Background: Osteoporosis poses a huge challenge in India, as it is a developing country due to demographic transition and aging of the population along with limited resource availability in rural India.Osteoporosis predominantly affects postmenopausal women. The mal-nutrition, and smoking, consumption of liquor and tobacco may have an effect on bone mineral density (BMD) .Osteoporosis occurs in all populations, but not all populations are at equal risk. According to various studies, Asian women have higher predisposition for osteoporosis than their Caucasian people. Reasons attributed for lower bone mineral density (BMD) in Indians include possible genetic differences, nutritional deciency and smaller skeletal size. Smoking or tobacco intake, malnourishment, alcohol has a negative effect on bone mineral density [BMD]. Tea garden people are probably more affected than other communities in the surrounding area as evidence by high attendance of patients with osteoporosis & fragility fractures in Orthopaedic OPD of JMCH. Increase prevalence in the community might be wholly or partly due to poor socio-economic status , poor nutrition, lack of calcium and vitamin d in diet, dark skin and addiction to alcohol. Purpose of the study: to study the prevalence of osteoporosis in middle-aged to elderly tea garden women of Jorhat district. Materials and Methods: In this community based cross-sectional study, BMD (bone mineral density) of 360 female subjects, aged 35 to 65 years, were calculated using quantitative ultrasound bone densitometry.(QUS) In our study 24.7% were Results: osteoporotic, followed by 39.5% were osteopenic and 35.8% had normal BMD. Thus, the prevalence of osteoporosis in our study, in the female population of tea gardens of Jorhat district was 24.7%

Introduction : Bilateral hip degenerative arthritis is a frequent nding in 42% population with osteoarthritis. Unbearable pain restrict daily activities of living to a great extent. Bilateral total hip arthroplasty is an well established reconstructive procedure for advanced arthritis. The objective of this study was to evaluate functional outcome of bilateral cementless total hip arthroplasty using Harris Hip Score. A prospective study conducted in 20 patients with 40 hips w Materials And Methods : ere analyzed for clinical and functional outcome. Age, sex , operative indication and preoperative Harris Hip Score were documented. Operative time and complications were noted. Patients were evaluated immediate post operative period ,3 month and at 6 months . Harris Hip Score , Visual Analogue score , range of movement evaluation was done and documented. Mean preoperative Harris hip score w Results : as 38.6 on left side and 39.3 on right side . This score improved to 88.04 on left and 86.03 on right side immediate post operative period and 94 on left and 93 on right side on 6 month followup. A signicant improvement in Visual analogue score (VAS ) and range of movements were observed in post operative follow up. The outcome after bilateral total hip replacement was excellent in 95% and good in 5% of cases. Current generation of prosthesis used in cement less Conclusion : bilateral total hip arthroplasty for degenerative arthritis of hip, provides satisfactory functional and radiological outcomes . It is an effective and safe procedure and improves the quality of life by relieving pain and improving functional disability

High tibial osteotomy (HTO) being a re-emerged common procedure in orthopaedic practice now, which is safe and relatively simple and cost-effective technique requiring careful selection of subjects and precision of technique. Background: In isolated medial unicompartmental osteoarthritis (OA) of knee, in a physiologically young and high demanding individual, where preservation of knee is required, unicompartmental knee arthroplasty and total knee arthroplasty are not considered as treatment options. HTO is an excellent treatment option where the requirement of technical skills and infrastructure are less and high-volume low-cost surgeries can be performed with minimum instrumentation. 20 selected patients with unicompartmental OA of knee who attended the OPD of orthopaedics, Jorhat Medical College and Hospital were the subjects of this study, during the period of study from June 2020 to May 2021. In our study, average age was 55.9 years; higher incidence among females; higher incidence of OA in left knee; 80% of cases presented at Kellgren and Lawrence grade 2 and 3; most of the cases were having BMI within normal range and varus deformity of knee; plate and screw fixation after HTO provides more rigid fixation than staples alone. In this study, we got 60% good and 30% fair results after 6 months to 1 year of follow-up. Successful HTO is a very effective alternative low-cost surgery that makes it possible to delay or avoid knee arthroplasty in well selected patients.

Isolated tibial shaft fractures with intact fibula are a fairly common injury. Hospital records often fail to mention the intact fibula in such injuries. Many studies blame that with an intact fibula, tibiofibular length discrepancy develops resulting complications associated with the management of tibia fractures like delayed union, non-union, and malunion. A prospective study in 59 patients of tibial shaft fractures with 33 having fibula fracture (FF) and 26 patients with an intact fibula(IF) were treated by closed intramedullary interlocking nail between June 2019 to July 2020. Radiological follow up were at 6 weeks, 3 months, 6 months. The final functional evaluation was done with Johner and Wruh’s criteria at the end of 6 months.The mean duration of surgery in group IF was 106.62 minutes wherein group FF was 97.91 minutes The radiological union was early with a mean union rate of 19.09 weeks in group FF compared to group IF where the mean was 22.23 weeks. The percentage of nonunion was 3.85% in group IF. 4 patients had a deformity where the level of tibia fracture was lower 1/3 diaphyseal with fibula fracture at the same level. At the final follow up the functional score had no significance. The union of a tibial shaft fracture was slower in patients with an intact fibula compared to those with a fractured fibula. Although the intact fibula was more proven for the delayed union, non-union, it prevents malalignment.

BACKGROUNDFemoral neck fractures have remained as 'unsolved fractures' till today due to the high rate of associated complications. In the Indian scenario, the focus is always on femoral head preservation. In the elderly, however, the options in managing femoral neck fractures seem to be more in favour of head sacrificing surgery such as arthroplasty and the procedure may vary from either cemented to uncemented fixation or hemiarthroplasty to total joint replacement. Nevertheless, the 'gold standard' and the most appropriate treatment for these fractures remain controversial.The purpose of this study was to analyse the outcome of displaced femoral neck fractures in elderly patients who were fit to receive either a hemiarthroplasty using cemented modular (bimodular/bimod) bipolar prosthesis or total hip arthroplasty using a cemented prosthesis in terms of operation time, blood loss and transfusion, duration and cost of hospitalisation, hip joint function, pain relief, post-operative complications, rate of dislocation, revision and mortality. MATERIALS AND METHODSOver a period of 3 years (2013 -2016), a prospective randomised controlled trial study was carried out for a total of 40 cases of acute fracture of neck of femur in elderly patients, aged more than 65 yrs. attending the OPD and Emergency Department of Orthopaedics, Gauhati Medical College and Hospital. The patients were followed up and were evaluated clinically, radiologically and functionally (using Harris Hip Score). RESULTSIn the HRA group, we achieved excellent functional results in 70% cases and in the THA group we achieved excellent functional results in 90% cases and there was no statistically significant difference in terms of Harris Hip Score in both the groups. CONCLUSIONFrom our study, we have seen that there is no significant difference in treatment of neck of femur fractures treated with THA and HRA in terms of functional results and intra-and post-operative complication. However, there is a significant difference in intraoperative blood loss between the two types of procedures.