Forgotten intrauterine contraceptive device - A threat to total hip prosthesis: A case report with review of the literature.

Primary total hip replacement has become a routine procedure these days. With improvement in surgical techniques and implant designs, the survival rate of prosthesis has increased significantly but unfortunately, prosthetic infections though uncommon continue to be a threatening complication. We present a detailed review of the literature along with a case report of infected total hip prosthesis in a 36-year-old female who had been operated 6 years back. The causative organism was found to be Actinomyces israelii which was related to an infected intrauterine device used for contraception that had been forgotten after being implanted 8 years earlier.

Evaluation of clinical diagnosis by knee arthroscopy.

This prospective study was carried out in the orthopaedic department of a medical college to evaluate the accuracy of clinical diagnosis by knee arthroscopy. The reliability of clinical assessment (history and physical examination) was determined by comparing the initial pre-operative diagnosis with the postoperative diagnosis as determined by arthroscopy. The study group included 50 patients (50 knees) scheduled for arthroscopic surgery for suspected internal derangements of knees. The primary pre-operative diagnosis was fully correct in 16 cases (32%), partially correct in 16 cases (32%), and incorrect in 18 cases (36%), with an overall accuracy of 81%, sensitivity 82% and specificity 62%. The most common pre-operative diagnosis was medial meniscal tear and anterior cruciate ligament tear. The results of clinical assessment were comparable to the published reports. Though the present study suggests that the diagnostic value of arthroscopy is higher than clinical examination but it also makes it apparent that the two techniques complement each other and are more accurate when taken together than individually.

Traumatic inferior hip dislocation in an adult with ipsilateral trochanteric fracture.

Traumatic Inferior dislocation of hip in adult is an extremely rare occurrence. We report a case of an inferior hip dislocation associated with an intertrochanteric fracture. Treatment consisted of an initial closed manipulative reduction of the dislocation with the aid of a Schanz screw inserted in a T handle universal chuck and using C-arm imaging. A dynamic hip screw was then used to fix the intertrochanteric fracture. At 2.5 years after the injury, the patient has symmetrical range of motion versus his contra lateral normal hip. Radiographs of the hip show normal anatomy without signs of avascular necrosis of the femoral head. To our knowledge, this is the first reported case of an adult with an inferior hip dislocation with a trochanteric fracture.