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Legg-Calves-Perthes disease (LCPD) has a poor outcome leading to disability and early onset of osteoarthritis. Patient aged less than 8 years have usually good prognosis and are usually managed conservatively. The primary goal is to achieve spherical and congruent femoral head to reduce the chance of further subluxation of femoral head and secondary arthritis of the hip. Methods. The study aimed to analyze the radiological and functional outcomes of group-A (LSA) and group-B (LSA and trochanteric epiphysiodesis) in cases of LCPD. Our study retrospectively analyzed 80 patients (45 in Group-A and 35 in Group-B) between 2008 and 2018, 63 patients were boys and 17 patients were girls. Patients who did not respond to the conservative treatment over the course of 6 months and patients with Caterall type-II and III were taken into the study. Radiological parameters like Center edge angle, sharp angle, medial joint space distance, epiphysis height ratio, acetabular coverage, neck-shaft angle, articulo-trochanteric distance was noted for comparing radiological outcome. Results. Most of the patients in both the groups were Catterall-III -- 66.25 % and Catterall-II -- 33.75 %. According to Stulberg classification, excellent outcome was seen in 22.2 % of group A patients & 37.1 % of group B patients. Similarly, 15.5 % patients in Group A and 5.7 % patients in Group-B had bad outcome. Radiological and functional assessments were evaluated preoperatively and postoperatively till skeletal maturity which showed significant improvement in Group-B. 4 (8.8 %) patients in group-A and 3 (8.5 %) patients in group-B developed non-union & graft resorption was seen. Conclusions. Lateral shelf acetabuloplasty along with trochanteric epiphysiodesis helps in improving the neck shaft angle, gait, containment of subluxated head and maintains its congruity along with physiological remodeling. We recommend this combined procedure in cases of LCPD to counter the complications of early-onset arthritis and femoral head subluxation. [ABSTRACT FROM AUTHOR]

Introduction: Stroke is the primary cause of functional dependency in daily activities leading to disability of the individual. It becomes an economic burden for the person and society. Post-stroke management in rehabilitation gives more emphasis on improving functional performance. The improvement in functional activities of post-stroke survivors makes them independent in their daily activities at home but, still an impediment exists to participate in society and reintegrating into the community. The objective of the study is to find the association of community reintegration with the functional performance of one-year post-stroke survivors in eastern India and to compare their functional independence, community reintegration, and participation in instrumental daily living activities between stroke affection side and stroke subtype of the study group. Materials and Methods: A cross-sectional observational study was carried out on post-stroke survivors between 30 and 60 years of age without sex barrier. Ninety-four patients (mean age 54.38±12.06) were recruited for the study. The outcome was measured by the community integration questionnaire (CIQ), Lawton instrumental activities of daily living (LIADL), and functional independence measure (FIM). Results: Spearman rank order correlation was used and found a significant positive correlation persists between FIM to CIQ as the r=0.565 (P=0.01, 95% CI, -0.40%-0.70%) and LIADL to CIQ r=0.687 (P=0.01, 95% CI, -0.55%-0.79%) FIM to LIADL r=0.532 (P=0.01, 95% CI, -0.36%-0.67%). Mann-Whitney U test was done to compare FIM, LIADL, and CIQ between stroke affection side (right vs left) and stroke sub-type (ischemic vs haemorrhagic), and no significant difference was found. Conclusion: Functional independence, instrumental activities of daily living, and community reintegration are associated with each other. Hence, community reintegration should be incorporated into stroke rehabilitation to maintain a meaningful life as a part of society and family. [ABSTRACT FROM AUTHOR]

Background: Medial knee osteoarthritis can contribute to pain and stiffness, interfere with balance and limit functional activities of daily living. Unloader knee orthosis or lateral wedged insoles are current conservative approaches used to treat these conditions. The aim of this study was to identify and compare the effects of them on the balance parameters. Methods: 66 subjects with mild to moderate medial knee osteoarthritis were randomly assigned to wear unloader knee brace or full-length 6° lateral wedge insole. Primary outcome balance parameters were stability %, path length and average velocity of center of pressure and mobility score which were investigated by HUMAC® Balance and Tilt system. Secondary outcome measures were knee function score using Knee Injury and Osteoarthritis Outcome Score scale. Assessment was performed at baseline and six months post orthotic intervention period. Findings: Both orthoses improved all parameters compared to the baseline condition (p < 0.05). Unloader knee orthosis showed a significant improvement in all balance parameters compared to lateral wedged insoles (p < 0.001) except mobility scores (p=0.527). Except activities of daily living (p=0.752) and sports and recreational activities (p=0.437), unloader knee orthosis had a greater effect on the pain (p=0.002) and symptoms (p < 0.001) sub scales than lateral wedged insoles. However, quality of life sub-scale scores for insoles were more effective than the knee orthosis. Interpretation: Unloader knee orthosis improved balance and knee function scores more than lateral wedged insole, though both orthoses produced significantly improved results compared to baseline assessment. [ABSTRACT FROM AUTHOR]