Current available implants for total knee replacement are based on the mormphometry of the Caucasian knee. We believe there are significant morphometric differences in the Asian knee that will be relevant in future implant designs. Sixty nine consecutive patients (80 knees) underwent computer navigated primary total knee arthroplasty. The anterior posterior (AP) length, and the medial lateral (ML) width of the distal femur, were analyzed, with respect to the final sizing details of four implants (femoral component) commonly used locally. The mean AP length was 59.9 (SD 4.8) mm, and the mean ML width was 65.0 (SD 5.0) mm. The overall mean aspect ratio (ML/AP) was 1.09 (SD 0.07). The mean aspect ratio for females was 1.08 (SD 0.07). Both were smaller than the aspect ratio of the implants which ranged from 1.11 to 1.13. All four implants tend to overhang at the medial lateral width of the distal femur. This is more obvious in females. Future implant designs should provide more ML wdth sizes for a given AP length, in addition to gender differences, for ths population.
Orthopaedic

According to recently reported outcome studies, functional outcomes after arthroscopic rotator cuff repair are reasonable and comparable to open or mini open techniques. We report the functional outcomes after arthroscopic rotator cuff repair of 10 consecutive patients. The average age was 53.9(range 46 59) years. There was a significant improvement of the function of the shoulder when the preoperative scores were compared with those at the time of at least six months follow up (range of 6 months to 18 months). With the UCLA rating scale, the average total score increased from preoperative 9.8 (range, 6 15) to postoperative 32.6 (range, 23 35). With the use of ASES shoulder index, the average total score improved from 14.6(range, 1.6 35) to 92.3 (range, 66.6 to 100). We concluded that arthroscopic rotator cuff repair is a treatment method in selective patients with symptomatic rotator cuff pathology to alleviate shoulder pain and improve function.
Orthopaedic

Chance fracture is an unstable vertebral fracture, which usually results from a high velocity injury. An elderly lady with a previously healed osteoporotic fracture of the T12 and L1 vertebra which resulted in a severe kyphotic deformity subsequently sustained a Chance fracture of the adjacent L2 vertebrae after a minor fall. The previously fracture left her with a deformity which resulted in significant sagittal imbalance therefore predisposing her to this fracture. This case highlights the importance of aggressive treatment of osteoporotic fractures in order to prevent significant sagittal imbalance from resultant (i.e. kyphotic) deformity.
Orthopaedic

Pagets disease is common in Western countries but is very rare in Chinese populations. Although bisphosphonate has been widely used to treat symptomatic Pagets disease, prolonged use may be associated with insufficiency fracture. We highlight this rare case of Pagets disease in a Chinese lady who presented with an insufficiency fracture following long term use of bisphosphonate.
Orthopaedic

Objective: The aim of this study was to evaluate the role of polymerase chain reaction (PCR) in the diagnosis of spinal tuberculosis after 2 weeks of preoperative anti tuberculosis treatment and to compare PCR to the Lwenstein Jensen Culture (LJC) and histopathological examination (HPE) methods. Methods: Twenty five patients were included in this study. Sixteen patients were diagnosed and treated for spinal tuberculosis based on clinical and radiological evidence. Nine patients were controls. The LJC me
Orthopaedic

Objective: To review the presentation and outcome of developmental dysplasia of the hip (DDH) cases in the last 6 years. Methodology: We retrospectively reviewed the presentation as well as short and mid term outcome of 17 children (18 hips) with DDH seen and treated from 2004 to 2010. Treatment was either splinting with Pavlik harness, closed or open reduction depending on age at presentation and the individual needs of each patient. Results: The average age at presentation was 31.1 months, and the male t
Orthopaedic

Intertrochanteric fracture of the femur is one of the commonfractures in the elderly. Dynamic Hip Screw (DHS) fixation is the gold standard for treatment of intertrochanteric femoral fracture. Conventional methods of achieving reduction prior to instrumentation require utilization of a traction table. A manual traction technique applied in the supine position using only a translucent table was devised to do away with the use of traction table. The rationale for this technique includes enhanced ease of set
Orthopaedic

Talar neck fractures (TNFs) are complex injuries and treatment is fraught with complications. We retrospectively studied 18 patients with TNFs: 6 Hawkins type I, 7 type II, 4 type III, and 1 type IV. Five patients with type I and 2 with type II fractures were treated conservatively. The remaining 11 patients underwent operative treatment. Open reduction via posterolateral approach was performed in 10 patients while closed reduction was used in one patient. All operatively reduced fractures were stabilized
Orthopaedic

Background: The modified Stoppa approach was first described in 1993 by Hirvensalo as an alternative to the ilioinguinal approach for treatment of pelvic ring fracture. Methods: This is a retrospective study of 5 patients with unstable pelvic fracture treated with internal fixation using the modified Stoppa approach. Residual displacement of the pelvic ring was measured and graded using the methods described by Matta and Lindahl. Functional outcomes were assessed using the modified Merle D Aubigne and Pos
Orthopaedic

This retrospective study was undertaken to evaluate the outcome of primary total knee arthroplasty (TKA) performed from January 1986 to December 1997 at this institution. Case review included Knee Society scores and functional knee score. The records of 94 patients (128 knees) were available for analysis with the sample comprised of 76 females (80.9%) and 18 males (19.1%) and a mean age was 61.4 years. TKA was performed for osteoarthritis (OA) in 96 knees (75%) and rheumatoid arthritis (RA) in 32 knees (25
Orthopaedic