Introduction: Multi-ligamentous knee injuries (MLKI) are rare orthopedic injuries with diverse approaches to its management protocol. The purpose of this study was to determine the epidemiology of MLKI in our centre and its outcome in single stage reconstruction. Methods: 60 patients who were surgically treated for MLKI between 2014 and 2018 were included in this study, data was collected pre and postoperatively and their Lysholm and IKDC scores were used to evaluate the outcomes. Results: A male predominance was noted in the present study. Road traffic accidents (RTA) were the most common mode of injury (66.7%). ACL & MCL combination constituted the most common injury pattern (36.7%). 41.7% of our patients were treated within 3 weeks from injury and 58.3% were treated 3 weeks after injury and there was no statistically significant difference in their outcomes with a p value > 0.05 for their post op Lysholm scores and post op IKDC scores. Overall, there was a statistically significant difference in outcomes post surgery with regards to pre-operative and post-operative Lysholm and IKDC scores in our patients with a p value < 0.0001, substantiating the need for surgical management of MLKI. With a mean post-operative Lysholm score of 89.11 and mean post operative IKDC score of 85.25, this study showed functionally good results in the patients treated in a single sitting. 28 of 60 patients could get back to their sports activities after atleast 6 months of rehabilitation. Conclusion: MLKI are relatively uncommon injuries eluding a large scale prospective clinical studies and consensus regarding its management. In the present study, a male predominance was noted, high velocity injuries like RTA was the most common mechanism of injury. A combination of ACL & MCL accounted for the most common pattern of injury. We could also conclude that surgical management yields good results irrespective of the time since injury i.e. either early (<3 weeks) or delayed (>3 weeks) surgery. Single stage surgical management of MLKI produce considerably better outcomes compared to staged management. It was also found that surgical management of MLKI with reconstruction could help patients to return to their pre operative level of sports activities with a proper rehabilitation protocol.

Intramuscular hemangiomas of the forearm are rare. Patients typically present with pain, discomfort, and progressive enlargement of the lesion. Diagnosis is often difficult due to their infrequency, deep location, and unfamiliar presentation. In this case report, we present a 47-year-old woman with an intramuscular hemangioma with phleboliths involving the forearm. The patient reported swelling in the right forearm for the past 20 years, which was insidious in onset, gradually progressive in size, and associated with dull aching pain. Upon examination, a soft 20×4 cm swelling was present over the right forearm involving the ulnar aspect, with a positive Tinel’s sign at mid-forearm level. Clinical differential diagnosis included lipomatosis, neurofibroma, and intramuscular hemangioma. On Magnetic Resonance Imaging (MRI), a heterogeneously enhancing serpentine lesion was noted involving the flexor compartment muscles of the right forearm. The patient underwent excision of the lesion, and histopathological examination confirmed intramuscular hemangioma. During the postoperative recovery period, all range of movements at the elbow joint and wrist were normal. No recurrence was noted up to two years of follow-up

Total knee arthroplasty (TKA) is one of the commonly performed procedure for osteoarthritis knee, rheumatoid arthritis, post traumatic arthritis etc. with a main goal of providing a pain free, stable and functional joint. Assessment of clinical outcomes should be done by both objective findings and by taking into account the patients point of view and his/her own evaluation of the functional trends of the treated joint. Forgotten Joint Score (FJS) is one such recently developed patient reported outcome measure (PRO), with better discriminatory power. The main aim of our study was to evaluate the patient reported outcomes in our patients who underwent TKA for osteoarthritis knee using FJS system and to analyse the temporal relationship of the outcomes of the time since surgery. Though there are various scoring systems, the "forgotten joint score" system is a disease specific and joint specific scoring system . We concluded that the best scores among our patients was obtained in patients operated 12months and 24months before the conduct of study. Therefore we can conclude that the maximum improvement in functional status of patients can be expected between 6months to 12months after sugery. Age, gender had no affects on the outcomes and the FJS score. Patients with unilateral TKR as well as bilateral TKR both had equally better functional outcomes and FJS scores.