<p class="abstract"><strong>Background:</strong> Osteoarthritis (OA) is most common chronic degenerative disease in orthopaedic practice. The literature pertaining to comparison of the clinical outcome and functional outcome between the metal backed and all polyethylene prosthesis for the total knee replacement are scant.   </p><p class="abstract"><strong>Methods:</strong> A prospective study was undertaken in a tertiary hospital April 2018 to June 2019. The final sample size was 32 cases (40 knees) of newly diagnosed of primary OA knee cases treated with cemented TKR with Metal backed prosthesis and 29 cases (40 knees) with all polyethylene prosthesis. The patients were followed up at 1st, 3rd and 6th post-operative months.<strong></strong></p><p class="abstract"><strong>Results:</strong> Knee clinical score pre-op was not statistically significant. But after 1 month, after 3 months after 6 months, knee clinical score was statistically significant. Knee functional score pre-op, after 1 month, after 3 months, after 6 months was not statistically significant. 87% patients of metal back total knee replacement and 85% of all poly total knee replacement had no pain or just mild pain.</p><p class="abstract"><strong>Conclusions:</strong> Total knee arthroplasty resulted in excellent relief of pain, range of motion, restoration of function, and low prevalence of complications and continues to function well during the follow-up period. Improvement in clinical score in MB group is correlated significantly than all polyethylene group. Knee society scoring system is an effective in evaluating clinical, functional outcomes.</p>

Background: The tibial plateau fractures represent 1 to 2% of all fractures and approximately 8% of the fractures in elderly. Schatzker type V and VI tibial plateau fracture include Complex bicondylar injuries. The literature pertaining to functional outcome of closed bicondylar tibial plateau (Schatzker type V and VI) fractures treated using dual plates as internal fixation are scant. Material and Methods: A prospective study was undertaken in a Tertiary Hospital from April 2017 to June 2019, 30 cases of closed proximal tibia classified as Schatzker's type V and VI fractures (bicondylar tibial plateau fractures) were managed surgically. The patients were followed up at 2 nd , 6 th , 12 th and 24 th postoperative weeks. Results: Average oxford score was 38.5 ± 6.19, maximum (73.3%) of the patients had the score more than 40. The proportion of people having high oxford score was statistically significant (χ 2 =33.9, p< 0.0001). Conclusion:We conclude that open reduction and internal fixation using dual plates, is an excellent method of treatment of closed bicondylar tibial plateau (Schatzker type V and type VI) fractures in judiciously selected cases and we recommend the same.

Background: The ideal surgical management for Acromioclavicular joint dislocation (ACJ) is debatable and is unsolved as newer and more sophisticated techniques are being continuously evolved. The present study evaluates the functional outcome of ACJ reconstruction using the modified Weaver-Dunn procedure in rural setup where availability of latest implant is difficult. Materials and Methods: 30 patients (20 males, 10 females) with ACJ dislocation, between the age group of 18 years to 48 years (mean age 30 years), were operated using modified Weaver-Dunn procedure at our institute from JUNE 2017 to DECEMBER 2019. The dominant side was involved in 25 patients (17 right side, 8 left side). The mean period from the time of injury to the surgery was 8 days (range 3 to 16 days). All the patients were assessed with Oxford Shoulder Score (OSS) and time required to complete functional return to their work was assessed. Results: At the mean follow up of 6 months, the mean Oxford Shoulder Score improved from 23.36 (± 5.56) to 44.0 (± 4.1), 25 out of 30 patients had satisfactory results, while 5 out of 30 patients had mild shoulder dysfunction using Oxford Shoulder scoring system. Of these 5 patients who had mild shoulder dysfunction, 2 developed ossification around the coracoclavicular ligament and 1 patient had intermittent mild pain without any functional disability, 1 patient had a moderate stiffness at shoulder joint movements, and 1 patient had postoperative superficial infection. Conclusion: ACJ reconstruction using the modified Weaver-Dunn procedure in ACJ dislocation in rural setup is a good method and provides a good functional outcome without the use of latest sophisticated implants and instruments.

Background: The aim of this study was to evaluate the role of exchange nailing in isthmus and exchange nailing with poller screw fixation & multiplanar interlocking screws for Distal Third shaft femur aseptic non union. The evaluation was addressed by measuring the clinical, functional and radiological outcome of our treatment methods in both non union groups. Design: Retrospective study. Methods: Between 2006 to 2014, 55 patients with Non Union of shaft femur were operated using a standardised protocol at our institute and followed up for functional and radiological outcome. 5 patients were lost to follow up and thus were excluded from this study. Out of 50 patients, 29 were cases of Isthmus Non union and remaining 21 were cases of Distal Third Non union. Our approach in Isthmus group was closed Exchange nailing with 2mm larger nail with medullary reaming. Some needed isthmus when radiological signs of healing were delayed. In Distal Third group, poller screws were used in conjugation with reamed exchange nailing with a 2mm larger diameter nail and interlocking screws in different planes. Out of the 50 patients, 48 were men and 2 women. Their mean post surgical procedure period at presentation of non union was 11.60 months. Results: Out of a total 55, 5 were lost to follow up- all from isthmus group. In isthmus group, healing was observed in 25 out of 29 patients with union achieved in a mean of 7.60 months. Delayed union was seen in 3 patients and addressed with dynamisation of distal screws leading to union in all cases in a mean of 13 months without further intervention.1 patient had superficial infection which resolved with debridement at 4 months. 1 patient required additional bone grafting for persistent non union and healed at 18 months. Non union was encountered in 3 patients who refused further treatment and accepted functional limitations. Harris Hip Score for this group was 87.40. In Distal Third group, all 21 patients achieved union in a mean time of 10.30 months. No patients required further revisions however 4 patients had superficial infection which was treated with antibiotics and debridement. No further complications were encountered in this group of patients and bony union was uneventful otherwise. Harris Hip Score of this group was 92.40. Conclusion: Using exchange nailing for isthmus and poller screw augmentation for Distal Third Shaft Femur Non union yields excellent clinical, functional and radiological outcome. Exchange nailing with or without poller screw augmentation is a less invasive method to treat aseptic non union of shaft femur fractures without additional complications. Keywords: Nonunion, exchange nailing, poller screw, femoral non union, aseptic non union.