Calcifying Tendinitis (CT) shoulder a self limiting disorder characterized by deposition of calcium salts in rotator cuff muscles. The main symptom being pain followed by activity restriction resolving on its own in most cases. Symptomatic patients are initially managed by NSAIDs, Physiotherapy, Corticosteroid injections. ESWT involves acoustic waves causing fragmentation of deposits with pain releif. Ultrasound guided needling barbotage have shown promising results. Arthroscopic excision remains the definitive management for patients associated with complications as cuff tear and for uncomplicated patients. In calcifying tendinitis the initial evaluation, maintenance of function and appropriate choice of treatment modalities determines the prognosis.
Total knee arthroplasty is the standard of care for the patients with severe degenerative joint disease. There are still controversies among surgeons about restoring alignment in knee with Extra Articular Deformity. Some author reports corrective osteotomy to align anatomical axis there by restoring mechanical axis indirectly, while others restores mechanical axis directly using special instruments. We conduct a qualitative analysis of outcome in restoring mechanical axis directly and indirectly by, Post op alignment, Perioperative morbidity, Advantages and disadvantages of devises used for osteotomy fixation, Merits and demerits of navigation and Period of rehabilitation. Twenty five articles have been identified with Extra Articular Deformity. Twelve are evaluating outcome of single stage corrective osteotomy coupled with Total Knee Arthroplasty, two studies about dual stage Corrective osteotomy with Total Knee Arthroplasty. Seven are restoring mechanical axis by intra articular correction using computer assisting navigation, and three achieving Mechanical axis by intra articular correction using Patient Specific Instrumentation, and remaining one is a comparative study between intra articular correction with Extra Articular Deformity. Our review shows that average preoperative deformity is slightly higher (>20* in coronal plane) in Extra articular correction group than Intra articular correction. But restoration of mechanical axis is superior with intra articular correction than with corrective osteotomy, more over complications like delay in rehabilitation, non-union, delayed union, and infections at osteotomy site are reported in extra articular correction which are not there with deformities corrected intra-articularly. Considering overall outcome, extra-articular deformity corrected by intra-articular resection carries good postoperative alignment with less complication rate. But not sufficient studies are available to support intra articular correction in knee with higher degree of extra articular deformity. As most of the studies with intra articular correction of extra articular deformity provides encouraging results not much studies supporting it with higher extra articular deformity.Keywords: Knee arthroplasty, Deformity correction knee arthroplasty, intra articular correction, Extra articular correction IntroductionThe incidence of knee osteoarthritis are increasing in trend, with view to upgrade quality of mobility and restore function patient with symptomatic OA often require total knee arthroplasty. In many case studies TKA shows excellent results with minimal complication rate. But in situations like pre-existing deformity of bone or soft tissue pathology can lead to raise the complication rate from 5% to 41% [1] . Aiming to improve the result of total knee arthroplasty in special situation clinical researches and technological researches are being made throughout the world. Success of total knee arthroplasty depends on number of factors starts with a) Patient selection, b) Appropriate p...
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Implants used in inter trochanteric fracture are categorized into two types: intramedullary, extra-medullar [1] . Intra-medullar implants are usually less invasive and the choice of patients, who have comorbidities restricting the surgical exposure and anesthesia time [1][2][3] .Commercially available intramedullary implants are 20 times costlier than conventional dynamic hip screw (DHS) implant. On reviewing the literature, no many articles focused the advantages of minimally invasive technique (MIDHS) in DHS fixation [4] , so we discuss economically viable MIDHS technique for patients requiring (Fig. 2). Instead of triple reaming, 8 mm and 13 mm reamers are used through 14 mm sleeve (Fig. 3).
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