In the 1960s, Sir John Charnley introduced to clinical practice his concept of low-friction total hip arthroplasty (THA). Although early designs were plagued by poor performance and even failure, there have been steady advances in implant designs, biomaterials, surgical techniques and an understanding of the biomechanical restoration of the hip; these advances have contributed to improvements in implant survival and clinical outcomes of THA in the past three decades. With improved wear resistance and mechanical reliability, a potential to last for at least 25 to 30 years are now available for THA. In this review, we focus on the evolution of THA and review current controversies and future directions of this procedure based on a single surgeon's 29-year of experience at a single institution.

Intramuscular haemangiomas are believed to be hamartomatous and are a distinctive type of haemangioma occurring within skeletal muscle. They account for less than 1% of all haemangiomas. They occur more often in trunk and extremity muscles.A sixty five year old lady presented with swelling and pain from the back of the left knee for two years.On clinical examination, a mass of about 10X10 cms in size was noted in the left popliteal fossa. The swelling was tender with well defined borders but fixed to the muscle. She had a flexion deformity of knee of ten degrees.MRI revealed a large encapsulated cystic lesion in the posterior aspect of the muscular compartment of the knee.She underwent excision of the mass, intraoperatively the mass was noted to be arising from the gastrocnemius. Histopathology revealed large cavernous filled spaces filled with blood which indicated a cavernous haemangioma.Most of the literature suggest the occurance of capillary haemangioma to be a commoner one. Occurance of a cavernous haemangioma is usually before the third decade and is congenital in most times. Most of the authors emphasize that radiological methods are generally insufficient for the correct diagnosis of intramuscular hemangiomas, and surgery is the treatment of choice to exclude malignancy and for adequate treatment of these lesions.Hence, the present case which we are reporting here is a rare occurance of a cavernous haemangioma of the gastrocnemius in a 65 year old lady, which was managed by surgical methods.

Introduction: Glenoid labral cyst in shoulder is an entity akin to meniscal cysts in knee. It usually manifests with features similar to impingement syndrome or rotator cuff weakness. Clinical Picture: A 42yr old male patient with complaints of left shoulder pain and restriction of movement for 2 months with muscle wasting in left supraspinatus and infraspinatus region. MRI left shoulder showed partial tear of supraspinatus tendon, glenoid labral cyst in closed proximity and causing compression to suprascapular nerve with atrophy of infraspinatus muscle. Treatment: Left shoulder diagnostic arthroscopy was done and followed with ganglion excision done through a posterior approach and suprascapular nerve was decompressed. Histopathology report showed features of an inflammatory cystic lesion. Outcome: patient experienced resolution of symptoms within 4 months of surgery with significant restoration of rotator function and bulk. Conclusion: Suprascapular nerve compressive neuropathy secondary to glenoid labral cyst is a rare entity but easily recognizable on a MRI scan and responds quickly to decompression.