Is there a role for total ankle replacement in polio patients?: A case report and review of the literature.

Although poliomyelitis is almost eradicated, as orthopaedic surgeons we occasionally encounter residual deformities in patients who suffered the disease in the past. An equino-varus deformity of the foot is the commonest deformity seen. In this report we present a 53 years old lady who had poliomyelitis as a child and presented with a painful, degenerate ankle and 12 degrees of varus deformity. CT confirmed advanced degenerative changes. The management options included realignment and fusion, supramalleolar ostoetomy or total ankle replacement. In view of the satisfactory active range of motion and advanced OA confirmed by CT scan we considered the option of total ankle replacement. To our knowledge this has never been reported before. At two and half years follow up the patient showed satisfactory functional results (AOFAS score 88/100) and high satisfaction. Plain radiographs revealed a well aligned joint with no evidence of loosening or osteolysis.

Hallux varus: A literature review.

Hallux varus is a rare foot deformity due to iatrogenic, post-traumatic, idiopathic, inflammatory, spontaneous, or congenital pathologies. Acquired hallux varus, in particular, iatrogenic type, is the commonest. The primary pathology is the abnormal musculotendinous forces secondary to soft tissue or bony imbalance exerting varus deforming force. Understanding the anatomy of the hallux stabilisers and the pathophysiology of hallux varus is vital in its management. It would be helpful to understand the potential surgical pitfalls leading to iatrogenic hallux varus. This literature review summarises all the published facts about hallux varus, focussing on anatomy, pathophysiology, clinical and radiological assessment, and management.

Interesting clinical presentation of anterior knee pain causing diagnostic dilemma.

A diverse variety of lesions may occasionally occur in the patella. In this case report, we are presenting an interesting case of anterior knee pain in middle aged gentleman. Initial investigations including Magnetic Resonance Imaging not showed any abnormality. Due to prolonged continued pain he had bone scan and MRI, which confirmed the diagnosis of Brodie's abscess. We are presenting this case of Brodie's abscess of the patella causing diagnostic dilemma because of its rarity.

The influence of postoperative coronal alignment on revision surgery in total knee arthroplasty.

This study examines the association between postoperative coronal tibiofemoral alignment and revision surgery in knee arthroplasty. We retrospectively reviewed the case notes and post-operative long-leg radiographs of 197 Kinemax knee arthroplasty with mean follow-up of 9 years (SD 2.2). They were divided into three groups: neutral, valgus and varus. Revision or decision to revise was used as a hard endpoint. There was no statistical difference among the three groups (p=0.78). We conclude that aseptic failure of a total knee is multifactorial. Coronal tibio-femoral alignment may not be as important a cause of failure as has been previously thought.