A prospective study on functional outcome of uncemented total hip arthroplasty in patients with inflammatory arthropathies

Background: Although medical management has improved the outcome and may have reduced the need for surgery, total hip arthroplasty (THA) is often required to manage pain and restore function and mobility. The successful functional outcome of THA in patients with inflammatory arthropathies is essential in understanding the need for THA, and its benefits in those undergoing it. Objective of the study is to evaluate the functional outcome of total hip arthroplasty in patients suffering from inflammatory arthritis using Harris hip score (HHS) and to assess the post operative complication in these patients.Methods: In a prospective study conducted on patients with inflammatory arthritis treated with THA between a study period of January 2018 to January 2020. All the patients after assessing them clinically and radiologically were operated with uncemented THA through posterolateral approach. Functional outcomes of hip were evaluated using HHS at various intervals.Results: In this study, patients were followed up to 24 months. About 46.7% of patients were diagnosed with rheumatoid arthritis, 33.3% of patients were diagnosed with ankylosing spondylitis, 20% of patients were diagnosed with sero negative arthritis. 90% of patients had no limb length discrepancy, no other post-operative complications were noted. The final functional outcome of hip according to HHS were 13.3% of excellent, 56.7% good results and 30% of fair results.Conclusions: This study concludes that THA in patients with inflammatory arthritis with restricted activities of life had improved in short term follow up and ease of rehabilitation and return to function

The prospective analysis of functional outcome of osteosynthesis of extra-articular distal tibia fractures using minimally invasive percutaneous plate osteosynthesis technique

Background: Extra-articular distal tibial fractures are one of the most complicated ones to treat, specially comminuted fractures. Its subcutaneous nature and lack of adequate musculature makes it more prone for soft tissue damage and bone loss. The key to handle these troubling fractures is to skilfully preserve and reconstruct the soft tissues, early mobilisation and functional use of the extremity with the maintenance of satisfactory length and alignment of the fracture.Methods: This prospective longitudinal study involved 30 patients with extraarticular distal tibia fracture, who are admitted in Vydehi Institute of Medical Sciences and Research Centre between January 2017 to 2019. All were treated with closed reduction and internal fixation using pre-contoured anatomical distal tibia locking plate using minimally invasive percutaneous plate osteosynthesis (MIPPO) technique. Functional and radiological outcome along with associated complications are evaluated in serial follow up.Results: 30 patients with minimal follow up criteria of 6 months was evaluated with AOFAS score for functional outcome. At the end of 1 year, 21 cases (70%) of the cases had excellent results, 5 cases (16.7%) had good results, 3 cases had fair results and only 1 case had poor result.Conclusions: With the use of pre-contoured anatomical locking plates used, MIPPO technique is effective in extra articular distal tibia fractures where it not only helps in decreasing operating time but also in achieving excellent functional outcome with radiological union the fractures by preserving osseous vascularity and minimal soft tissue insult due to surgery

Gaint cell tumour of phalynx: have you seen it?

Giant cell tumors are rarely seen in the foot. Only 1-2% cases of GCT occur in the foot. They can cause a significant amount of pain and deformity due to their aggressive and recurrent nature whenever it occurs in foot. We present an unusual case of a giant cell tumor of proximal phalynx of middle toe of left foot. 26 year old male came with complaints of pain and swelling over the middle toe of left foot since 6 months. Clinical and radiological features showed features consistent with GCT. Foot Function Index revealed a) Pain scale: 29 / 50 = 58%, b) Disability scale: 56 / 90 = 62%, c) Activity limitation scale: 8 / 30 = 27%. Authors performed enbloc resection with ray amputation of 3rd toe. Histopathological examination of excised specimen revealed classic findings of mononuclear cells with interspersed fibro-collagenous strands and numerous multinucleated osteoclast-like giant cells which confirmed our diagnosis. Patient was serially followed up and at 6 months followup, there were no signs of recurrence with markedly improved foot function index