Background: Knee replacement surgery also known as knee arthroplasty can help relieve pain and restore function in severely diseased knee joints. The aim of the study was designed to determine the current incidence and outcome of infected total knee arthroplasty (TKA) in our unit. Methods: Present study was performed at department of orthopedics, Gujarat Adani institute of medical science, Bhuj, Kutch, Gujarat. Questionnaire was designed as per our needs and we explained the study to all the individuals who had undergone knee replacement surgery in three years. In the questioner the patient were asked whether they had any suspicion of infection in the joint or wound after the knee surgery. If there reply was found to be affirmative than next they were asked if they had any reddened wound area, any inflammation area, readmission to the hospital due to infection, pus discharge from the wound, any further debridment or resurgery was planned for their infection and whether they were asked to take antibiotics to rule out infection. Results: Infection was identified in 20 patients of the study. All the cases underwent culture media for detection of microorganisms. Staphylococcus and E. coli were identified in majority of the cases. Six patients had undergone revision of their primary TKA for deep infection; four were having a two-stage revision with no sign of residual infection at the latest review; the oxford knee score when calculated were found to be 35, 38, 45, 48 respectively. Conclusions: During this study period, infection after primary TKA was rare but devastating and invariably led to a poor outcome.

Background and Aim:The exposed anatomical location of the tibia makes it vulnerable to the direct blow and high energy trauma as a result of motor vehicle accidents, thus resulting in comminuted fractures which are frequently open with significant loss of skin and soft tissues. The purpose of our study was to present results of fixation of unstable tibial shaft fractures in children with Ender's nailing. Material and Methods: This is a study of 30 patients of unstable tibial shaft fractures in children treated with Ender's nailing. 24 were closed fractures & 6 were open grade one fractures with only punctured wounds. Twenty patients had concomitant fibula fractures. In 26 patients tibia fracture was an isolated injury, one had associated same side clavicle fracture and one had associated same side lower end radius fracture. Results: Average time for fracture union was 9 weeks (range 6 to 15 weeks). All fractures united without 2nd operative intervention. Slight nail back out occurred in many patients, but only in 2 patients significant proximal migration of nails occurred causing some knee irritation, but not requiring any operative intervention before fracture union. In all patients implant removed 6 to 7 months after surgery. There was some restriction of knee movements in 4 patients in which nails were significantly backed out, but after implant removal full knee movements achieved in all patients there was full ankle movements in all patients at final follow-up. Conclusion:Based on our results, Ender's nailing is an effective method of treatment in these cases, which allows rapid healing of tibial shaft fractures with an acceptable rate of complications.

Background and Aim: Cubitus varus deformity is the most common late complication aftersupracondylar fracture of the distal humerus in children, incidence varying from 4% to 58%. Thepresent study was done to evaluate the results of dome osteotomy. Material and Methods: Thisprospective study was conducted in a tertiary care hospital over 16 months. In all patients humerus-elbow wrist angle was measured on both sides and the correction needed was calculated. The lateralcondyle prominence index (LCPI) was calculated by anteroposterior view radiographs of thedeformed and the normal elbow in full extension by (AB-BC)/AC. Dome osteotomy with para tricepsapproach was used. Pre and post-operative carrying angle of elbow, range of motion and lateralprominence indices were compared. Results: The age of patients ranged from 3 to 15 years with amean age of 8.47±3.14 years. Preoperative carrying angle of normal side ranged from 80 to 140and that of effected side ranged from -23 to -13 and the difference was statistically significant(p<0.05). LCPI ranged from -8.4 to 5.9%. The majority of cases had LCPI >2.7%. As compared to,an improvement in carrying angle at defect side was observed to be 28.41±2.15 which wassignificant (p<0.05). At baseline mean LCPI was 0.39±3.87% which changed to -0.86±3.47%, themean change of this was significant (p=0.01). baseline Conclusion: Dome osteotomy is a relativelytechnically demanding technique for correction of cubitus varus deformity but with a betterfunctional outcome without being associated with lateral condyle prominence.

<p class="abstract"><strong>Background:</strong> To evaluate analgesic efficacy when catheters are positioned with assistance of arthroscope to block suprascapular and axillary nerves in patients undergoing arthroscopic repair of rotator cuff under general anesthesia<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> Present study was performed at department of orthopedics, Gujarat Adani Institute of Medical Science, Bhuj, Kutch, Gujarat. 24 patients who experienced arthroscopic repair of rotator cuff between July 2015 and October 2015 were catheterized to block suprascapular and axillary nerves through shoulder arthroscopy were incorporated in the study. Clinical outcomes were assessed using visual analog scale (VAS) scores preoperatively and at 0 h, 6 h, 12 h, 18 h, 24 h, and postoperative day 2.<strong></strong></p><p class="abstract"><strong>Results:</strong> Preoperative and postoperative 0 h, 6 h, 12 h, 18 h, 24 h, and day 2 mean VAS scores were 6.37±0.91, 0.45±0.39, 0.59±0.40, 0.62±0.39, 0.61±0.42, 0.51±0.35, and 1.54±0.50, respectively. No statistical difference was found among 0 h, 6 h, 12 h, 18 h, and 24 h time points; however, assessment of postoperative day 2 and postoperative 0 h, 6 h, 12 h, 18h and 24 h VAS scores showed statistically significant difference (P<em> </em>&lt;0.05). All patients were discharged at the end of 24 h with no complication. The mean time (in minutes) required for blocking suprascapular nerve and axillar nerve were 14.38±3.21 and 3.75±0.85, respectively<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> These results confirmed that blocking two nerves with arthroscopic approach was an excellent pain management method in postoperative period. Accordingly, patients could recover rapidly and patients’ satisfaction could be improved<span lang="EN-IN">.</span></p><p class="abstract"> </p>