Results The gold standard arthroscopic procedure diagnosed 15 peripheral & 6 central TFCC tears in 22 patients. 4 scapholunate ligament tears were also identified. MRI diagnosed 16 peripheral & 5 central TFCC tears in these 22 patients. MRA identified 9 central tears and 14 peripheral tears. The sensitivity in diagnosing an overall TFCC tears with MRI as well as MRA was 94.4 & 100%. The specificity of the MRI and MRA in diagnosing an overall TFCC tear was 100% & 75% respectively. Discussion & conclusions Direct MRA has better sensitivity in detecting TFCC central tears. In view of ‘substantial’ agreement between MRI & MRA with Kappa analysis, conventional MRI can be relied on, in diagnosing TFCC injury. With comparatively low specificity, caution and restraint is advised in interpreting MRA, which may influence decision on surgery. Crown Aim To conduct a systematic review and meta-analysis comparing the incidence of fracture-related infections (FRI) following surgical management of closed and open fractures in HIV-positive and HIV-negative patients. Methods A systematic literature search was conducted using MEDLINE, ProQuest, Web of Science, The Cochrane Library and Scopus. Our own files and reference lists of identified key articles were also searched. We included studies where the primary outcome was the development of FRI in patients with open and closed fractures. Results Eleven studies were included for data synthesis. HIV-positive patients had a non-significant increase in FRI when compared to HIV-negative patients (in open and closed fractures combined). Open fractures treated in the pre-antiretroviral era had a 5.6 times greater risk for developing a FRI. In the post-antiretroviral era (1997 onwards) HIV-positive patients did not have a greater risk of FRI than HIV-negative patients for both open and closed fractures. The small retrospective natures of these studies, together with the heterogeneous outcome definitions used, are limitations to this study. Conclusion While there are few large prospective studies, the available data suggests that before the introduction antiretroviral therapy HIV infection was associated with a greater risk of FRI. In the post-antiretroviral era HIV infected patients did not show an increased risk of FRI. © 2020 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.Periprosthetic distal femoral fractures are occurring in increasing numbers. There is limited research into outcomes and mortality. This study aimed to assess the 1 year mortality and complications requiring further surgery in the two years following a presentation with a periprosthetic distal femoral fracture. A retrospective case series of periprosthetic distal femoral fractures at a single trauma centre was undertaken. All patients were included who presented with a distal femur periprosthetic fracture between 1st January and 2008 and 31st March 2015. 60 patients with 49 females and 11 males. Mean age was 80.7. Median time to surgery was 63 h 42 (70%) underwent open reduction internal fixation, 13 (21.7%) underwent revision arthroplasty and 5 (8.3%) underwent non-operative treatment. Median length of stay was 14 days. There were 12 (20%) complications requiring further surgery within 2 years. There were 2 (3.3%) deaths in 30 days and 8 (13.3%) within 1 year following fracture. Periprosthetic distal femoral fractures are becoming a common orthopaedic presentation. They occur in a complex group of patients and have high rates of mortality and complications. © 2019 Published by Elsevier B.V. selleck products on behalf of Professor P K Surendran Memorial Education Foundation.Background Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) are a well-known pathological entity.We have encountered several patients with MD of the ACL, found to have a anterior translation of tibia a exceeding 5 mm with an intact ACL. We studied this cohort and investigated the likely cause of this. Methods A retrospective search of our department’s radiology system to identify all patients referred from the knee orthopaedic clinic for MR imaging over a span of 10 years. All patients had MD within the substance of the ACL and an intact ACL. We evaluated the degree of anterior translation of the tibia (ATT) in relation to the femur in mucoid degeneration of ACL. Results We identified 464 consecutive cases. The mean age was 52 years. There was a male predominance of 261 to 203 female. The average PTF measurement was 2.4 mm with a range of 0-20mm. Of the 464 cases, 3 397 patients had an insignificant ATT of 5 mm. Of them, 32.8% had a ATT of 6 mm, 53.7% had a ATT range between 7 and 9 mm, with the remaining 13.4% above 9 mm in length. Conclusion It is essential to look for other secondary signs of ACL tears and not only focus on ATT as well as correlate this with clinical findings. © 2020 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.Background End stage arthritis in young patients requires surgical intervention. THA remains the treatment of choice for restoring function and activity in end stage hip arthritis. The medium term outcome of uncemented THA in Indian population is less studied. Hence this study was taken up with aim to study clinical and radiological outcome of uncemented THA in patients with age less than 40 years. Methods This study was conducted during January 2013 to December 2013. Overall 66 patients with 74 arthritic hips were operated by single surgeon (1st Author) with Uncemented THA. All patients were either unilateral or bilateral arthritis of hip less than 40 years of age. Patients were evaluated preoperatively and postoperatively. After discharge patients were followed up at regular intervals. Activity level and Harris Hip score was calculated. Radiological evaluation was done with anteroposterior and lateral X-rays. Results Total 50 patients (56 hips) followed up at five year follow-up. Clinical and radiological evaluation was done during follow-up. Most common etiology was avascular necrosis of hip (56.6%). None of the patients had any major complications. Mean Harris Hip score improved from 36 to 92. The activity level was assessed at five year follow-up with maximum patients in moderate manual labor category. Bony ingrowth with no evidence of loosening was seen consistently both on femoral and acetabular side in all patients on X-ray. No statistically significant association was found between initial alignment of the femoral component and clinical outcome. Conclusion Uncemented THA can be used in young patients with excellent to good functional and radiological outcome at midterm follow-up, high satisfaction rate and lower rate of complications. © 2019 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.