BACKGROUND Hip joint is a polyaxial ball and socket joint. At different stages of gait cycle, joint reaction forces at the hip joint depend on abductor leaver arm which is function of neck length (Offset), neck shaft angle and body weight. During Arthroplasty operation of hip, femoral offset measurement and its restoration to anatomical limit is important. In our study, we have measured the femoral neck length, between two fixed bony points, from the tip of greater trochanter (GT) to the center of the femoral head peroperatively and again post-operatively, from the true size x-ray of the replaced femoral head. We compared this measurement with the postoperative x-ray of normal side hip, to compare, how far normal offset is achieved after operating with various prosthesis (fixed bipolar prosthesis and modular prosthesis) available in the Indian scenario. MATERIALS AND METHODS This is a prospective, comparative study on presentation at in-patient department (IPD). Total 53 patient (22 male and 31 female) above 60 years of age, admitted at our institution 'Ramakrishna Mission Seva Prathistan (VIMS)' in the year 2015-16, with intracapsular fracture neck femur of either right or left side were studied. Per-operative measurement was taken during hemiarthroplasty operation using fixed bipolar prosthesis or modular prosthesis (cemented/un-cemented) available in the Indian market. Post-operative measurement taken in the true size x-ray of two fixed points on the operated and normal side. Limb length was measured clinically. The values obtained were compared to establish how far the normal anatomical offset is achieved after hemiarthroplasty operation by using prosthesis manufactured by different companies in India. RESULTS Intraoperative measurement of distance between tip of GT and center of femoral head corresponded with the measurement taken from tip of GT to the prosthetic femoral head. This signifies that we have successfully corrected the offset with available prosthesis with correct surgical technique. There is no significant difference in the postoperative true size x-ray of distance between tip of GT to the center of prosthetic femoral head and the tip of GT with center of femoral head of normal side. CONCLUSION Our study results shows that by opting correct surgical technique and appropriate neck resection, currently available prosthesis (FBP & MBP) in our country can achieve desired neck offset length in comparison to the normal hip and had no significant limb length discrepancy.
BACKGROUND Recurrent patellar instability is not an uncommon entity with acute patellar dislocation accounting for 2% to 3% of all knee injuries and is the second most common cause of traumatic knee haemarthrosis. Based on recent biomechanical studies, among the medial patellar stabilisers the Medial Patellofemoral Ligament (MPFL) is considered as the primary restraint against lateral dislocation of the patella. MATERIALS AND METHODS This is an observational study. 25 patients (15 males and 10 females) with recurrent patellar dislocation were operated with MPFL reconstruction with tendon graft and bio screw. Their clinical outcome was measured with respect to pre-op, 3 months post-op and 6 months post-op Kujala score. SPSS software was used for analysis. RESULTS Pre-op mean Kujala score was 71.24 and 6 months mean Kujala score was 75.12. CONCLUSION This study demonstrates that clinical outcomes are good after isolated MPFL reconstruction, as evidenced by the Kujala score. Study findings correlate well with other previous studies done on MPFL reconstruction for recurrent patellar dislocation.
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