<p class="abstract"><strong>Background:</strong> <span lang="EN-GB">In the management of peri-trochanteric fractures, </span>intramedullary (IM) devices have proven advantage over <span lang="EN-GB">extramedullary devices. IM devices</span> allow for stable anatomical fixation of more comminuted fractures without shortening the abductor lever arm or changing the proximal femoral anatomy. Between IM devices like proximal femoral nail (PFN) and proximal femoral nail antirotation (PFNA), the helical blade of latter is believed to provide stability, compression and rotational control of the fracture with higher cut out strength. The following study was undertaken in an attempt to compare these two types of Intra-medullary devices<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> Between January 2012 and June 2013, 50 patients with unstable intertrochanteric fractures fulfilling inclusion and exclusion criteria, were randomized into 2 groups to undergo CRIF with either standard PFN (n=25) or PFNA (n=25). They were compared in terms of demography, per-operative variables and postoperative parameters including functional evaluation till 1year postoperatively.<strong></strong></p><p class="abstract"><strong>Results:</strong> Background demographic variables, fracture type and pre-injury ambulatory status were comparable between the groups. Operative duration of surgery, amount of blood loss and number of fluoroscopic images were significantly lower in PFNA group as compared to PFN group. Post op complications like infection, non-union, cut out/z-effect, loss of reduction, re-operation and mortality rates didn’t differ significantly between the groups. Post op functional recovery as evaluated by pain, use of walking aids and Harris hip scores were similar in both groups<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> PFNA significantly reduces the operative time, amount of blood loss and fluoroscopic imaging as compared to PFN. However PFNA offers no significant benefits over PFN in terms of post-operative functional recovery or complications<span lang="EN-IN">.</span></p>

<p class="abstract"><strong>Background:</strong> Residual anterior knee pain after total knee arthroplasty is one of the common causes of early revision surgery in form of patellar resurfacing and even resurfacing the patella in these circumstances may not relieve the symptoms. So, the decision to perform patellar resurfacing during total knee arthroplasty to prevent anterior knee pain remains controversial. The purpose of this study is to determine if the outerbridge classification can predict the need for Patellar resurfacing as part of total knee arthroplasty.</p><p class="abstract"><strong>Methods:</strong> 100 patients with advanced osteoarthritis of knee fulfilling the inclusion and exclusion criteria were randomized into two groups of 50 patients each. In group A-patellar resurfacing done and in group B-patella was not resurfaced while carrying out TKR. Each patient was assessed intraoperatively and his/her patella classified as per Outerbridge classification. Patients were followed-up at 03, 06 and 12 months postoperatively and assessed by modified hospital for special surgery (HSS) knee scores.<strong></strong></p><p class="abstract"><strong>Results:</strong> In case of Outerbridge class III group there is a statistically significant difference (p value -0.002) in HSS score at 03 months, which becomes highly significant at 06 months (p value -0.001) and 01 year (p value &lt;0.001). Similarly, there is statistically significant difference in HSS score (p value- 0.001) in Outerbridge class IV group at 03 months, 06 months and 01 year.</p><p><strong>Conclusions:</strong> Patellar resurfacing in patients undergoing total knee arthroplasty with patella in Outerbridge class III and IV can be safely carried out to further improve the functional outcome. There is no distinct advantage of resurfacing patella in Outerbridge class I and II in terms of functional gain. Thus, Outerbridge classification for patella can effectively guide us whether to resurface patella or not in patients undergoing total knee arthroplasty. </p>