Purpose: Glenoid bone defect and the defect on the posterior-superior surface of the humerus "Hill-Sachs lesion" are the commonly seen bony lesions in patients with recurrent dislocation shoulder. Computed tomography (CT) scan is considered as the best option in assessing the bony defects in the recurrent dislocation shoulder. The aim of this study was to assess the clinical and radiological co-relation in the patients with recurrent dislocation shoulder. Methods: Forty-four patients of recurrent dislocation shoulder who were evaluated between January 2015 and December 2017 at a tertiary care center, clinically and radiologically using CT scan and meeting the inclusion criteria, were included. The correlation between the clinical history of the number of dislocations and the bone loss using CT scan was evaluated. Two sided statistical tests were performed at a significance level of α = 0.05. The analysis was conducted using IBM SPSS STATISTICS (version 22.0). Results: All the patients were male with mean age of 25.95 (SD ± 4.2) years were evaluated. Twenty-four patients sustained injury in sporting activities while 20 patients sustained injury in training. There were an average of 4.68 (SD ± 3.1, range 2—15, median 3) episodes of dislocation. Forty-one patients had the glenoid bone loss while 40 had the Hill-Sachs lesions. The mean glenoid width defect was 10.80％ (range 0—27％) while the mean Hill-Sachs defect was 14.27 mm (range 0—26.6 mm). The mean area of bone loss of the glenoid surface was 10.81％ (range 0—22.4％). The lesions were on track in 34 patients and off track in 10 patients. Conclusions: CT scan of the shoulder joint is an effective method for assessing the amount of bone loss. The number of dislocations are correlated significantly with off-track lesions and the amount of bone loss on the glenoid and Hill-Sachs lesion. The glenoid width bone loss of more than 9.80％ or Hill-Sachs defect of more than 14.80 mm are the critical defects after which the frequency of dislocations increases.

Background: Anterior cruciate ligament reconstruction (ACLR) remains the gold standard treatment for anterior cruciate ligament (ACL) injury. However, a good functional outcome even after a successful surgery depends on multiple factors. It has been observed that certain patients with a chronic ACL injury demonstrate knee instability voluntarily. The authors observed that these patients might not perform well even after a successful surgery. This study aims to assess the outcome after ACL and other ligament reconstruction in patients with voluntary knee instability. Methods: From a total of 824 patients who underwent ACLR, 13 patients with a history of voluntary knee instability were selected, and data of these patients (demographic and clinical profile) were obtained. Outcomes of surgery in this group of patients were evaluated by using Lysholm score and Tegner activity level. Results: All patients were young men with a chronic ACL injury and manifested instability. Associated injuries were lateral meniscus tear in 3 patients, medial meniscus tear in 2, and posterolateral corner (PLC) injury in 3. ACLR was done using the semitendinosus-gracilis graft in all patients. Further, anterolateral ligament reconstruction was done in 2 patients and PLC reconstruction, in 3 patients. The mean Lysholm score was 54.76 (range, 48–62) preoperatively and 60.92 (range, 54–78) at a mean follow-up of 14.3 months (range, 11–26 months). The median Tegner activity level was 6 (range, 5–7) before injury and 4 (range, 3–5) at the final follow-up. Twelve of the 13 patients were able to demonstrate instability voluntarily at the time of the final follow-up. Conclusions In patients with ACL and other ligament injuries who demonstrated voluntary knee instability, the functional outcome even after successful ligament reconstruction was poor.

Purpose::Recurrent dislocation of shoulder (RDS) is a common injury in high demand professionals, like athletes and military personnel. The treatment for the patients with Bankart lesion is the arthroscopic repair. This present study compares the outcomes of two different techniques of arthroscopic Bankart repair i.e. a standard two anterior portals technique and a single anterior portal technique in patients with RDS.Methods::Patients with traumatic RDS met the inclusion criteria were managed with Bankart repair using either two anterior portals (Group A) or a single anterior portal (Group B) technique. Patients were evaluated before the intervention and at the mean follow-up of approximately two years using Rowe score, Oxford shoulder score and Tegner activity scale.Results::The mean age of the patients in Groups A ( n = 34) and B ( n = 37) was 29.64 years and 29.05 years respectively ( p = 0.66). The dominant shoulder was involved in 27 patients in Group A and 22 patients in Group B ( p = 0.069). The operative time in Group A and B was 68.52 min and 46.35 min, respectively ( p < 0.001). The complications at follow-up, the mean Rowe score and Oxford score improved significantly in both groups compared with the pre-operative values. However, the final outcome scores were not significantly different between the both groups. The median Tegner's score preoperatively and at follow-up was 7 and 6, respectively in Groups A and B. Conclusions::Single anterior portal technique is an effective treatment modality, yielding a similar outcome as two anterior portals technique in the management of RDS.