<p class="abstract"><strong>Background:</strong> Anterior cruciate ligament (ACL) tear is a common injury sustained during contact games hampering performance of the sportsmen and thus requires promt management. Arthroscopic ACL reconstruction is commonly associated with postoperative knee effusion which affects the functional recovery. Various treatment modalities are available for managing effusion after ACL reconstruction, which are associated with various grades of success and side effects.</p><p class="abstract"><strong>Methods:</strong> This prospective interventional study was carried out at tertiary care Orthopaedic centre. It involved 48 Young male athletes with ACL tear managed subsequently by arthroscopic ACL reconstruction. Subjects were divided into Injection group and non injection group by randomization and blinding was ensured. Postoperative rehabilitation, prophylactic antibiotic and chemoprophylaxis for DVT was kept standardised for all patients. Patients were assessed for pain at operative site by visual analogue scale, effusion of knee by classification of Coupens and Yates and Lysholm knee scoring at 2nd, 6th and 12th week postoperatively.<strong></strong></p><p class="abstract"><strong>Results:</strong> During follow ups it was found that Injection group was having significant less incidence of effusion as compared with Non injection group; which also has reflected in functional recovery.</p><p class="abstract"><strong>Conclusions:</strong> It can be concluded that use of inj tranexamic acid preoperative dose in case of patients undergoing ACL reconstruction is efficient to reduce the knee effusion.</p>

<p class="abstract"><strong>Background:</strong> Arthroscopically aided anterior cruciate ligament reconstruction using hamstring graft can be fixed to femoral condyle by suspensory and aperture fixation methods. The following study was undertaken to investigate whether there is any difference in functional outcomes with these fixation methods as measured by the Lysholm knee score and to determine tunnel widening post operatively with these two methods and does it affect the functional outcome.</p><p class="abstract"><strong>Methods:</strong> 50 patients of clinically and radiologic ally diagnosed ACL tear fulfilling the inclusion and exclusion criteria were randomized into two groups to undergo arthroscopic ACL reconstruction using quadrupled hamstring graft with  suspensory (n=25) and aperture (n=25) fixation methods on femoral side. They were compared post operatively with Lysholm score, clinical laxity tests and percentage of tunnel enlargement using computed tomograms at 01 year.<strong></strong></p><p class="abstract"><strong>Results:</strong> At the end of 6 months there was no much difference in Lysholm score between both the groups (P =0.663) and at the end of 01 year aperture group had slightly better outcome. However, the difference was not statistically significant (p =0.173). There was more tunnel widening in the suspensory group especially of the femoral tunnel in the coronal plane. However, the amount of tunnel widening in both the groups was not significant statistically (P =0.071 and P =0.963). Tunnel widening is not associated with inferior clinical outcomes or functional knee score.</p><p><strong>Conclusions:</strong> Aperture and Suspensory fixation methods of hamstring graft at femoral condyle in ACL reconstruction are comparable clinically and there is no advantage of one particular method over other. Although comparatively more tunnel widening is seen in suspensory fixation methods; it does not affect the final clinical outcomes or functional knee scores. </p>

Objective: To find and evaluate the results of a cost-effective technique for supplementary tibial side fixation of hamstring graft without complications which are usually associated with the use of hardware (staples, suture disc, suture post, etc.). Materials and Methods: A study was done on 20 young high demand male patients (military soldiers) at our hospital from December 2018 to July 2020 who fulfilled the inclusion criteria. All patients underwent arthroscopic anterior cruciate ligament (ACL) reconstruction ± meniscus repair/balancing and supplementary fixation of hamstring graft on tibial side via intraosseous tunnel by a single surgeon. Subjects were followed up to 1 year for ligament laxity via anterior drawer test/Lachman test, Lysholm knee score and visual analog score (VAS). Average time of surgery and complications if any were noted. Results: Out of 20 patients 18 had a mean Lysholm score of 95.6 and VAS was 0 in all patients by the end of 48 weeks. Two patients who underwent ACL reconstruction with meniscus repair (outside-in technique) had a score of <90 at the end of 48 weeks. None of the patients had ligament laxity, tunnel blowout. Conclusion: Study concluded that intraosseous tibial side supplementary fixation of hamstring tendon graft when done is a safe, cost-effective procedure and does not have any complications which otherwise are associated with a hardware use.

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Background:Venous thromboembolism (VTE) is a frequent and serious complication in orthopaedic surgeries of the lower limbs. Subsequent pulmonary embolism (PE) makes it the most common cause of death after joint replacement surgeries of the lower limbs. In this study, a multimodal approach for thromboprophylaxis was adopted in patients undergoing total hip replacement (THR) and hemiarthroplasty (HA), including pharmaceutical and mechanical agents recommended by the American Academy of Orthopaedic Surgeons (AAOS) as per risk stratified approach, and the effectiveness of the same was measured by clinical and radiographic assessment. Methods:This was a prospective observational longitudinal study with evaluation at multiple points of time carried out at a tertiary care orthopaedic center. The study included 66 consecutive patients who underwent hip replacement arthroplasty (45 THR, 21 HA). Mechanical and pharmacological (soluble aspirin) prophylaxis modalities for deep venous thrombosis (DVT) were administered to all patients after risk stratification. Patients were assessed for evidence of DVT at 2,6, and 12 wk postoperatively by clinical tests and color Doppler flow imaging (CDFI). Results:This study confirmed efficacy of AAOS recommended risk stratified approach of thromboprophylaxis by combined use of soluble aspirin and various other mechanical measures in patients having standard risk for PE and bleeding undergoing THR or HA because none of the patients developed DVT per clinical assessment and confirmed by CDFI carried out at follow-up. Conclusions:Prevention of DVT as recommended by AAOS has proven to be effective as well as cheaper in moderate-risk patients undergoing hip replacement surgery. Though there were no major differences in complication rates in respect to other prophylaxis except prevalence of major bleeding was very low.