Background: Unstable pertrochanteric fractures pose a significant health problem in elderly homeambulant patients with increased morbidity and mortality, and their attendant co-morbidities. Objective: To study the functional outcome of cemented hemiarthroplasty in home ambulant elderly patients with unstable pertrochanteric fractures. Methods: A hospital-based, prospective, non-randomized study between September 2013 and September 2019. All patients aged 65 years and above with unstable pertrochanteric fractures were included with the exception of those who were non-ambulant before injury and those with histologically confirmed tumors. Harris Hip Scoring (HHS) was done for all patients on both hips pre-and postoperatively. Cemented bipolar hemiarthroplasty was done using cement mantle to reconstruct the calcar, and biopsy was taken for histology at surgery. Subperiosteal detachments of the iliopsoas muscle and adductor tenotomy were done when indicated. Full weight-bearing ambulation was commenced on the second postoperative day. Data was analyzed using SPSS version 23 for windows. Results: Forty-eight hips in 47 patients were analyzed. The mean age was 83.4 +/-5.0 years with a F: M ratio of 2.4:1. Average duration of presentation was 26.4 +/-12.8 days as all the patients had had traditional bone setters' treatment prior to their presentation. Hypertensive heart disease was the commonest co-morbid condition. The mean operation time was 77.9 +/-9.5 minutes (range 60-98 minutes). The mean estimated blood loss (EBL) was 385.6 +/-198.2 ml (range 150-850ml). Twenty-two (45.8%) patients were transfused. All patients ambulated at second postoperative day. Forty-seven (97.92%) hips had good and excellent functional outcomes at 12 weeks, and 46 (95.83% of total hips studied, but 100% of those still alive) had good to excellent functional outcomes at 2 years with p value < 0.0005. A patient had both hips recruited 2 years apart. A deep surgical site infection and two limb length discrepancies were associated complications. Two (4.26%) of the patients died of unrelated causes before the end of the first year of follow up. Conclusion: Primary cemented bipolar hemiarthroplasty allows early weight bearing and produces good to excellent functional outcomes in home-ambulant elderly patients with unstable pertrochanteric fractures with minimal complications.

Though anterior cruciate ligament (ACL) is the most commonly reconstructed ligament all over the world, its arthroscopic reconstruction was relatively less frequent in the West African sub region until recently. The patronage of the traditional bone setters in the acute phase of closed knee injuries has made Chronic ACL injury the main form of presentation with significant secondary injuries and degenerative changes from sub-optimal initial care. The aim of this study was to determine functional outcome and patient's satisfaction from Arthroscopic chronic ACL injury repair. Diagnoses were made using clinical parameters and MRI. Lysholm scores were determined preoperatively, and repeated with patient's satisfaction assessment (using the Likert scale) at 3, 6, 12, 24 and 48 months postoperatively. Arthroscopic single-bundle ACL repair using a triple-weaved hamstring tendon (s) was done for all the patients. Debridement and meniscectomy were done for various degrees of degenerative changes and irreparable meniscal injuries respectively. No one was dissatisfied and 91.4% of the patients had well to excellent Lysholm scores at 2 years of follow up. It was concluded that arthroscopic chronic ACL rupture reconstruction using single-bundle triple-weaved hamstring autografts with good rehabilitation offers good to excellent knee function and patients' satisfaction with minimal complications.

Background: Sickle cell disease (SCD) is the commonest cause of avascular necrosis (AVN) among teenagers in our environment. When diagnosed early, joint preserving operations and physical therapy may prolong the congruency of the hip joint. However, due to the sociocultural behavior and the disequilibrium in universal health system in our sub region, the affected population often gets to the orthopaedic surgeons with advanced stage of the pathology affecting activities of daily living and carrier progression. This makes total hip arthroplasty (THA) inevitable. We looked at the functional outcome of THA in teenagers with advanced AVN secondary to SCD.