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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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
Saturday, 21 September 2024
Tuesday, 13 August 2024
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.
Saturday, 3 August 2024
Thursday, 9 May 2024
Tuesday, 14 November 2023
10 yrs post latarjet asymptomatic and played badminton till this day
This Rt handed OT male nurse (now in UK )was my ? success until this!!. The bone graft broke off while sleeping after 10 yrs post op. Did the graft ever incorporate or did it break off being avascular. i already have an asymptomatic arthritic shoulder i know after 20 years postop in a badminton player.
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. Do we need fresh osteoarticular grafts with live chondrocytes or sandwich ACI technique. Just food for thought.
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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
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