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Introduction Ideal surgical positioning and placement of implants during arthroplasty are crucial for long-term survival and optimal functional outcomes. Inadequate bone stock or defects, and anatomical variations can influence the outcomes. Threedimensional printing (3DP) is an evolving technology that could provide patient-specific instrumentation and implants for arthroplasty, taking into account anatomical variations and defects. However, its application in this field is still not adequately studied and described. The present review was conceptualised to assess the practicality, the pros and cons and the current status of usage of 3DP in the field of hip and knee arthroplasties and joint reconstruction surgeries. Methods A PubMed database search was conducted and a total number of 135 hits were obtained, out of which only 30 articles were relevant. These 30 studies were assessed to obtain the qualitative evidence of the applicability and the current status of 3D printing in arthroplasty. Results Currently, 3DP is used for preoperative planning with 3D models, to assess bone defects and anatomy, to determine the appropriate cuts and to develop patient-specific instrumentation and implants (cages, liners, tibial base plates, femoral stem). Its models can be used for teaching and training young surgeons, as well as patient education regarding the surgical complexities. The outcomes of using customised instrumentations and implants have been promising and 3D printing can evolve into routine practice in the years to come. Conclusion 3D printing in arthroplasty is an evolving field with promising results; however, current evidence is insufficient to determine significant advantages that can be termed cost effective and readily available.

Case: A 9-year-old girl presented with a painful stiff elbow consequent to an injury she had sustained 4 months ago. The radiographs were suggestive of a type 2 Monteggia equivalent injury. She underwent an open reduction of the radial neck fracture and proximal ulna extension osteotomy to restore radiocapitellar alignment. At one-year follow-up, the child had a painless elbow with a good functional outcome. Conclusion: Monteggia lesions can be frequently missed and result in significant morbidity. Obtaining appropriate radiographs for a comprehensive understanding of the injury and proper surgical planning is important for achieving a good functional outcome in such injuries.

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Inflammatory cytokines produced at the site of disc herniation are considered as pain generators in patients with lumbar disc disease. Whether a high-sensitivity C-reactive protein (hs-CRP) assay can be used in order to predict the quantum of inflammation surrounding nerve roots is a matter of investigation. This study aimed to evaluate the association of hs-CRP level and functional outcomes measured by the Modified Oswestry Low Back Pain Disability Questionnaire (MODY) before and after epidural steroid injection (ESI) in patients with lumbar disc disease. Overview of Literature: Although many studies examining the role of hs-CRP levels and lumbar pain have been published previously, the results are equivocal, and there is no clear consensus regarding which patients will benefit from an ESI. Methods: This was a prospective study, with 77 patients in the study group and 23 participants in the control group. Baseline hs-CRP levels were obtained for both groups. Study group patients received a single ESI and were subjected to detailed pre-and postprocedure evaluation using MODY scores. For this group, hs-CRP levels were measured at 1 and 2 months after injection. Results: Out of 77 patients, 52 had acute and 25 had chronic low back pain. Thirty-six patients with acute pain obtained significant improvement, while 16 had an insignificant response to the ESI. None of the chronic cases had a significant response. The mean baseline hs-CRP (mg/L) among the study group (29.83±10.43) was significantly higher than for the controls (10.26±2.783). The baseline hs-CRP among acute cases, where post ESI MODY score at 2 months had significant reduction, was 32.19±5.126, and those with insignificant reduction was 18.13±7.949 (p<0.001). Conclusions: Baseline hs-CRP levels can be used to prognosticate the outcome following ESI in patients with acute lumbar disc disease, with radicular pain refractory to physiotherapy and analgesics.