Background: Degenerative changes in the knee occur with increasing frequency after the third decade of life. In early osteoarthritis with no mal-alignment of the knee, arthroscopic surgery is an attractive alternative for many elderly patients as it reduces the degree of surgical insult and postoperative rehabilitation with hope of restoration of painless mobility. To study the role of arthroscopic debridement in alleviation of pain in cases of osteoarthritis knee and to evaluate the effectiveness of arthroscopy in diagnosis of osteoarthritis knee and its co-relation with radiological diagnosis. Methods: The present study is cross-sectional study of consecutive cohort of 53 patients. Body mass index was calculated based on height and weight of the patients and from their assessment of X-Rays patients were graded from 0 to 4 based on Kellegren-Lawrence radiological grading method. Selected patient were then assessed by pain domain of the knee society scoring system, which is joint specific score ranging from 0 to 50. These patients were then subjected to arthroscopic examination and debridement. Results: Overall 17 (32.08%) out of total 53 cases studied showed improvement after one year. Majority of patients improved were grade 2 (57.89%) but none of the grade 4 patients showed improvement at 1 year. Conclusions: Arthroscopic debridement does not influence the ongoing pathological process; it is only useful for symptomatic relief in cases of low grade osteoarthritis where it provides pain relief. Conversely, in patient with sever osteoarthritis there is very limited role of arthroscopy.
The hip allows mobility of the entire extremity in 3 planes. Therefore any little derangement in the anatomy of the hip can affect it's functioning and can cripple & severely affect daily living of the person. The most common causes of disability are trauma and degenerative disease, and till date the most successful2 treatment for joints severely damaged has been replacement by artificial parts. Today replacement arthroplasties are very commonly performed by orthopedic surgeons the world over. In India too this procedure has gained wide acceptance among both surgeons and patients. The primary goal of this procedure is to restore normal anatomy of the hip joint so as to provide painless free mobility with a stable hip, and immediate functional outcomes of this procedure are very satisfactory. Technically there is little debate that the results of revision procedure are less satisfactory and the primary THR offers the best chances of success. Therefore it would be rational to assess and eliminate the human/iatrogenic factors that would-be influencing and jeopardizing the longevity of the implant since such surgeries in Indian patients are mostly once in a lifetime job. Also since the indications of arthroplasty have expanded and more surgeries are being done, so there is a statistic increase in the percentage of loose implants, which ever the reason. Although definite evidence and impact of loosing manifests late but the parameters reflecting the causative factors can be detected early in the form of altered anatomy and function. And repetitive cyclical loading of the implant in an unfavorable mechanical environment will over time, ultimately build up to a negative result.
Introduction: Intracapsular femoral neck fractures are common in the elderly population. To avoid the poor outcome of internal fixation and for early mobilization, hemiarthroplasty is performed.
Aims & Objective:To study the management of fracture neck of femur by bipolar prosthesis and to study post-operative prosthetic components motion radiologically.
<p><strong>Background:</strong> Tibial shaft fractures are common traumatic fractures especially in road traffic accidents. Intramedullary interlocking nailing is considered treatment of choice tibial diaphyseal fractures, minimizing soft tissue injury and permitting early weight bearing and fracture healing. Anterior knee pain and reduced range of motion are some common complications that patients have to face in post-operative period.</p><p><strong>Methods: </strong>The<strong> </strong>60 patients of both sex with traumatic diaphyseal tibial shaft fractures were included in this study out of which 30 were operated with interlocking tibia nailing with trans patellar (tendon splitting) approach while 30 were operated with medial parapatellar approach for tibia nail insertion. Range of motion at knee joint (in degrees) and anterior knee pain (on visual analogue scale) was evaluated on post-operative day 1, 2 weeks, 1 month, 3-month post operatively and compared for both groups.</p><p><strong>Results: </strong>Mean anterior knee pain was significantly lower in parapatellar approach group at 2 weeks, 1 month and 3 months while there was no significant difference on post-operative day 1. Mean range of motion at knee joint was more in parapatellar approach group on post-operative day 1 and 2 weeks while there was no significant difference in range of motion after 2 weeks.</p><p><strong>Conclusions: </strong>In our study medial parapatellar approach is superior than tendon splitting approach with comparatively greater range of motion and lesser anterior knee pain. Thus, medial parapatellar approach should be encouraged for interlocking tibia nailing.</p>
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