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Pivot-shift examination is a better measure than Lachman examination or instrumented knee laxity as far as patients' functional outcome and overall satisfaction is concerned.

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Introduction: Subtalar dislocation is a rare injury around foot and ankle. Most common mode of injury is high-energy trauma (road traffic accident (RTA), fall from height (FFH) and sports activities) (Saini R, Dhillon MS, Gill SS. Congenital subtalar dislocation — a case report. Foot 19; Kaufmann RA, Davidson R, McCarthy J. Bilateral congenital subtalar dislocation: a case report. Clin. Orthop. Related Res. 397). It is commonly seen in young men and the mechanism is inversion injury in plantar-flexed foot. Medial-type dislocation is most commonly seen with incidence between 65% and 85%, as stated in various studies. Pure ligamentous injuries have shown good prognosis, which when associated with fractures can affect the functional outcome. Methods: We conducted a prospective study from 1st January 2017 to 1st December 2020 including seven patients (five males and two females) with closed medial subtalar dislocation with (1) or without fractures (6). In our study, closed reduction was performed in all the cases. At final follow-up, functional outcome was evaluated using ‘AOFAS-AHFS Score’ and radiological assessment. Results: All seven patients had good functional outcome at final follow-up and found no difficulty in doing daily routine activities. Routine clinical and radiological assessments were also done at final follow-up. All patients had complete ROM at final follow-up. Conclusion: Closed medial subtalar dislocation without significant articular fractures has good outcome in terms of function if managed properly.

Introduction: Rotator cuff tendinopathy/partial tear is the most common cause of shoulder pain encountered in clinical practice. The treatment varies from conservative to surgical options. Recently there has been extensive use of blood-derived products for the healing of tendon injuries. Platelet-rich plasma (PRP) is hypothesized to augment tendon healing due to various growth factors including PDGF, VEGF and TGF-b. While the theoretical explanations look promising, the clinical efficacy of PRP is conflicting, thus establishing a clear need for extensive studies. Aim: The purpose of this study is to evaluate the results of the use of PRP in patients having partial rotator cuff tears. Material and Methods: Fifty patients of the age group 25–50 years who had partial cuff tears ([Formula: see text] involvement) identified on Magnetic Resonance Imaging (MRI) and had continuous pain for a minimum three months were studied. They were treated with PRP therapy and the results of their function were evaluated over time. Results: Shoulder function assessment was done was UCLA and Quick DASH score. Each of these scores showed a statistically significant improvement at 6 and 12 months. The Mean UCLA score pre-procedure was [Formula: see text] and at final follow-up was [Formula: see text]. There was reduction in the average Quick DASH score from [Formula: see text] pre-therapy to [Formula: see text] at 12 months follow-up. Conclusion: After the final follow-up, most of the patients were able to resume their daily activities. The world of PRP therapy looks promising and is needed to be explored further in orthopedics as a lot of controversy over its benefits exists in the literature.

Introduction: Anterior Cruciate Ligament (ACL) is the most commonly injured ligament in the knee that requires surgical intervention. The weakness of quadriceps muscle is a sequele of ACL tear that can persist even after reconstruction. Muscle wasting if identified in early postoperative period can help to formulate structured protocols for rehabilitation that can help patient to recover. Best available method for scan of the same includes Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) scan, but it is neither accessible nor affordable to masses of population. Aim: To evaluate the quadriceps thickness using an easily available modality i.e., Ultrasonography (USG) and thigh circumference to detect early wasting. Materials and Methods: This prospective longitudinal study was done on 48 patients between the ages of 18-45 years with ACL tear operated arthroscopically. After six months of surgery, all patients were evaluated for quadriceps thickness using USG and thigh circumference using traditional measuring tape at the same points. Paired t-test was used for evaluation of the results. Results: This study quantifies quadriceps thickness using USG at two distinct levels of the thigh and found a significant deficit of 13.05% in the involved extremity at 1/3rd of femur length from knee joint and a deficit of 11.72% in involved extremity at 2/3rd of femur length from knee joint. This study established that the quadriceps of the involved extremity definitely goes under atrophy despite early rehabilitation. Also, there was a deficit of 5.04% in thigh circumference at 1/3rd of femur length from knee joint and 4.43% at 2/3rd of femur length from knee joint in the operated limb. There was no positive correlation between both the methods. Conclusion: This study concluded that USG is an easily available and affordable method to determine quadriceps thickness and it’s wasting early in the postoperative rehabilitation phase. It can assist in establishing early vigorous rehabilitation protocols. The traditional method of measuring thigh circumference using measuring tape to quantify quadriceps muscle bulk can be misleading as its underestimates the atrophy due to various factors.

Introduction: Medial Collateral ligament (MCL) is the primary stabilizer of knee joint against valgus stress force. Sprains of MCL are fairly common due to any injury and are treated conservatively most of the time. These have been classified by Hughston in grades I, II and III based on the severity. While grades I and II mostly have only sprain of the ligament, grade III is complete tears and may warrant surgical correction. Stener-type lesion is a rare finding seen with grade III MCL injuries. Here, superficial MCL (sMCL) tears at its distal insertion and is retracted upwards leading to pes anserinus tendon to lie in between the bed and its distal end. This does not allow the MCL tendon to regain its attachment to bed and needs surgical correction. Material/Methods: We report five patients who presented to us with stener-like lesion. They were then operated with repair of MCL tendon and its reattachment to the Tibial bed using similar techniques. Pre-procedure outcome values (Lysholm score and KOOS score) were evaluated and the patients were followed up for 1 year. At the final follow up, final outcome values were calculated along with complete clinical examination was done. Results: All five patients were fully satisfied and reported no problems in resuming work and daily activities. Clinical evaluation was done and there was reported no joint laxity or opening of joint line with varus/valgus stress conditions. There was a complete range of motion reported in all patients. There was no limping/misalignment or gait disturbances reported at the end of follow up in any of the patients. Conclusion: Stener-type lesion of knee is rare and is needed to be explored further. Our study emphasizes the early diagnosis and surgery with excellent results of cases reported in due course of time. Very limited literature is currently available for this severe sMCL injury. Thus, longer studies involving a larger number of cases and extended follow up are needed in future to explore the ways of early diagnosis and various treatment options further.

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