Aim: To compare the outcome of primary ACL reconstruction in patients who had either an autograft or allograft ACL procedure for symptomatic instability.

Methods: 21 patients reviewed and assessed between 2 and 8 years post ACL reconstruction using patient centred scoring methods.

Results: 21 patients underwent isolated primary ACL reconstruction. 14 patients underwent reconstruction with autologous patellar tendon “bone-tendon-bone” ipsilateral graft (mean time post op 3.55 years) and 7 had “bone-tendon-bone” allografts (mean time post op 2.13 years). Both operations were performed through an open approach. Previously validated Knee Outcome Survey of the Activities of Daily Living Scale questionnaires were completed for all patients and also a single score for overall satisfaction with the outcome.

Overall levels of patient satisfaction and function were good. Testing the data with a one-sample t-test showed that donor graft patients showed higher levels of satisfaction, higher knee scores and less pain than autologous graft patients (p< 0.01).

These data suggest that although autologous grafts are more commonly performed, there is an improved outcome in the group of patients following donor grafting of the ACL.

Introduction: The incidence of Peri-prosthetic fractures is about 1% following Lower limb arthroplasty. The management of these fractures is difþcult,complex,challenging and controversial. Aim of Study: To study the results of Dal- Miles Plating system in Peri-prosthetic fractures. To þnd the difference, if any in the outcome of Transverse vs. Spiral fractures. Material and Methods: 13 patients, who were treated with Dal-Miles plating for periprosthetic fractures in last 4 years in our hospital, were reviewed. There were 7 females and 6 males. Average age of the patients was 73.8 years. Fractures were classiþed according to Vancouver classiþcation. Fractures were also classiþed according to their pattern into Transverse and Spiral Fractures. Results: There was high rate of complications during the postoperative period with half the patients having some complication. (Implant failure-3, malunion-1, Infection-2, Fracture distal to plate-3). All the patients who had Implant failure had transverse type of Fracture. No patient with spiral type fracture had non-union. Conclusions: Treatment of Peri-prosthetic fractures with Dal-Miles Plating is complicated and associated with high rate of complication. Transverse type fractures have high rate of failure (50% in our study) following þxation with Dal-Miles Plating system.

Low lumbar pain with radiation into the leg is a common symptom pattern caused by a number of pathological processes. Isolated disc resorption is one such entity which can be readily identified and is amenable to surgical treatment. This study consisted of two groups of patients. Group I were 50 patients suffering from isolated disc resorption at L5--S1 with ill-defined low backache extending into the buttocks and down one or both legs, but not into the feet. Clinical signs of nerve root dysfunction were found in 16 per cent of patients. Radiographic changes with loss of disc height, facet over-riding and intrusion into the nerve root canal and intervertebral foramen were common and frequently associated with sclerosis of the vertebral end-plate. Group II were a series of 45 patients with isolated disc resorption independently reviewed an average of 45 months after surgical decompression of the S1 (98 per cent) or lower lumbar nerve roots. Based on objective grading by the clinician and subjective assessment by the patient complete success was achieved in 62 per cent of the patients and partial success in 24 per cent. Provided there is full appreciation of the pathological anatomy, strict diagnostic criteria and meticulous surgery, decompression of the nerve root canal is a useful surgical procedure in severely disabled patients suffering from isolated disc resorption.