The study reconfirms the belief that DVT has a lower incidence in Indian patients as compared with other ethnic groups.

Background:Limb length discrepancy and its effects on patient function have been discussed in depth in the literature with respect to hip arthroplasty but there are few studies that have examined the effect on function of limb length discrepency following total knee arthroplasty (TKA). The aim of this study was to determine whether limb length discrepancy after TKA in patients with bilateral osteoarthritis of knee with varus deformity affects functional outcome.Materials and Methods:Fifty-four patients with bilateral osteoarthritis of knee with varus deformity, who were operated for total knee arthroplasty from 1996 to 2008, were reviewed retrospectively. The patients were divided into two groups. Thirty patients (mean age 64 years) were operated for unilateral TKA and thirty patients (mean age 65.8 years) were operated for bilateral total knee arthroplasty. Six patients underwent staged surgery and were included in both groups as the time interval between the two surgeries was more than the minimum 6-month follow-up period specified for inclusion in the study. The limb length discrepancy was measured and statistically correlated with the functional component of the Knee Society Score.Result:In the unilateral group (n=30), the mean limb length discrepancy was 1.53 cm (range: 0-3 cm) and the mean functional score was 73 (range: 45-100). In the bilateral group (n=30), the mean limb length discrepancy was 0.5 cm (range: 0-2 cm) and the mean functional score was 80.67 (range: 0-100). A statistically significant negative correlation was found between limb length discrepancy and functional score in the unilateral group (Spearman correlation coefficient, r =−0.52, P=0.006), while no statistically significant correlation was found in the bilateral group (Spearman correlation coefficient, r = −0.141, P=0.458).Conclusion:Limb length discrepancy affects functional outcome after total knee arthroplasty, especially so in patients of bilateral osteoarthritis with varus deformity undergoing surgery of only one knee.

Study DesignWe performed a multicentric, randomized, comparative clinical trial. Eligible patients were randomly assigned to receive 150 mg of Tolperisone thrice daily or 8 mg of Thiocolchicoside twice daily for 7 days.PurposeTo assess the efficacy and tolerability of Tolperisone in comparison with Thiocolchicoside in the treatment of acute low back pain with spasm of spinal muscles.Overview of LiteratureNo head on clinical trial of Tolperisone with Thiocolchicoside is available and so this study is done.MethodsThe assessment of muscle spasm was made by measuring the finger-to-floor distance (FFD), articular excursion in degrees on performing Lasegue's maneuver and modified Schober's test. Assessment of pain on movement and spontaneous pain (pain at rest) of the lumbar spine was made with the help of visual analogue scale score.ResultsThe improvement in articular excursion on Lasegue's maneuver was significantly greater on day 3 (p = 0.017) and day 7 (p = 0.0001) with Tolperisone as compared to Thiocolchicoside. The reduction in FFD score was greater on day 7 (p = 0.0001) with Tolperisone. However there was no significant difference in improvement in Schober's test score on day 3 (p = 0.664) and day 7 (p = 0.192). The improvement in pain score at rest and on movement was significantly greater with Tolperisone (p = 0.0001).ConclusionsTolperisone is an effective and well tolerated option for treatment of patients with skeletal muscle spasm associated with pain.

Background: Trigger finger or stenosing tenosynovitis is a disproportion between the volume of the tendon sheath and its contents. This disproportion prevents gliding of the tendon as it moves freely through the annular pulley. The technique of percutaneous release of the annular pulley for trigger finger has been described well in the literature, which has undergone several modifications, like use of hypodermic needle, tenotome or specially designed knives. Method: We performed percutaneous trigger finger release using a 20-gauge hypodermic needle to know the outcome and efficacy of the technique post release. A Prospective cohort study was conducted in 80 consecutive trigger fingers of 67 patients who were treated by percutaneous release using 20-gauge hypodermic needle. Quinell's grading system was used to quantify severity of triggering and pain was assessed using visual analogue scale (VAS) before and after the procedure. Patients were evaluated based on these two parameters at timely interval and final outcome was assessed at the end of one year. Results: Out of 80 digits treated, most of the subjects were in the age group 40e50 years (39.07%). Most common grade of trigger finger observed was Grade 3 (60%) followed by Grade 4 (30%) with VAS score of 8 (46%) followed by VAS score of 7 (24%) before release. At a year follow-up 95% of patients improved to grade 0 and mean VAS score was 0.44. Three patients developed scar tenderness, which gradually subsided by analgesics and physiotherapy with no other major complications. Conclusion: Our technique of percutaneous release of trigger digit with 20 G needle is effective and can be performed safely with ease. It is cost efficient and has a short learning curve with great acceptance being an outpatient procedure.

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