Painful DDH in a pt with Prior Limb lengthening done

 

Postop the limb was perceived to be long

The postop Pelvic tilt was suggested as the IT band being pulled due to the lentgening

3 month wt bearing xray showed a corrected LLD

Was caught out by un noticed limb lengthening done as a kid Happy to see her today standing on operated leg with no limb at 6 months without an abductor lurch( modified Hardinge approach) She is off to canada for studies and our entire team wishes her well

Proximal bone loss in art distal loading solution stem compared with proximal loading distal fitting srom MOM on lt side

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Paget’s disease with bowed femur 12 degrees Varus and 12 degrees flexed

The options of navigated and robotic replacement were offered. Settled for a simpler local custom made distal cutting jig , followed by gap method for a Varus valgus stabilised knee 

 

  

  

Revascularisation of acl allograft

 

Z shaped MCL tear /MCL tear is not always onesided

Z shaped MCL tear associated with  PCL and medial meniscal root tear
 root tear

16 years post revision with alumina ceramic on poly THR

has some pain Rt thigh . bloods normal/ bone scan below. waiting for a 3 month review to repaet bloods and clinical assesment.lass="separator" style="clear: both;">

74 year gentle man with periprosthetic fracture 2 years post fracture

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 usTKR 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.