Background:Posterior heel pain due to retrocalcaneal bursitis, is a disabling condition that responds well to the conventional methods of treatment. Patients who do not respond to conservative treatment may require surgical intervention. This study evaluates the outcome of endoscopic decompression of retrocalcaneal bursitis, with resection of posterosuperior eminence of the calcaneum.Materials and Methods:This present study included 25 heels from 23 consecutive patients with posterior heel pain, who did not respond to conservative treatment and underwent endoscopic decompression of the retrocalcaneal bursae and excision of bony spurs. The functional outcome was evaluated by comparing the pre and postoperative American Orthopedic Foot and Ankle Society (AOFAS) scores. The Maryland ankle and foot score was used postoperatively to assess the patient's satisfaction at the one-year followup.Results:The University of Maryland scores of 25 heels were categorized as the nonparametric categories, and it was observed that 16 patients had an excellent outcome, six good, three fair and there were no poor results. The AOFAS scores averaged 57.92 ± 6.224 points preoperatively and 89.08 ± 5.267 points postoperatively (P < 0.001), at an average followup of 16.4 months. The 12 heels having noninsertional tendinosis on ultrasound had low AOFAS scores compared to 13 heels having retrocalcaneal bursitis alone. At one year followup, correlation for preoperative ultrasound assessment of tendoachilles degeneration versus postoperative Maryland score (Spearman correlation) had shown a strong negative correlation.Conclusion:Endoscopic calcaneal resection is highly effective in patients with mild or no degeneration and yields cosmetically better results with fewer complications. Patients with degenerative changes in Achilles tendon had poorer outcomes in terms of subjective satisfaction.

Bicondylar Hoffa's fractures of the femur is very uncommon. Conjoint bicondylar Hoffa fracture with ipsilateral patellar dislocation, Bicondylar Hoffa's with patellar fracture and extensor mechanism rupture has been described in literature. We report a case of unconjoint bicondylar Hoffa's fracture with lateral patellar dislocation in 17-year-old male patient treated with open reduction and cancellous screw fixation that subsequently healed well with good functional outcome.

Habitual dislocation of the patella (HDP) is a common presentation in pediatric age unlike adults. Many surgical procedures using proximal realignment and distal realignment have been reported to treat HDP in children with satisfactory results. However, late presentation of habitual patellar dislocation with osteoarthritis is rare and treatment plan has not yet been established. We present a case of neglected iatrogenic habitual patellar dislocation with osteoarthritis in a 50-year-old woman. Two-staged procedure was planned, first with patellar realignment and later with definitive total knee arthroplasty. Quadricepsplasty, medial patello-femoral ligament reconstruction, lateral release and tibial tuberosity transfer was done as primary procedure and total knee arthroplasty, which was planned as secondary procedure, was deferred as the patient improved functionally.

<p class="abstract"><strong>Background:</strong> ACL injuries result in persistent recurrent instability and increased risk of meniscal tears and intra-articular damage, leading on to degenerative changes in the knee. There are many studies about ACL reconstruction using bone patellar tendon bone graft (BPTB) and its outcome, but there is not enough literature on the subjective assessment following reconstruction. We decided to do a study of the patient’s subjective outcome as per the International knee documentation committee score (IKDC) and other clinical parameters following ACL reconstruction using the BPTB graft.</p><p class="abstract"><strong>Methods:</strong> This was a prospective study consisting of 50 patients who presented with ACL injury and underwent arthroscopic ACL reconstruction using BPTB graft in our hospital in the period from May 2008 to July 2010.  Patients were followed at regular intervals at 4 weeks, 8 weeks, 3 months &amp; 6 months and 1 year. Patients were assessed at every visit with clinical tests and IKDC subjective assessment score.<strong></strong></p><p class="abstract"><strong>Results:</strong> 50 patients with ACL insufficiency underwent ACL reconstruction. Postoperative knee flexion improved; the mean flexion was 131.70 with standard deviation of 6.534, which was significant. The mean preoperative IKDC was 56.97 and standard deviation of 9.188 and postoperative IKDC score was 92.33 and standard deviation 5.198 which showed a marked improvement and was statistically significant. The complications included; 8 patents with anterior knee pain, 1 case of patellar fracture while harvesting graft, which healed with wiring and 2 patients, had re-rupture of ACL due to road traffic accident.</p><strong>Conclusions:</strong> ACL reconstruction with BPTB graft showed a significantly good subjective outcome on assessment using IKDC score. Isolated ACL reconstruction showed a better subjective outcome compared to the patients who had associated meniscal injury.