purpose. To evaluate the outcome of one-stage longstem total knee arthroplasty (TKA) for patients with arthritic knees and tibiofemoral stress fractures. Methods. Records of 11 men and 18 women aged 47 to 78 (mean, 66) years who underwent fixedbearing posterior-stabilised TKA for osteoarthritis or rheumatoid arthritis of the knee with tibial (n=31) and femoral (n=3) stress fractures were reviewed. All the tibial fractures involved the proximal half. There were 7 associated fibular stress fractures. Of the 31 knees with tibial stress fractures, 26 and 5 manifested varus and valgus deformity, respectively. results. The mean follow-up period was 51 (range, 24-96) months. The mean tibiofemoral angle improved from 23.2º to 1.9º varus. The mean Knee Society knee score improved from 38.5 (range, 15-63) to 89.6 (range, 80-95)

Giant cell tumor (GCT) of bone is a benign but locally aggressive and destructive lesion generally occurring in skeletally mature individuals. Typically involving the epiphysiometaphyseal region of long bones, the most common sites include the distal femur, proximal tibia and distal radius. On radiographs, GCT demonstrates a lytic lesion centered in the epiphysis but involving the metaphysis and extending at least in part to the adjacent articular cortex. Most are eccentric, but become symmetric and centrally located with growth. Most cases show circumscribed borders or so-called geographical destruction with no periosteal reaction unless a pathological fracture is present. There is no mineralized tumor matrix. Giant cell tumor can produce wide-ranging appearances depending on site, complications such as hemorrhage or pathological fracture and after surgical intervention. This review demonstrates a spectrum of these features and describes the imaging characteristics of GCT in conventional radiographs, computerized tomography scans, magnetic resonance imaging, bone scans, positron emission tomography scans and angiography.

Background: Restoration of spinopelvic balance during spinal surgery is very important to ensure a good outcome. Many studies have been conducted to define the normal ranges, examining the correlation between these individual parameters and their relation with spinal parameters of thoracic kyphosis and lumbar lordosis. The ranges, specific to individual ethnicities, is very essential to restore the sagittal balance in patients suffering from spinal degenerative conditions. Hence this study aims to define the average ranges of relevant spinopelvic parameters in the adult population of Indian origin. Methods: A observational cross sectional study was conducted in 130 healthy volunteers in Mumbai without having any spine, hip or pelvis pathology. Spinopelvic parameters like Pelvic Incidence(PI), Sacral Slope(SS) and Pelvic Tilt(PT) were studied and compared between various other similar studies with patients of different ethnicities. The correlation of those parameters with each other was also evaluated. Results: The mean value of PI was 51.50(±6.85 ), that of SS was 39.17 (±6.26 ) and for PT it was 12.32 (±5.41 ). These values were statistically significant between both sexes for PI and PT. The strongest positive correlation among the parameters was between pelvic incidence and sacral slope, with a r-value of 0.668. Comparison of our study with similar studies within the country (Chennai, Delhi and Surat) showed statistically significant differences in PT and SS of all three studies while PI was not significant when compared with the Surat study. Conclusion: There appears to be considerable variation of the values of the spinopelvic parameters as determined by various studies due to ethnic variations. Further studies should be done with larger samples and directed towards early detection of individuals at risk of developing degenerative spinal disorders with sagittal imbalance, so that interventions can be made at an earlier stage.

Acromio-clavicular joint ganglion cysts are a rare manifestation secondary to either degenerative acromio-clavicular joint arthritis or a rotator cuff tear arthropathy. We report a case of 76 year old female with acromio-clavicular joint cyst associated with cuff tear arthropathy and advanced acromio-clavicular joint arthritis with normal shoulder functions. She had superficial pain over the cyst with no complaints of cuff tear and provocative tests were negative. The shoulder arthrogram revealed the "geyser sign". The cyst was excised en bloc along with distal clavicular resection. The check valve was identified and the defect in the acromio-clavicular joint capsule was treated with capsulorraphy. Patient at one year follow up showed no signs of recurrence. Excision of cyst along with distal clavicular resection and capsulorraphy is a good procedure in patients with acromio-clavicular joint cysts.

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