Fall reported as intermedius tear.
20 days later comes with Atypical sub trochanteric fracture, not on bisphosphonates.
Intraop biopsies were normal.
Friday, 20 February 2026
ACI Vs UNI in 54 year uni-compartmental arthritis
We debated about ACI vs Unicompartment replacement. Weighing the options the patient opted for ACI.
Did not do HTO as there was grade 2 wear in lateral compartment which was small lesion
lt is 9 month standing postop xray with increased joint space after ACI
unstable periprosthetic fracture post TKR in an octogenarian caregiver
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 for his wife, at six weeks he is back taking care of his wife. adv metabolic consult for osteoporosis
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