Total knee arthroplasty (TKA) patients express minimal comfort regarding postoperative pain management. The use of parenteral opioids or epidural analgesia may have unfavorable adverse impacts that interfere with quick healing and rehabilitation. It is uncertain if periarticular multimodal drug injections (PMDI) are effective at easing pain following total knee or total hip arthroplasty (THA). We conducted this study to assess the effectiveness of PMDI following TKA or THA. Articles were sourced using the following keywords on Pubmed, Google scholar, and the Web of Science: multimodal drug cocktail in total knee arthroplasty OR hip arthroplasty, periarticular injections AND multimodal drug cocktail, epidural versus periarticular injections AND pain management after total joint arthroplasty. After screening 438 articles and abstracts, 200 pertinent studies were found, of which a total of 10 articles were included in the study. From this review, we want to conclude that despite the various ways to address postoperative pain, there is no acknowledged gold standard for postoperative pain management following total joint arthroplasty. To reduce narcotic intake and prevent narcotic-related adverse reactions, multimodal techniques utilizing regional anesthetics appear to be on the rise such as periarticular injections, or patient-controlled analgesia with or without femoral nerve block. Even though the ideal duration and kind of medications are unclear, preoperative pain management or preemptive analgesia with anti-inflammatory drugs and opioid analgesics seem to be useful in lowering postoperative pain.

Chondrosarcoma is a kind of bone tumor that can be anywhere in the body but most commonly affects the pelvis, glenohumeral joint, proximal femur, and proximal one-third of the tibia including condyles. It accounts for 20-25% of all bone sarcomas. Chondrosarcomas with clear cell variants are extremely uncommon, making up just around 6% of all cases. We are presenting a case of a 52-year-old male with a bony lesion over the epiphysis of the left tibia. He was managed with resection of the tumor followed by a limb salvage procedure with mega-prosthesis. Chondrosarcoma affects men in the third to fourth decades of their life more commonly than females. Long-standing localized pain over a prolonged duration is the most common presenting symptom. There are various treatment modalities available for clear cell chondrosarcoma, ranging from wide local resection and intralesional therapy to amputation. The decision of tumor resection followed by prosthesis was chosen over amputation here, as the patient had the lesion for 2 years and there were no signs suggestive of metastasis after thorough screening. Limb salvage gave a better outcome for the patient in our study. A large-segment prosthesis is a suitable reconstructive alternative to amputation. At the majority of the anatomical sites where the prosthesis was employed, the functional results were good or exceptional after this type of treatment. The patient now has a functional limb and is able to resume his life as before, making mega-prosthesis a better alternative and treatment of choice for patients with large lesions.

Achilles tendon rupture has been a difficult problem for surgeons, especially in older patients, since tendon strength and flexibility are significantly diminished compared to young people. The Achilles tendon endures the highest tensile stresses in the body while running, leaping, and skipping, with tensile loads up to 10 times body weight. There are many treatment options for Achilles tendon repair, including open surgery, percutaneous repair, and ultrasound therapy. Open repair has the danger of scar dehiscence owing to poor skin conditions. In contrast, small invasive operations have the risk of sural nerve damage and a higher possibility of re-rupture. The gold standard method or approach is still under question. Plantar flexion in the ankle is primarily a function of the Achilles tendon; hence, post-operative plantar flexion is a significant determinant of the desired result. We present the case of a 57-year-old male farmer suffering from a left Achilles tendon rupture due to trivial trauma. This rupture consisted of a significant defect, present in the watershed area with signs of tendinosis at the insertion of the tendon. The patient was managed surgically by turn-o-plasty and the degenerated insertion site was augmented with the help of a suture disc. This case report focuses on surgical management by turn-o-plasty for significant defects in the Achilles tendon by using a suture disc to augment the defect.