Functional assessment after anterior cruciate ligament reconstruction using quadrupled semitendinosus graft

Background: Anterior cruciate ligament is the primary stabilizer of the knee and prevents translation and rotatory forces and it is one of the most prevalent ligament injuries in the knee. Arthroscopic ACL reconstruction is recommended for which different graft options can be Quadrupled Semitendinosus and Gracilis, doubled Peroneus, Quadriceps Tendon, and Bone patellar tendon-bone. As all grafts have their advantages and disadvantages in terms of donor site morbidity, fixation, and failure rate; the ideal ACL reconstruction graft remains a point of contention. So, we did a functional assessment after ACL reconstruction using Quadrupled Semitendinosus graft.Methods: The prospective cohort study included 30 patients under the age of 55 years admitted with ACL deficiency from August 2019 to August 2020 in the orthopedic department of a Sapthagiri hospital, Bangalore who underwent arthroscopic ACL reconstruction. This study aims to evaluate the functional result of arthroscopic anterior cruciate ligament reconstruction with only quadrupled semitendinosus tendon graft using the Tegner, Lysholm, and IKDC knee grading systems.Results: Patients were followed up for a minimum period of one year. On evaluation, the maximum Lysholm, IKDC score achieved was 97 and 79 respectively while the minimum score was 86 and 69 respectively. Comparisons of pre-and postoperative improvement scores were statistically significant.Conclusions: Arthroscopic ACL reconstruction with quadrupled semitendinosus graft yields good functional results with minimal postoperative morbidity irrespective of graft diameter

Stiff hip managed with capsular incision in adolescent girl: a case report

Idiopathic chondrolysis is an uncommon condition defined by the complete loss of femoroacetabular articular cartilage in a child with no previous trauma, slipped capital femoral epiphysis, infection, or extended immobilisation. Because of the gradual onset of symptoms, escalating radiographic abnormalities, and the lack of a diagnostic laboratory test, diagnosis is sometimes delayed. Localized osteoporosis, subchondral erosions, femoral head alterations, and a reduction in joint space are all common radiographic findings. We report a case of Idiopathic chondrolysis of the hip in a 14‑year‑old Indian girl who presented with pain and stiffness in her right hip with an MRI differential diagnosis of avascular necrosis/ tuberculosis of right hip joint

Non-pigmented villonodular synovitis of knee joint in a 11-year-old boy on long term steroids: a case report

Pigmented villonodular synovitis (PVNS) is a rare condition, commonly affecting the knee joint and hip joint. It is seldomly seen in pediatric age group. Aetiology is unknown. Magnetic resonance imaging (MRI) is the imaging modality of choice. Managed by surgical resection of the synovium performed with an open, arthroscopic or combined approach. Post-operative adjuvant external beam radiotherapy have reduced recurrence rate. In this case report we are going to present a rare case of eleven-year-old boy on long term steroid intake, who presented with a history of pain and swelling of right knee joint with restriction of range of movements. MRI suggested extensive villonodular synovitis of knee joint. Diagnostic arthroscopy showed extensive villonodular synovitis of suprapatellar pouch, medial gutter, lateral gutter, intercruciate space, posterior-medial and posterior-lateral compartments and villi had atypical yellow fatty appearance. Extensive arthroscopic synovectomy was done and histopathology showed chronic synovitis. Post-operatively pain and swelling reduced and range of movements improved. Arthroscopic synovectomy is the most effective line of management for villonodular synovitis

Modified Mclaughlin procedure for neglected posterior dislocation of shoulder: short-term results

Between 2017 to 2020, A prospective case series for assessment of short-term outcomes was carried out on 10 shoulders with 3 being bilateral cases and diagnosed as neglected posterior dislocation of shoulder at a tertiary care centre and treated with the Modified Mclaughlin procedure. All patients had articular defect ranging from 27-46% as confirmed with computerised tomography. All the surgeries were carried out by a single team of surgeons. After 24 weeks follow up of 10 shoulders with mean age 32 years, all patients were found to have excellent results in terms of ROWE and constant score. Patients had significant reduction in VAS score. Timely diagnosis of articular involvement plays a vital role in management for which computed tomography has a pivotal role. Depending upon the articular involvement, line of management is to be decided. So, it can be concluded that, in cases of articular defect >25% following posterior dislocation of shoulder, better outcomes can be achieved with modified Mclaughlin procedure in terms of radiographic union and clinical scoring

Dual plate osteosynthesis in bicondylar tibial plateau fractures-case series

Tibial plateau fractures accounts for about 1% of injuries. Various mechanisms have been described, resulting in milder form to serious injuries depending upon force of impact.  High velocity injuries resulted from valgus or varus impacted forces combined with axial loading such as in Schatzker type 6. The ideal method of treatment for these fractures is always a matter of debate. As all intra-articular fractures necessitate anatomic reduction of the articular surface, restoration of axial alignment, and stable fixation, which can be achieved very well by open reduction and internal fixation (ORIF) with dual plating. To study the functional and radiological outcome of Tibial plateau fractures treated surgically with dual plate osteosynthesis. 15 patients in the age group 18-60 were included. Rasmussens criteria was used to assess the functional and radiological outcomes with follow up period of 1 year prospectively. The outcome assessment using Rasmussens score concluded good results. The average duration for union was ­6 months. ROM achieved in these patients were to be at least 124 degrees. The infection rate in this study was accounted as 13.3%. Open reduction and internal fixation of tibial plateau fractures, by dual plating has good functional and radiological outcome. This is an effective method of treatment even with moderate soft tissue injury if meticulous surgical technique, appropriate soft tissue handling and adequate healing period given. All these have shown to decrease the postoperative complications such as infection