BackgroundLong-term success reports by Dr. Ponseti with the Ponseti method in the treatment of congenital idiopathic clubfoot have led to a renewed interest in this method among pediatric orthopedists. The purpose of this study is to evaluate mid-term effectiveness of Ponseti method for the treatment of congenital idiopathic clubfoot.Material and MethodsA total of 49 patients (67 clubfeet) were treated by Ponseti method by single orthopedic surgeon during the period of October 03 to July 07 and were studied prospectively up to July 10 (mean follow up period 5 years, minimum follow-up period of 3 years). Age at the initiation of the treatment, gender, bilaterality, severity of the initial clubfoot deformity measured by Pirani Severity Score System, total numbers of Ponseti casts before the tenotomy, details of tenotomy, compliance with brace and CTEV shoes were examined. Passive range of movements and look of club foot are evaluated with mean 5 years follow-up.ResultsWe followed the functional Ponseti Scoring System and got good to excellent results in 44 patients - 89.79% (58 clubfeet - 86.56%) at mean five year of follow up. Parents of 32 patients (65.30%) accept the look of the clubfoot nearly normal and parents of 12 patients (24.49%) accept the look of clubfoot as normal. Of the 49 patients who responded to initial Ponseti casting, 14 patients - 28.57% (19 clubfeet - 28.35%) had relapse at varying age; out of which 9 patients - 64.29% (10 clubfeet - 52.63%) were corrected by Ponseti casting method, while 5 patients - 35.71% (9 clubfeet - 47.37%) were resistant to Ponseti method. Poor compliance with the Denis Browne splint was thought to be the main cause of failure in these patients.ConclusionPonseti method is a safe and satisfactory treatment for congenital idiopathic clubfoot with mid- term effectiveness.

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The hip joint is the most important joint of the body as it enables a person to assume various postures. Diseases of this joint are always alarming because if untreated, produces serious disability, for this reason various methods of management of hip diseases have been devised, but failure of conventional management in advanced stages of hip diseases like AVN, osteoarthritis, rheumatoid arthritis, congenital subluxation or dislocation, bone tumor etc. have brought a new surgical era of Total Hip Replacement (THR). The knee joint is the largest articulation in the body. Also this is a main weight bearing joint of the body. The usual degenerative changes due to advancing age most commonly affect this joint. Diseases of this joint are alarming because if untreated it produces more and more pain and disability, for this reason various methods of management of knee joint ailments have been devised, but failure of conventional management in the advanced stage of knee arthritis have brought a new surgical era of total knee replacement. Arthroplasty is an operation to restore pain free motion to a joint and function to the muscles, ligaments and other soft tissue structures that control the joint. There has been an explosion in this eld of knowledge in recent years. Objectives: The aim of this work is to study outcomes of 1 year follow-up of joint replacement (THR+TKR) under government scheme and to study in terms of Pain relief,Range of motion, Functional improvements- To measure the functional outcomes, Complications - To evaluate short term as well as long term complication rate. Materials and Methods: This is the retrospective study operated with total hip arthroplasty and total knee arthroplasty with atleast 1 year follow up of cases belonging to various age groups and having various pathologies of hip joint and knee joint and treated with uncemented THR and cemented TKR were assessed in respect to midterm follow up. Cases were assessed in respect to postoperative results of short and long term follow up with proforma and post operative radiographs at department of Orthopaedics, Guru Gobind Singh Govt. Hospital, Jamnagar Results: TKR- Average functional score is 91.15 with 12 patients having score >90. Maximum score is 100 and minimum score is 5. Average knee score is 93.5 with maximum score 99 and minimum score 88. THR- Almost all patients were walking with normal gait. Almost All (100%) patients were pursing their daily activities either normally or with minor modication in life style.82% had excellent Harris hip score.