Satya Kumar Koduru

Abstract

Osteoarthrosis of knee is the most common cause of disability in the older. Pain and limitation in the mobility of knee are the major causes of disability. Total knee arthroplasty, which aims to relieve pain, improve joint function and mobility, is the main surgical treatment in this patient population Proximal fibular osteotomy is the new alternative in the young patients with arthritis of medial compartment. From July 2016 to July 2017, 60 consecutive patients who underwent PFO at our hospital were followed prospectively (n = 37; age range, 48 – 72 years; 40 female, 20 male) with follow-up at 3,6,9 weeks, 3months, 6months, 9months, 12months, and 24months post-operative. Out of 60 patients who underwent PFO medial pain relief was observed in 54 patients after PFO with in one or two days post operatively remaining 6 had no change in pain . Results showed an increase in mean visual analog score (from 8.02+/- 0.50 to 2.74+/-2.34) and an improvement in knee and function subscore of american knee society scores (pre operative 44.41 +/-8.90 and 41.24 +/-13.48 post operative 69.02+/- 11.12 and 67.63 +/-13.65) and an increase inratio of medial/lateral joint space ratio (pre operative 0.20 +/-0.28 post operative 0.48+/- 0.30). Postoperative complications like paresthesias on dorsum of foot were observed in 6 patients, which recovered by 6 to 12 weeks. Thus we conclude that proximal fibular osteotomy is a safe, simple and affordable day care surgery that doesn’t require insertion of implants. Keywords: PFO, OA knee, Medial compartment OA.

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Abstract

Introduction: The Anterior Cruciate ligament (ACL) is the primary stabilizer of the knee and prevents the knee against anterior translation. Arthroscopic reconstruction of torn ACL has become the gold standard in treating ACL tears. The surgical reconstruction of the anterior cruciate ligament with auto graft represents an attempt to reestablish knee kinematics. Materials and Methods: This is a prospective type of study conducted at NRI Medical College & General Hospital, Chinna Kakani, Guntur, Andhra Pradesh. During the period of December 2015 to November 2017 in ACL injuries, reconstruction of ACL using autologous quadruple hamstrings graft. All the cases were operated electivley on regular operation theatre days. Results: The present study consists of 30 cases of complete ACL tear treated surgically with arthroscopic ACL reconstruction. In age distribution, 10 (33.3%) patients were between 18-24 years, 13(43.3%) were between 25-31 years and 7(23.3%) were between 32-38 years. In sex distribution, there were 27 (90%) males and 3(10%) females. Left lower limb was involved in 12 (40%) cases and right lower limb in 18 (60%) cases. All the cases were operated electivley on regular operation theatre days. ACL associated with medial meniscus injury in 8(26.6%) and ACL associated with lateal meniscus injury in 2(7.2%). Chronic ACL injury in 22(73.33%) and acute ACL injury in 8(26.6%). Post operative complications like Anterior knee pain in three patients(10%) treated with analgesics, Infection (Superficial)in one (3.3%) treated with intravenous antibiotics, deep Infection in one (3.3%) treated with intravenous antibiotics+ debridement finally hardware removal and extensor lag in one (3.3%) treated with rehabilitation. Conclusion: Clinical outcome after arthroscopic anterior cruciate ligament reconstruction using autologous quadrupled hamstrings graft with post operative rehabilitation is excellent to good and patients will have near normal pre injury activity level. Keywords: Anterior Cruciateligament (ACL), Quadruple hamstrings graft, Arthroscopy.

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