Background: Arthroscopic ACL reconstruction surgery is commonly performed as an outpatient procedure and is often associated with postoperative pain. Objectives: We aimed to find out the effects of intra-articular ropivacaine-morphine on postoperative pain in patients undergoing elective arthroscopic ACL reconstruction surgery. Materials and Methods: A total of 46 patients undergoing elective arthroscopic ACL reconstruction under spinal anaesthesia were enrolled. The participants were allocated to two groups to receive the following intra-articular medications after completion of the surgery and before deflation of the tourniquet: Group I, 20 mL of saline, Group II, 0.25% Ropivacaine and 5 mg morphine 20 mL in volume. Visual analogue scale (VAS) values were recorded at 1, 3, 6, 12 and 24 hours postoperatively, duration of analgesia, total analgesic consumption, and number of rescue analgesia at 24 hours were evaluated. Results: VAS was significantly higher in group I in comparison to other groups. Duration of analgesia was significantly longer in Group II than in Group I. Number of rescue analgesia and total analgesic consumption at postoperative hour 24 was significantly fewer in group II. Conclusions: Intraarticular ropivacaine-morphine combination provides effective pain relief, longer analgesic duration, and less analgesic requirement when compared with intra-articular ropivacaineclonidine combination and saline after arthroscopic ACL reconstruction surgery.

Aim: Outcome of precontoured locking plates fixation in Distal Humerus Fractures. Material and methods: Twenty-five patients with distal humerus fractures were treated with ORIF with pre-contoured locking plates. There were 16 males, 9 females, with an average age of 42.8 years (21-59years). As per the AO classification performance score, the results obtained were graded as excellent or good results in 24 patients (96%), fair in 1 (4%) and poor in 0 (0%) of cases. Average time interval between admission and surgery was 3.8 days (average 1, there were 3 type A fractures(12%),1 type B(4%) and 21 type C fractures (84%).In addition to clinical examination, functional results were evaluated using the Mayo elbow performance score (MEPS). Results: Using the Mayo elbow -9 days). All the fractures as well as the olecranon osteotomies united by 10-16 weeks (13.76 weeks). No patient had deep infection, implant failure, non-union of fracture site or olecranon osteotomy site. Superficial wound infection, which occurred in 2 (8%) patients, resolved with oral antibiotics. Transient ulnar nerve palsy developed in 1(4%) case. However, the patient recovered with conservative treatment. Conclusions: An anatomically precontoured distal humerus locking plates are useful in providing stable fixation of distal humerus fractures, thereby facilitating early postoperative rehabilitation.

Introduction: Osteoarthritis of knee is more common among all types of arthritic conditions. High tibial osteotomy is an accepted surgical technique for treatment of medial compartment arthrosis of knee in younger patients. Selection of the appropriate patients, extensive pre-operative planning and accurate surgical technique are essential for successful outcome. The methods of high tibial osteotomy include open wedge osteotomy and closed wedge osteotomy, the later procedure being more popular. Aims and Objectives: To assess the functional outcome among patients undergoing high tibial osteotomy. Methodology: A hospital based prospective interventional study was done on 30 patients of osteoarthritis with varus deformity. For all the 30 patients after a proper preoperative assessment the surgical intervention in the form of high tibial osteotomy was done and the outcome was evaluated using knee society scoring system. Results: Among the study population 73.3% of the patients had grade III type of osteoarthritis and only 26.6% had grade IV type of osteoarthritis based on Kellgren and Lawrence type of classification. The mean knee score and the mean functional score of the patients before surgery were 54.6 and 53.9 respectively and post operatively at the end of 12 months the knee score and functional score was 83.1 and 82 respectively. A statistically significant improvement was seen in both the knee society score and the functional score. Conclusion:The main improvements seen in this study was the increase in the knee score and functional score after high tibial osteotomy for the patients of osteoarthritis with varus deformity. Appropriate patient selection, proper osteotomy types and precise surgical techniques are essential for the success of high tibial osteotomy.

Nuclear medicine plays an important role in the evaluation of infection and inflammation. Fluorine 18 fluorodeoxyglucose is a readily available radiotracer that offers rapid, exquisitely sensitive highresolution tomography. In the musculoskeletal system, fluorodeoxyglucose PET accurately helps diagnose spinal osteomyelitis, it appears to be useful for defining the extent of disease and monitoring response to treatment. Baseline fluorodeoxyglucose uptake by normal cortical bone is quite low. Bone marrow uptake is variable and can be slightly to moderately more intense than that of bone.