<p class="abstract"><strong>Background:</strong> The objective of the study was to evaluate the functional outcome of arthroscopic Bankart repair for anterior shoulder instability to assess whether the number and position of suture anchors plays a role in determining the functional outcome.</p><p class="abstract"><strong>Methods:</strong> This was a prospective study on 32 patients operated with arthroscopic Bankart repair between December 2017 to April 2019. Pre-op and regular follow-up scores were measured at 1 month, 3 months and 6 months post-op using Rowe score and American Shoulder and Elbow Surgeons score to assess functional outcome.<strong></strong></p><p class="abstract"><strong>Results:</strong> Mean age of the study group was 24.5±6.9 years. Functional outcome as determined by Rowe score and ASES score at 6 months follow-up were found to be 90.5±7.2 and 85.9±14.1 respectively when compared to the pre-op scores of 23.2±8.2 and 47.9±5.7 respectively; all of which showed highly significant functional improvement with highly significant reduction in visual analog scale (VAS) pain score. Patients had no recurrent dislocations with mean external rotation limitation of 5^o. 25 (78.1%) patients had two suture anchors inserted and 7 (21.9%) patients had multiple (&gt;2) anchors; and when analysis was done, there was no statistically significant difference between number of suture anchors used with respect to the functional scores.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that arthroscopic Bankart repair is a useful and successful procedure. Patient identification and selection remains the key in determining the success of repair. Meticulous surgical technique and correct positioning of suture anchors may help in reducing the number of anchors without compromising on the final functional outcome, thereby reducing the economic burden on patients.</p>

Post-operative pain management in Total Knee Arthroplasty (TKA) remains a challenging issue even though it is a commonly performed procedure today. Majority of the patients report severe pain following surgery due to which mobilization and early rehabilitation is hampered. Therefore, appropriate pain management is the need of the hour and Local Infiltration Analgesia (LIA) using periarticular cocktail injection is one of the preferred techniques. The objective of this study was to assess the functional outcome and patient satisfaction after using LIA in the form of periarticular Ranawat-cocktail among post-TKA patients. Materials and Methods: This study was conducted at SGITO, Bangalore during the period between August 2017 to April 2018. In this study, we used LIA consisting of the Ranawat Regimen for TKA patients which contains (bupivacaine with adrenaline, morphine, methylprednisolone, cefazoline and normal saline) to manage postoperative pain in all 53 patients presenting to our institute for primary TKA. Functional outcome was assessed in terms of post-op VAS score, ROM, and SLRT at 12hrs, 24hrs, and 48hrs post-op. Opioid consumption, and patient satisfaction was recorded and statistical analysis was done. Results: The mean age of patients in the study was 60.83. Mean VAS pain score at 12hrs, 24hrs, and 48hrs post-op were found to be 5, 3.5 and 2.79 respectively which indicated a highly significant (p<0.001) reduction in pain following TKA. Majority of the patients (71.7%) did not require any opioid rescue analgesia. Post-op ROM was satisfactory and all patients were able to do SLRT by day 1 and there was excellent patient satisfaction at time of discharge. Conclusion: Local Infiltration Analgesia is a safe, simple and efficient method of reducing postoperative pain after total knee arthroplasty (TKA) which facilitates early rehabilitation among the patients and has an overall improvement in patient satisfaction with the procedure.

Low back pain is one of the most common and disabling morbidities in the world and its relationship with spino-pelvic parameters is not yet fully understood in the Indian population. Our objective was to study the spino-pelvic parameters in patients who presented to the OPD with low back ache (LBA). Materials and Methods: Cross-sectional study conducted at SGITO, Bangalore between March-August 2018. 90 patients with LBA were asked to take standing lateral radiographs showing the pelvis with both hips and lumbar spine. The lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS) were calculated; and statistical analysis was done. Results: The mean age of patients was 46 years. The average duration of LBA was 14.5 months. The average PI, SS, PT, and LL among the patients was found to be 52.53 (+/-10.85), 35.08 (+/-9.17), 17.56 (+/-7.72), and 49 (+/-3) respectively. PI had statistically significant association with PT and SS but not with LL among both men and women in all age groups. Mean PI and PT was found to be higher in women (53.82+/-11.85) (18.35 +/-8.45) and in above 50 years age group (54.58 +/-11.41). Similarly, the mean PT was higher in among women (18.35 +/-8.45) and in the above 50 years age group (18.93 +/-8.02). The duration of lower back pain was found to be positively associated with PI, SS, PT, and LL but didn't reach statistical significance. Conclusion: Spino-pelvic alignment is maintained in patients with low back pain and differences in sagittal alignment in patients with low back ache are minor and clinically, multiple factors contribute to LBA. However, further studies need to be conducted to corroborate these findings in the Indian population which may help in early detection and management of patients prone to develop lumbar disc degeneration and low back ache.

Introduction: The use of modular implants for revision TKA are ever increasing in number due to their definitive advantage over their monoblock counterparts by providing the surgeon with the versatility needed to achieve equal gaps and manage bone defects. This superiority comes at the cost of certain unique complications attributable to its modular design such as loosening and fractures at the areas of component coupling that are prone to fatigue failure with suboptimal fixation. Case Report: We present a case of modular femoral component failure in a 59-year man of Asian decent after revision TKA secondary to disengagement and migration of the extension stem locking bolt of a Total Condylar-III prosthesis. Patient presented with pain, effusion, and instability 2.5 years after stage-2 revision TKA. Radiographs revealed migration of the femur-stem locking bolt into the joint cavity. The femoral component and stem were loose. The locking bolt was extracted, and he underwent re-revision surgery with revised femoral components. Conclusion: Stem-condylar junction of modern modular TKA implants are prone to early loosening and failure. This diagnosis should be anticipated on serial follow-up radiographs and in patients who complain of sudden onset of instability following revision surgery.

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