Background: The purpose of this study is to formulate a simple and effective method of calculating native joint line and Posterior Condylar Offset (PCO) in proper lateral modern lateral radiographs of knee joint with minimal magnification coefficient. Methods: Knee joint line is measured from a. Posterior condylar flare and b. Tibial tuberosity. Line (A) was drawn from posterior cortex of femur that crossed the flare of posterior condyles. Joint line was measured by a perpendicular line (B) from the proximal most point of tibial tuberosity to the line joining the posterior cortex femoral line on lateral view. Posterior condylar offset: PCO was measured (B) relative to the tangent of the posterior cortex of the femur. The ratio was calculated from these measurements in relation to KSS also. Patients attending to Nizam's Institute of Medical Sciences, Hyderabad, in orthopaedic OPD with ideal body mass index who were evaluated for knee radiographs are included in the study after taking proper consent (n=210). Insta RIS PACS software is used to measure the parameters. Results: The mean joint line measured was 16 mm (range 14 to 18) with 3.0 as standard deviation and the mean PCO was 25mm (Range 19 to 31) with a standard deviation of 3.0. The KSS score had a mean of 85 (Range 80 to 90) indicating excellent score with standard deviation of 2.0. Joint line ratio was 95% Confidence interval (CI) and the ratio for PCO was also 95% CI. There was a significant difference in the measured joint line between genders. Conclusion:Using the current measuring method related to standard fixed bony land marks (Posterior femoral line, posterior femoral condyle and tibial tuberosity) which are unaffected even post-surgery the restoration of native joint line and PCO is reliable and reproducible.

Background: Mesenchymal stromal cells are origin for benign tumor osteoclastoma of bone. Different location of presentations with varied manifestations is a unique feature of osteoclastoma. Extended curettage of the lesion and supplementary allogenic bone grafting in selected cases is widely used treatment regimen. Selection of cases is important for successful outcome using this as a treatment protocol. Our study with 30 cases aims in selection of cases for successful outcome with this treatment protocol. Materials and Methods: Biopsy proven (core and open biopsy) 30 cases of osteoclastoma are selected. The cases are evaluated clinically, radiographically, CT &MRI scan and by histology. Campanancci grading and Enneking staging was used in the study. Chi square tests, Mann Whitney test and ANOVA were used for statistical analysis. Tumors with cortical breach which is confined to one surface and cortical breach less than one third of circumference were managed by extended curettage and bone grafting. Results: The average age of presentation was 25 years. Distal femur is the commonest site (16 cases) followed by upper end of tibia (12 cases) and 2 cases are from distal radius. Pathological fractures were seen in 2 cases. 4 tumors had less than 5 mm of subchondral bone free of tumor. The average follow up period was 18.6 months (range 2-84). 4 cases of recurrence were seen in a grade III recurrent distal femur lesion (3) and proximal tibia group (1) in the intralesional curettage group. Conclusion: Extended curettage with allogenic bone grafting is a reliable method with good functional outcome with less complications than other methods (enbloc excision) whenever we stick on to principles of tumor surgery with proven guidelines of case selection. Recurrence can always be treated with recurettage.

Introduction: Conventional fixed-bearing knee prostheses have been proved to be clinically successful in elderly individuals with low activity levels. Polyethylene wear and loosening remain important problems with current fixed-bearing knee prostheses. In mobile-bearing knee prosthesis rotation of polyethylene insert is allowed and the contact area of the articular surface can be greatly increased and there can be a consequent reduction in contact stresses, and decreased polyethylene wear and there is decreased constraint forces at the bone and tibial prosthesis interface leading to decreased loosening. The objective of this study were to assess the clinical outcome of the procedure, to assess the complication rate of bearing dislocation associated with mobile bearing prosthesis, to compare our results with those of other similar studies and to compare the results of the study with those of fixed bearing prosthesis done earlier in our institute. Materials and Methods: This prospective study involved 30 total knee arthroplasties which were performed on 20 patients using Low Contact Stress (LCS) prosthesis. The patients were assessed preoperatively and pos-operatively clinically and radiologicallyat each visit and also using the Knee Society Rating System. The Depuy (Johnson & Johnson) LCS total knee arthroplasty was used in this study. Results: Total of 30 total knee arthroplasties were performed using low contact stress prosthesis in 20 patients. The mean post-operative knee society knee and function scores in the present study were 89.2 (range, 73-97) and 87 (range, 75-100), at mean follow-up period of 16 months. Our study has shown excellent results in 26 knees and good results in 4 knees. Conclusion: LCS prosthesis TKR showed excellent clinical outcome with excellent improvement in the pain relief scores, this study was comparable with other studies and those of studies on total knee replacement with fixed bearing prosthesis performed earlier in the same institute.

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