Background Mucoid degeneration of the anterior cruciate ligament (ACL) has been shown to cause restricted terminal range of motion and rest pain. If present in a patient undergoing unicompartmental knee arthroplasty, it can deteriorate the final outcome. This study aims to compare functional and clinical outcomes of debulking the mucoid ACL in patients undergoing mobile-bearing unicompartmental knee arthroplasty (UKA). Methods Patients with mucoid ACL undergoing mobile-bearing UKA at five different centres by five different arthroplasty surgeons were included. They were segregated into two groups matched for all demographic and pre-operative values: group A did not undergo debulking; group B underwent open debulking by a 15-number blade prior to UKA. Patient-related outcome measures, rest pain, clinical outcomes, and subjective patient satisfaction were recorded and compared at 2 years follow-up. Results A total of 442 patients (226 patients underwent debulking, 216 patients did not undergo debulking) were included. Both groups showed overall improvement after surgery, however, patients who underwent debulking performed better at 2 years follow-up in terms of Knee Society functional score, International Knee Documentation Committee scores, range of motion, rest pain and overall patient satisfaction (p < 0.05) as compared with their counterparts. Conclusions Debulking of mucoid ACL in patients undergoing unicompartmental knee arthroplasty significantly reduces the rest pain and improves the final range of motion of the knee joint, subsequently improving the overall functional and clinical outcome of the patient and resulting in greater patient satisfaction.

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Introduction: Intraosseous hemangiomas (IH) are one of the rarest bone tumors that an orthopedic surgeon comes across, more so in the long bones. It most often affects adult females, severely blunting their activities of daily living, coupled with potential debilitating complications such as pathological fracture. Case Presentation: We present a case of a 38-year-old female who presented with long standing pain and swelling in the left knee. Radiology, in the form of plain radiographs and magnetic resonance imaging, narrowed the diagnosis down to a benign form of osteoblastoma or hemangioma. With this in mind, the patient underwent radical excision of the lytic lesion, along with a margin of the surrounding normal bone. The defect was filled with impaction bone grafting and supplemented by a hydroxyapatite block and a poly ethyl ether ketone plate. The patient had excellent clinical, functional, and radiological outcomes at 6 months follow-up. Conclusion: With the inherent rarity of IH, especially when it affects the long bones, it has barely been reported in orthopedic literature. Subsequently, management protocols for such lesions are ill-defined, which can be deleterious to the patient as well as the surgeon. Through this case report, we show how to approach a patient presenting with associated complaints, and show a detailed outline of an efficacious management regime that gave excellent outcomes in our patient.

Acute abdomen is a term frequently used to describe the patients who are having abdominal tenderness and rigidity. Before the use of imaging technique, these patients were candidates for surgery. Ultrasound plays an important role in the initial evaluation of the acute abdomen. Ultrasound may be used as a first line of investigation in order to make a definitive diagnosis or can be used as a triage tool to direct subsequent patient management appropriately. Ultrasonography remains the primary imaging technique in the majority of cases, especially in young and female patients, when there is a limitation of the radiation exposure. Material and methods: 50 cases of acute abdomen were selected for the study. Patients with trauma and with compromised vital signs were excluded from the study. History taking and thorough clinical examination was carried out. All necessary biochemical and haematological investigations were carried out. Provisional diagnosis was made on the basis of sonographic findings. Results: 27 patients were male and 23 were females. Mean age of the patients was 36.34± 21.03 years. Final diagnosis was made on the basis of operative procedure, histopathology and therapeutics. Finally, 15 (30%) cases were diagnosed as acute appendicitis. 9 (18%) were diagnosed as acute cholecystitis, 4 (8%) each as pancreatitis, ulcer perforation and instentinal obstruction, 2(4%) each were diagnosed as ectopic pregnancy, Amoebic liver abscess, psoas abscess and Renal cause, 4 (8%) were diagnosed as pelvic inflammatory disease and 2 (4%) were chronic liver disease. Among the surgically treated patients, 38 patients (72%) were correctly diagnosed by preoperative ultrasonography. These included acute appendicitis (n = 14), acute cholecystitis (n = 10), ulcer perforation (n = 4), and liver abscess (n = 2), ectopic pregnancy (n=2), intestinal obstruction (n=4) and psoas abscess (n= 2). Conclusion: Ultrasonography plays an important role in the evaluation of the acute abdomen and initial evaluation by supporting the differential diagnosis.