Latif Zafar Jilani

Prediction of quadruple hamstring graft diameter for anterior cruciate ligament reconstruction by anthropometric measurements.

Background: The literature is scanty regarding the anthropometric predictors on the diameter of quadruple hamstring graft obtained in anterior cruciate ligament (ACL) reconstruction in Indian population. Minimum diameter of the graft for ACL reconstruction should be >7 mm to preclude failure. The objective of this study was to assess the prediction of the hamstring graft diameter by several anthropometric parameters including age, thigh circumference, weight, height and body mass index (BMI). Materials and Methods: 46 consecutive patients who had undergone ACL reconstruction by the same surgeon using quadruple hamstring grafts were evaluated. The age, thigh circumference of the normal side, height, weight and BMI were recorded preoperatively and Pearson correlation was done using these parameters with graft diameter measured intraoperatively. Regression analysis in a stepwise manner was undertaken to assess the influence of individual anthropometric parameters on the graft diameter. Results: There were 44 males and 2 females. Mean age was 29.4 years, mean height was 172.6 cm, mean weight was 70.9 kg, mean BMI was 23.8 kg/m2, mean thigh circumference was 47.1 cm and mean graft diameter was 7.9 mm. There was a positive correlation individually between the thigh circumference and graft diameter obtained (r = 0.8, P < 0.01, n = 46), and between the height and graft diameter (r = 0.8, P < 0.01, n = 46). On the regression analysis thigh circumference and height were found to be significant predictors of graft diameter giving the following equation: Graft diameter (mm) = 0. 079 height (cm) +0.068 thigh circumference (cm) −9.031. Conclusion: Preoperatively using the above equation if graft diameter came out to be <7 mm then alternate options of graft material must be kept in mind in order to prevent failure.

Unusual cause of anterior knee pain

[No Abstract Available].

Recent concepts of rehabilitation following anterior cruciate ligament reconstruction

Anterior cruciate ligament (ACL) reconstruction is the most common ligament reconstruction done till date. The tendency has inclined toward the surgical reconstruction from conservative means. In this review article, we will discuss the phases of the rehabilitation of the patient following the surgical reconstruction of the ACL. Importance will be given especially on early return of passive motion, early weight bearing, bracing, kinetic chain exercises, neuromuscular drill, and accelerated rehabilitation. There are many young individual who are not recovering enough to regain the preinjured level of activities. In this review article, we will present some of the recent evidences regarding ACL rehabilitation in an effort to help the hectic surgeons and physiotherapist comprehend and associate basic and clinical research to rehabilitation of a patient following reconstruction.

Primary synovial chondromatosis of the first tarsometatarsal joint: a rare case report

Primary synovial chondromatosis is a rare condition and commonly involves a single large joint, although it may involve any synovial joint. It occurs as a result of metaplasia and focal formation of cartilage in the intimal layer of the synovial membrane. Diagnosis could be made after thorough clinical and radiological assessment. Diagnosis must be confirmed by histopathological examination, because malignant transformation has been reported. Here, we report a case of primary synovial chondromatosis on an extremely rare location involving the first tarsometatarsal joint.

Giant cell tumor of acromion process with secondary aneurysmal bone cyst

Giant cell tumor (GCT) or osteoclastoma develops after attaining physeal closure with the most common sites of involvement being the ends of long bones. It is uncommon in the small bones of hands and feet and extremely rare in the flat bones. GCT is a locally aggressive tumor, but in rare cases, it may metastasize to lungs, ribs, regional lymph nodes, and skull. Secondary aneurysmal bone cyst (ABC) may also develop in some cases. Histopathological appearance is pathognomonic in most of the cases of GCT with secondary ABC formation, and immunohistochemistry is rarely needed for a confirmatory diagnosis. The usual treatment is excision or curettage with an adjuvant such as bone cement, liquid nitrogen, and phenol. Involvement of the acromion process is extremely rare. Here, we report a case of a young male having GCT of the acromion process with secondary ABC, and it is the second case reported in literature.