Aim: To study the outcome of Birmingham mid-head resection (BMHR) arthroplasty of the hip in young and active patients with avascular necrosis of femoral head with gross defects.Materials and methods: Study was conducted between Oct 2007 and Dec 2009. Twenty-three hips were operated upon in this period and data was collected for all patients. Radiographs were obtained in all subjects pre-operatively and compared to post-operative radiographs to determine migration of the components. Functional outcome was assessed in all patients using the University of California, Los Angeles (UCLA) scores. Complications, if any were recorded.Results: None of the patients were lost to follow up. None of the components migrated. All the patients remained active with mean UCLA score of 7.23 and there were no failures till our last review. Conclusion:This study shows promising early results of bone preservation and restoration of the biomechanics of normal hip in young and active patients with gross defects of the femoral head using BMHR procedure.

Introduction: Rheumatoid arthritis (RA) is a chronic inflammatory disorder of the synovium resulting in joint destruction. The knee is among the most commonly affected joints in RA and advanced arthritis of the involved joint is associated with poor prognosis contributing to patient pain and disability. In advanced disease, total knee arthroplasty (TKA) has proven to be the most successful intervention that reduces knee pain and improves physical function in RA patients. Materials and methods:A total of 34 total knee arthroplasties were performed in a tertiary care centre for rheumatoid arthritis of the knee joint with a posterior stabilized knee. Patients were regularly followed up and were assessed at the end of two years for the function of the knee joint, quality of life, ability to walk and perform routine daily activities, local signs of infection, activity of the disease and general condition. Results and conclusion:The difference in the average knee society score and the difference in the average knee available range of motion were found to be statistically significant at end of 3 years. There is a significant improvement in functional scores of the knee. However, there will be involvement of multiple joints, associated systemic complications and further progression of the disease. Because of the above said reasons overall functional outcome of the patient might not be significant improvement when compared to excellent clinical outcome of the operated knee.

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