Explore the vast range of titles available.

Background Patellofemoral arthroplasty (PFA) is indicated for isolated patellofemoral arthritis. PFA is a less invasive, bone-preserving procedure with faster recovery when compared to total knee replacement. We aim to present the functional outcome, survival rate, and complications of PFA from our center. Methods A total of 45 consecutive PFA performed (mean age 58.02 ± 9.2 years; 34 females and 11 males; Avon prosthesis) during the study period was included. Prosthesis survivorship was measured using revision as the endpoint, and functional outcome was assessed using Oxford knee scores (OKSs), EQ-5D, and satisfaction scores. Postoperative complications, the number of revisions, and the reasons causing them were collected. Results The mean follow-up was 48.7 (range 16-66) months. As compared to preoperative scores, OKS and Eq5d showed significant improvements (p<0.001). The satisfaction scores indicated that 28 patients (62%) were very satisfied, 10 (26.7%) were satisfied, and seven (15.5%) were dissatisfied. Four patients (8.9%) underwent revision surgery with a total knee replacement. Out of four patients requiring revision, two had progressive arthritis of the medial compartment, one had aseptic loosening of the implants, and one had trauma. Five patients showed persistent anteromedial knee pain (12.2%); one patient had maltracking requiring lateral release; one patient developed stiffness with knee flexion less than 60 degrees requiring manipulation under anesthesia. Conclusion Our results indicated that good or excellent functional outcomes can be expected in >80% of patients with survivorship of 91.1% at mid-term. Careful patient selection and counseling should be done informing of the risk of dissatisfaction/persistent pain and revision surgery in the mid and long term. Long-term outcomes and factors determining good outcomes need to be evaluated in future research.

This review aims to evaluate the morbidity, mortality, and functional outcomes associated with instrumented posterior lumbar arthrodesis in elderly patients aged 65 years and above. A systematic review and meta-analysis adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted using PubMed/MEDLINE (Medical Literature Analysis and Retrieval System Online), Cochrane, Embase, Emcare, CINAHL (Cumulated Index to Nursing and Allied Health Literature), and the international prospective register of systematic reviews (PROSPERO) databases. Relevant studies were identified based on inclusion criteria, with data extraction focusing on mortality rates, operative duration, blood loss, length of hospital stay, complication rates, and clinical and functional outcomes. Functional assessments included the Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA) scores, and the Visual Analogue Scale (VAS) for pain intensity. Out of 6,241 studies, 45 met the inclusion criteria. The pooled mortality rate was 0.7% (95%CI: 0.2-1.3%), with a mean operative duration of 181.6 minutes (95%CI: 138.8-224.5 minutes) and an average blood loss of 337.8 ml. Complication rates included dural tears (4.3%), neurological deficits (2.2%), metalwork failure (7.06%), and wound dehiscence (3.29%). Significant postoperative functional improvements were observed, with reductions in ODI by 3.47 points, leg pain intensity by 4.29 points on the VAS, back pain intensity by 4.95 points on the VAS, and an increase in JOA scores by 9.9 points. Despite concerns regarding morbidity and mortality, this meta-analysis highlights that instrumented posterior lumbar arthrodesis in elderly patients is associated with considerable improvements in clinical and functional outcomes, supporting its role in the management of degenerative spinal conditions in this population.

Cervical canal stenosis, localized to upper cervical spine, is very rare which can be developmental or acquired. Hypertrophic osteoarthritis accompanied by dens hypertrophy, hypertrophy of the osodontoideum, ossification of the transverse atlantal ligament, aplasia or developmental defect of the posterior arches of Atlas, and unilateral lateral mass hypertrophy are some of the rare reported conditions causing cervical myelopathy. Localized upper cervical canal stenosis due to hypertrophied C1 posterior arch and C2 laminae hypertrophy as an isolated cause of cervical myelopathy has not been reported earlier to our knowledge. We report a case of cervical myelopathy in a 52-year-old gentleman due to the hypertrophied posterior arch of atlas and laminae of axis. C2 laminectomy along with removal of the posterior arch of Atlas and decompression is the treatment. No adjuvant radiotherapy or chemotherapy is needed. The knowledge of such an entity will avoid surprises in the diagnosis and facilitates the management.