Introduction: Amputation is no longer the sole contribution of the orthopaedic surgeon to the management of primary bone tumours. Improvements in the design of endoprostheses and surgical reconstructive techniques have combined with advances in chemotherapeutic regimens to result in surgical procedures for salvaging limbs with aggressive sarcomas and in limb reconstruction. This has made limb salvage a viable alternative to amputation in many cases. The aim of this study was to evaluate functional outcome and complications of patients with primary bone tumours who were treated with re-section and mega-endoprosthetic replacement. Materials and Methods: Nineteen patients with bone tumours were retrospectively reviewed. These patients had wide local re-section and mega-endoprosthetic reconstruction performed between 1999 and 2006 in a tertiary hospital. Functional evaluation was performed based on the Musculoskeletal Tumour Society (MSTS) scoring system, with numerical values from 0 to 5 points assigned for each of the following 6 categories: pain, function, emotional acceptance, use of supports, walking ability and gait. These values were added, and the functional score was presented as a percentage of the maximum possible score. Complications were also analysed. Results: The final mean functional score was 78.3% ± 16.6%. Eight patients had complications related to surgery, including infection and subluxation of hip implant. Six patients had infection, while 2 had subluxation of hip implants. Infection was a common complication in our study. None had implant breakage, loosening or fracture. We found no statistical difference in the functional outcome between upper limb and lower limb procedures, and between hip and knee procedures. T-test also showed no evidence of gender differences in functional outcome. Kaplan-Meier survival analysis revealed the mean survival duration of megaprosthesis to be 75.6 months. Conclusion: Mega-endoprosthetic reconstruction in limb salvage provides good functional outcome in patients with bone tumours. The early results from patients treated with mega- endoprosthesis have been encouraging. Keywords: Limb salvage, Megaprosthesis

Bilateral extraperitoneal USL is an effective operation to restore apical support with low morbidity, which avoids potential risks associated with opening the peritoneal cavity.

Provocative discography has conventionally been performed to localize the "pain generator" disk in patients with history of low back pain (LBP) that has failed conservative treatment. It is usually undertaken when surgical intervention is being contemplated. It is almost never used as the first test in the diagnostic work-up of discogenic LBP. The procedure involves injection of contrast agent into the nucleus pulposus of the disk under image intensifier guidance and assessing patient's response to contrast injection. Indications and technical details of the procedure have been described. Newer advances along with its current status as a diagnostic modality for discogenic LBP have also been discussed. A brief mention of cervical and thoracic discography is made.Key Words: discography-low back pain-degenerative disk disease-provocative discography. (Tech Orthop 2013;28: 73-77) From the