BACKGROUND Among the various surgical approaches for total knee arthroplasty, medial parapatellar and subvastus approach are two commonly used surgical approaches in total knee arthroplasty. The aim of this study is to compare the functional outcome between subvastus approach and medial parapatellar approach. METHODS This is a prospective study which compared medial parapatellar approach (Group-1, 30 patients) and subvastus approach (Group-2, 30 patients) from November 2017 to March 2019, in Rajarajeswari Medical College and Hospital, Bangalore. Patients were followed up for 16 months. Revision knee arthroplasty cases and total knee arthroplasty cases operated by other surgeons were excluded. RESULTS There was no significant difference between subvastus approach and medial parapatellar approach. Except that in subvastus approach, quadriceps tendon was not disrupted. Pain was better controlled in subvastus approach on post-operative day but operative time was more in subvastus group. There were no difference between two groups with regard to duration of stay, blood loss and post-operative complications. CONCLUSIONS Subvastus approach provided better pain relief postoperatively, but operative time was more in subvastus group. There was no significant difference between the two groups in duration of stay and post-operative complications. Subvastus can also be considered as an alternative surgical approach along with standard medial parapatellar approach for primary total knee arthroplasty.

A BS T R A C T BACKGROUNDPain, functional limitations, and impaired health related quality of life, are key concerns for individuals with advanced osteoarthritis of the knee. Total Knee Arthroplasty (TKA) is the primary treatment for patients with end stage arthritis. Despite being a common intervention associated with generally favourable outcomes, 1 a large proportion of individuals do not have expected outcomes following TKA. 2 So, the present study was conducted to evaluate functional outcome following primary TKA in an institute which caters to rural and semi urban population with limited financial provisions. RESULTSIn our study, pre-operatively all of our patients had moderate to severe pain, postoperatively 24 knees had no pain and 36 knees had mild pain. Pre-operative average flexion of 76˚ was increased to 95.8˚ post-operatively. All the 60 knees had poor knee score of < 60 pre-operatively, post-operatively 42 knees had excellent score (80-100) and 17 knees with good score (70-79). 38 patients had poor functional score (< 60) and 3 patients had fair functional score (60-69) pre-operatively. Post-operatively 21 patients had excellent score (80-100), 11 patients had good score (70-79), 6 patients had fair score (60-69) and 3 patients had poor score (< 60). CONCLUSIONSTKA is now a common and established surgical procedure. Functional outcome of the procedure is dramatic, durable, and satisfactory with high patient acceptance.

Humeral shaft fractures are common injuries making upto 1-3% of all fractures. They are widely treated by conservative methods leading to higher rates of non-union. Henceforth surgeons tend to perform operative procedures to treat them. To statistically analyse and compare the functional and radiological outcome of two treatment modalities of humeral shaft fractures, they are plate osteosyntheis and antegrade intramedullary nailing. A total of 22 patients of humeral shaft fractures were operated by either of two methods 12 in plating (P) group ,10 in nailing (N) group and their radiological outcome was assessed by rate of union, time taken for callus formation etc and their Functional outcome was analysed based on Rodriguez Merchan criteria. The commonest age group of patients operated is 21-40 years (70%) majority being males (70%) and road traffic accident being commonest mode of injury. The plate osteosynthesis group stands superior than nailing group in terms of duration of union (20 weeks), rate, percentage of union (100%), least risk of non-union (0). Statistically significant (p<0.05) improvement in shoulder joint function with minimal complications. The plate osteosynthesis method is the most promising surgical procedure for treating humeral shaft fracture due to negligible rates of non-union and early recovery of motion. Though nailing group has minimal need of soft tissue dissection, preserves fracture biology, decreased operative time and early rehabilitation period it still stands inferior when it comes to complications like rotator cuff injury, shoulder impingement pain and restriction of shoulder movements. Ultimately the post operative quality of life is equally good in both techniques.

Background: Partial tears of anterior cruciate ligament (ACL) were more commonly identified in young group with knee twisting. Partial tears are characterized by tear involvement of less than 50% of the ligament is torn. The arthroscopic evaluation is considered as gold standard in diagnostic evaluation. The comparison of findings between partial and complete tears in magnetic resonance imaging (MRI) and arthroscopy helps in finding out reliability of diagnostic modalities and consider the surgeon to establish the plan of treatment. Methods: 2-year prospective study at the department of orthopedics, RRMCH, Bangalore, India. 40 consecutive patients with suspicion of cruciate injuries of knee were selected for the study from July 2018 to May 2021. The MR imaging of knee in selected cases were performed and the findings were obtained.  The descriptive statistical analysis was prepared which includes spectrum of MRI findings in cruciate injuries of knee that were correlated with arthroscopy findings in determining the accuracy. Results: Total 40 patients, we obtained 100% sensitivity and 66.67% specificity, 93.75% accuracy of MRI with arthroscopy in diagnosing complete ACL tears. We obtained 90.91% sensitivity and 80% specificity, 87.50% accuracy of MRI with arthroscopy in diagnosing partial ACL tears. Conclusions: The partial tears can be missed or can be over diagnosed on MRI. These misinterpretations are more likely to happen due to intra-substance signal abnormality. Description of the status of ACL ligament in arthroscopy helped the orthopaedic surgeons in decision making as conservative approach in partial tears and reconstruction in a complete tear.

ABSTRACT: Osteoporosis is a common metabolic disorder characterised by decreased bone mass and weakened micro-architecture of bone tissue. In 2014 Osteoporosis international estimated osteoporosis to be one of the leading causes of disability, depression, and early mortality in the elderly. After 50 years of age, 1 in 3 women and 1 in 5 men experience osteoporotic fractures. This is projected to cause a yearly loss of 5.8 million healthy life years to disability. The number of patients who attend the outpatient clinic and emergency department of Sanjay Gandhi institute of trauma and orthopaedics with fragility fractures has been increasing, hence to know the prevalence of osteoporosis in the general population who were asymptomatic, we decided to conduct a study in the rural areas of south India. RESULTS: The prevalence of osteoporosis in the rural population was more in females at 42.2%, whereas the males had a prevalence of 32.5%. Among the population with habits of tobacco consumption and alcohol consumption, the prevalence was 78% and 30.6% respectively. 20.2 % of non-smokers and 39.7% of non-alcoholics were osteoporotic. Among the population with comorbidities, 53.6% of diabetes and 55.4% of hypertensives were osteoporotic. 33.7% of non-diabetics were osteoporotic, and 29.5% of hypertensives were osteoporotic. The correlation between osteoporosis and the individual risk factors ranged between weak negative to moderately positive.(r = - 0.2 to 0.5). The correlation between the combination of all the four risk factors and osteoporosis is weakly positive (r = 0.339), which is highly significant (p-value = 0.001). CONCLUSION: The prevalence of osteoporosis is high in rural populations over 50 years. There is a significant positive correlation between osteoporosis and secondary risk factors like smoking, tobacco chewing, alcohol consumption, diabetes, and hypertension.