Heterotopic ossification is the abnormal formation of mature, lamellar bone in nonosseous tissue such as tendons, ligaments, muscles, and soft tissue. We discuss a rare case of a young adolescent with patellar tendon rupture postheterotopic ossification. A 13-year-old male presented to us with knee pain and inability to extend for 6 weeks following trivial trauma. Preliminary radiological investigations revealed a high riding patella with ossification in the patella tendon. The magnetic resonance scan confirmed the same with patellar tendon disruption and heterogeneous ossification. He underwent surgery with patella tendon repair, augmentation with autograft, and had complete recovery at 6 months' follow-up.

The objective of this study is to describe a series of cranio-cervical dissociation victims and evaluate their outcomes as well as discuss the clinical dilemmas we faced in the context of current literature evidence. This is a retrospective cohort study of traumatic occipito-cervical dissociation in five patients (three males and two females) encountered between 2010 and 2016 at a tertiary care facility in the Middle East region. All patients underwent occipito-cervical fusion using screws and rods system with mean postoperative follow-up period of 2.5 years. All patients survived, and four were independently mobile and one wheel chair bound. Most had some degree of neurological sequelae, often due to associated injuries and all complained of limited neck range of motion. Contemporary literature review shows that CT scan with MRI is often the best diagnostic modality. Surgery is usually indicated though rare cases treated conservatively have been reported. The commonest predictor of mortality is missed injury, associated head injury and wide separation between the skull base and C1 on imaging studies.

Objectives: The outcome of revision anterior cruciate ligament reconstruction (ACLR) is inferior to that of the primary reconstruction and is influenced by multiple factors. The purpose of this study was to identify the better autograft suited for revision ACLR and to assess the factors influencing the outcome of revision. Methods: A total of 102 patients who underwent revision ACLR were enrolled in this study. The patients were grouped based on the type of autograft used for revision. The mechanism of injury and the cause of the primary ACLR failure, meniscal, and chondral status were noted. All patients’ Tegner Lysholm functional scores were assessed at 2 years of follow-up. Results: Almost 37.3% of the patients underwent revision ACLR with bone-patellar tendon bone, 41.3% with semitendinosus-gracilis, and 21.3% with quadriceps tendon autografts. The mean Tegner-Lysholm score was 85.4 ± 15.8, with the majority achieving good to excellent scores. Chondral defect of Grade 3/4 was associated with an inferior poorer functional outcome (P = 0.03). At a 2-year follow-up, the non-contact mechanism of primary ACLR failure was associated with worse scores compared to the contact mechanism of failure (P = 0.03). On comparison of Lysholm functional score between different autografts using the Kruskal-Wallis test, the p-value was insignificant (P = 0.9). Conclusion: Non-contact mechanism of primary ACLR failure and Grade 3/4 chondral defects was associated with a poorer functional outcome at 2 years post-revision ACLR. The overall functional outcome of revision ACLR was good to excellent in our Middle East Asian population, with no one autograft found to be superior to the other.