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Aims  Rectal prolapse is a debilitating and unpleasant condition adversely affecting the quality of life. Laparoscopic ventral mesh rectopexy (LVMR) is recognized as one of the treatment options. The aim of this study was to evaluate the functional outcomes after a standardized LVMR. Methods  A cohort of patients who underwent LVMR from 2011 to 2015 were contacted and asked to fill questionnaires about their symptoms before and after the surgery. Three questionnaires based on measurement of Wexner fecal incontinence (WFI), obstructive defecation syndrome (ODS), and Birmingham Bowel and Urinary Symptom (BBUS) scores were used to assess the changes in postoperative functional outcomes. Some additional questions were also added to further assess bowel dysfunction. Results  There were 58 female patients with a mean age of 62.74 ± 15.20 (26–86) years in this cohort. About 70% of the patients participated in the study and returned the filled questionnaires. There was a significant overall improvement across all three scores (WFI: p  = 0.001, ODS: p  = 0.001, and BBUS: p  = 0.001). Some individual components in the scoring systems did not improve to patient's satisfaction. No perioperative complication or conversion to an open procedure was reported in this study. Three recurrences were seen in the redo cases. Conclusion  LVMR is a promising way of dealing with rectal prolapse. A careful patient selection, appropriate preoperative workup, and a meticulous surgical technique undoubtedly transform the postoperative outcomes.

Ankle arthritis is a common condition. It causes a significant socioeconomic burden, and is associated with significant morbidity. Patients with ankle arthritis are either elderly with significant co-morbidities, or young adults who have previously suffered with ankle injuries, resulting in post-traumatic arthritis. There is a wide variation in the management of these patients with ankle arthritis. We therefore present an overview of the current evidence based management of patients with symptomatic ankle arthritis.

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BackgroundThe presentation of patients with knee injuries which can have a significant impact on their ability to work and perform activities of daily living is constantly rising. The posterolateral corner of the knee has a complex anatomy of muscles, tendons, and ligaments, with huge variation in the population. The fabella is one such structure, found in the posterolateral corner of the knee, which can serve as a common origin point of various ligaments.Case reportWe present a case report of a 53-year-old white man who presented with atraumatic, posterior knee pain and was found to have a congenital, anomalous band originating from the fabella, causing semimembranosus impingement. This was diagnosed with magnetic resonance imaging; he underwent division of the anomalous band, which resulted in complete resolution of his symptoms.ConclusionWe propose that patients who present with posterior knee pain, without any history of trauma, and have no abnormalities on plain radiographs, should undergo magnetic resonance imaging of their knees. This will help in assessing the ligament complex in the posterior compartment of the knee, and exclude impingement of the semimembranosus as an, albeit rare, cause of posteromedial knee pain.

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Category: Other; Ankle; Ankle Arthritis; Bunion; Hindfoot; Lesser Toes; Midfoot/Forefoot Introduction/Purpose: With the COVID19 pandemic, virtual consultations are becoming a necessity. Clinicians are having to adapt consultations to determine where patients' symptoms are, and what the appropriate next line of investigation or treatment should be, without the benefit of traditional face-to-face contact. The aim of this project was therefore to use pain mapping in foot and ankle conditions, in order to see if there was a predictive correlation between certain symptomatic areas and the ultimate surgical treatment required by patients. Methods: Data was collected prospectively from patients attending foot and ankle clinics from 2014 to 2019, and this was cross- matched with operative data subsequently. Data included patient demographics, co-morbidities, smoking status and previous injuries or surgeries. In a structured questionnaire, patients also marked the regions of the foot and ankle that they thought were the most symptomatic. The foot and ankle was divided into 12 segments for the purpose of analysis. Results: A total of 2007 patients completed these questionnaires, from which operative data was available for 407 patients. In the first instance, data was analysed for 122 patients who underwent one of five specific procedures. Pain mapping was found to have a good predictive value for first MTP fusion and bunion surgery (n=20, 46), 1st metatarsal cheilectomy (n=10) and arthroscopic ankle arthrodesis (n=23). The least predictive pain mapping was seen for patients who had a triple arthrodesis (n=23), with those patients presenting with pain more globally in the foot and ankle. Conclusion: The results suggest that pain mapping can be used effectively as postal questionnaires, prior to a virtual consultation, as an aid to predict diagnosis and the ultimate treatment required in some specific foot and ankle conditions.

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