Bilateral Total Hip Arthroplasty in 20 Years Old Female with Neglected Developmental Dysplasia of Hip.

INTRODUCTION: Management of developmental dysplasia of hip in adult is challenging problem. Management protocols are not well defined in terms of operative technique. Patient may present very late. Usually they consult orthopaedic surgeons when osteoarthritic changes set in, leading to pain. Operative management is difficult because of difficult exposure, altered anatomy of soft tissue structures, hypoplastic femoral medullary canal and shallow and atypical acetabulum filled with soft tissues. Femoral head is up-ridden with contracted Abductors which resists reduction of femoral head into acetabulum. Altered anatomy of neurovascular structures also pose a risk of being injured during surgery. CASE REPORT: Here we are presenting a case of bilateral total hip arthroplasty in 20 years old female with developmental dysplasia of hip and sharing our experience of its operative management. CONCLUSION: We concluded from this case study that total hip arthroplasty in developmental dysplasia of hip is technically demanding but gives good functional and clinical result. For getting functionally good result contracted soft tissues around joint need special attention.

Arthroscopic synovectomy in pigmented villonodular synovitis of the knee: clinical series and outcome.

PURPOSE: The aim of this study was to evaluate the long-term results of arthroscopic excision of pigmented villonodular synovitis (PVNS) of the knee joint. METHODS: We retrospectively assessed the results of arthroscopic excision of PVNS done in 40 patients from 1987 to 2012 by the senior author (JVS). No radiotherapy was given to any patient. All patients were followed for a mean of seven years. At follow-up functional assessment was done using the Lysholm score. Recurrence-free survival and recurrence-free survival probability were calculated. RESULTS: No recurrence was noted in the localised variety. In the diffuse variety the five year recurrence-free survival probability was 57%. Twelve patients developed recurrences between three months and two years. No recurrence was noted after two years. The mean recurrence interval was 6.25 months. CONCLUSIONS: We concluded from this series that arthroscopic excision is an effective treatment for localised as well as diffuse PVNS. Recurrences can also be successfully dealt with by arthroscopic excision with excellent functional outcome.