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The aim of the study was to compare the efficacy of periarticular injection of a cocktail of analgesic drugs (PIC) with epidural infiltration (EA), in providing postoperative pain relief and early functional improvement following Total Hip Arthroplasty (THA). Methods: 50 patients undergoing unilateral THA were randomized to receive either EA or PIC for postoperative pain control. Postoperative pain relief, as determined by the visual analogue scale (VAS), functional recovery and side effects related to EA and PIC were assessed. Results: PIC resulted in significantly lower VAS scores [0.48(0.71) vs 3.04(2.07)] in the first 24 h after surgery [mean (SD)], when compared to EA. The pain relief continued to be significantly lower even on the 10th postoperative day. Functional recovery was significantly better in the PIC group, with patients being able to walk longer distances and climb steps more quickly following THA. EA, unlike PIC was associated with side effects like nausea, vomiting, motor weakness, back pain and urinary retention. The overall satisfaction rate with treatment was significantly better in PIC group (9.04/10) than those who received EA (7.76/10). Conclusion: PIC provides significantly better pain control and functional recovery in the early postoperative period, with less side effects when compared with EA. PIC should be the choice for pain control following THA.

Assessment of elbow flexion strength is an important component of upper limb neurological examination and is necessary for patient screening, planning of surgical interventions and rehabilitation. Medical Research Council (MRC) Scale is the most widely used method for grading muscle strength. The major drawback of MRC grading is that it is observer dependent and imprecise. A quantitative measure of elbow flexion strength is an objective measure that eliminates such bias. Several instruments have been developed for quantifying the elbow flexion power. However, availability, quality and measuring standards vary widely between these instruments most being cumbersome and expensive. We report the design of an instrument that is simple and cost effective for quantifying elbow flexion strength objectively. The validity of elbow flexion strength obtained from normal participants using this in-house instrument supports its clinical use in patients with brachial plexus injury.

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Osteoid osteoma is a rare entity in the tarsal bones especially in children. High degree of suspicion is needed for early diagnosis and delay in diagnosis can cause significant disability. Radiofrequency ablation (RFA) is safe, minimally invasive method especially to treat juxta-articular and inaccessible lesions. Atypical Osteoid osteoma can present with clinical features similar to that monoarticular juvenile idiopathic arthritis. This case highlights the unique features of a rare entity and a successful method of treating Osteoid Osteoma of the Talus with radiofrequency ablation after procuring tissue for biopsy by a novel method.