Medial condyle Hoffa fractures are intra articular injuries, which require prompt anatomical reduction and internal fixation. Arthroscopy-guided fixation of these fractures has also been advocated; the advantages include avoidance of soft tissue dissection, fast recovery and mobilization. We describe a case of a 28-year-old male patient presenting with a 10-day-old medial condylar Hoffa fracture. Skin condition prevented from conventional open reduction and internal fixation; hence, taking note of the urgency of fixation of an intraarticular fracture, arthroscopic-assisted minimally invasive approach was performed with good outcome.

Background: Use of mini-subvastus   approach for  total  knee  arthroplasty  (TKA )  in  obese  patients  is  still  debated . We had hypothesized in our  study published  in  July 2010 , that  obesity  should  not  be  considered  as  a  problem for  patients  undergoing  a  TKA  with  the  mini-subvastus  approach  as  the anatomy  of  the  quadriceps in  the  obese and  the  non-obese  patient population is  the  same. We present  a  mid-term  follow-up  study  of  the  same  set  of patients  with  an  average  follow  up  of  96 months.Materials and Methods: 97 obese patients (109 knees) 81 females + 16 males with mean age 64 years underwent TKA by mini-subvastus approach between January 2006 to July 2007. 16 patients (18 knees) were morbidly obese. Out of the total number of patients, 08 were lost in follow up and 01 died because of unrelated causes. Out of these 09 patients, two were operated for bilateral TKR. Thus, we have a midterm follow up results of 98 knees in 88 patients. Knee society and functional scores were used for patient evaluation and compared to their pre-operative and earlier follow up scores.Results: At our latest follow-up of 96 months the Knee Society Score and functional scores were 84(range 64-90) and 58(range 45-75) respectively. One morbidly obese lady had aseptic loosening of tibial component at 42 months which needed a revision.Conclusion: Our mid-term results show that the mini-subvastus approach can be  considered  for TKA in obese and morbidly obese patient population with outcomes comparable to standard surgical approach.Keywords:  Mini-subvastus approach, Total knee arthroplasty ,Obesity