In February and March 2004, 35 hip and 15 knee arthroplasties were performed. Indications for surgery included primary OA, avascular necrosis and fractures. Revision surgery was performed for aseptic loosening and recurrent dislocations. There were three revision hip arthroplasties and three arthroplasties were done for subcapital femoral fractures. The mean age of the patients was 64.2 years (33 to 84). The male to female ratio was 1:1.5. Both cemented and uncemented implants were used.

In the hip arthroplasties, the mean intraoperative blood loss was 515 ml (300 to 1520 ml). Intraoperative blood loss was minimal in the knee arthroplasties. Postoperative suction drainage averaged 477 ml for the hips and 925 ml for the knees. Postoperative blood transfusions were administered in seven patients. The mean time to mobilisation was 3 days postoperatively, and discharge was on day seven.

Early complications included superficial cellulitis in four patients, who were treated with intravenous antibiotics. After a knee replacement one patient developed a haematoma, which drained spontaneously. One patient had an early dislocation. Three patients developed upper respiratory tract infections. One 32-year-old man developed intraoperative pulmonary fat embolism and required ventilation for 24 hours. Following a knee replacement, one patient developed a transient drop foot, which improved after 24 hours. No incidence of clinical DVT was encountered.

Hip and knee arthroplasties are major procedures. Adequate preoperative evaluation to identify potential risks could limit major complications.

Between 1997 and 2002, seven talipes equino varus deformities in six patients were treated using gradual distraction and correction with the Ilizarov external fixator. Three patients had poliomyelitis, four patients had neglected clubfeet and two patients had relapsed club-feet. The mean age of patients was 13.3 years (5 to 21) and the mean duration of fixator application was 3.25 months. When the plantigrade position was achieved the fixator was removed and a below-knee walking cast was applied. Four months after fixator removal, additional bony correction surgery (triple arthrodesis) was done in three patients. At the time of fixator removal, a plantigrade foot was achieved in all patients.

The mean follow-up time from surgery was 26 months. Pin-tract sepsis in two patients was treated effectively with oral antibiotics. Other complications included meta-tarsophalangeal subluxation from flexor tendon contractures in one foot. There have been no recurrences of deformities.

Compared to preoperative status, gait was subjectively improved in all patients. Correction of the deformity in the patients who had a triple arthrodesis of the foot was achieved with less bone loss than in patients who had undergone a primary triple arthrodesis. These results suggest that treatment with Ilizarov frames is effective in the management of neglected and relapsed clubfoot deformities.