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Careful pre-operative evaluation and planning are necessary for patients with risk factors to avoid poor outcome. A stable internal fixation abiding the standard principles of fracture fixation and arthroplasty is needed to achieve a satisfactory functional and radiographic outcome, thus avoids early prosthetic failure.

The resident's ridge is an arthroscopic landmark that is consistent with the anterior border of the anterior cruciate ligament (ACL) femoral attachment. The identification of the landmark allows for accurate graft placement.

We report a case of a 30-year athletic individual with an ACL-deficient knee, who had an abnormally large resident's ridge, abutting the midsubstance of the torn ACL; the residual femoral attachment was behind the ridge. Resection and burring of this ridge were needed to expose the posterior aspect of the intercondylar notch; even after bone-patellar tendon-bone graft placement, some additional removal of bone had to be done to reduce graft impingement on this area in extension.

Abnormal resident's ridge may be misleading about the anatomy of the lateral femoral condyle area. Appropriate resection of abnormal bone is the key to the identification of femoral footprint and graft placement. We speculate that this bony projection may even have contributed to the ACL injury, and extra bone had to be removed to minimize subsequent impingement.

Abnormal resident's ridge may be misleading about the anatomy of the lateral femoral condyle area. Appropriate resection of abnormal bone is the key to the identification of femoral footprint and graft placement. We speculate that this bony projection may even have contributed to the ACL injury, and extra bone had to be removed to minimize subsequent impingement.

Osteoid osteoma (OO) is a common tumor of the diaphysis of long bone, where the reported incidence is up 10% of all benign bone tumors. Its presence in flat bone is seldom mentioned in literature and can be misleading when the bone involved is in proximity to a zone of wide variety of possible pathology. We report a case of a young patient with OO in a very rare location of the body -the scapular neck - that was misdiagnosed for a long period of time before receiving adequate therapy.

A 20-year-old female patient presented to the clinic with chronic left shoulder pain. During the past 2 years, she received medical and physical therapy, to deal with different diagnosis such as cervical spine pathology, muscular spasm, and rotator cuff disease. However, she did not improve. At time of presentation to our clinic, radiographs of the shoulder were done and turned to be inconclusively normal. After negative magnetic resonance imaging of the cervical spine, a computed tomography scan of the shoulder was done and a common benign neoplasm with high variable clinical picture and anatomic localization. Despite being more common in long bone, flat bone OO localization should be always kept in mind. Careful history and physical examination should be done for each patient presenting with unexplained pain; night pain should always raise suspicion of this condition. Radiographs are not always conclusive, and the patient with high suspicion of this condition should undergo more investigation to make the diagnosis.

Reconstruction of the anterior cruciate ligament (ACL) is a common procedure. Injury is the predisposing risk factor for developing heterotopic ossification(HO). We like to report a case of HO of the knee following arthroscopic ACL reconstruction.

A29-year-old patient was admitted with complaints of painful instability of the left knee after a fall from bike. MRI study confirmed a complete ACL rupture along with tear of the body and posterior horns of the medial meniscus. ACL reconstruction was carried out using ipsilateral hamstring tendon graft by knee arthroscopy. Eight months after the procedure, the patient complained of pain in the lateral side of the knee joint evidencing a slight prominence of hard consistency. The radiological study confirmed it to be a case of HO. The patient was managed conservatively.

Bone is the only tissue that has an incredible property as such that it can differentiate and develop into its mature form outside its native locations. Numerous studies have suggested ways of preventing and treating this complication. One has to be aware that even these simple surgical procedures can lead on to HO.

Bone is the only tissue that has an incredible property as such that it can differentiate and develop into its mature form outside its native locations. Numerous studies have suggested ways of preventing and treating this complication. R788 One has to be aware that even these simple surgical procedures can lead on to HO.

In cases with markedly decreased hip function, patients predominantly utilize spine movement while standing up to compensate for the hip malfunction. However, spinal fusion surgeries might lead to the disruption of this compensatory mechanism, resulting in difficulties in walking and standing up as well as proximal junctional failure (PJF) due to the excessive stress on the spine caused by the pendulum-like motion needed for standing up. Hence, in patients with severe hip pathology, surgeons should be cautious about the indication for spinal fusion, which inevitably affects spinal mobility. This is the first report presenting a case that supports the aforementioned theory.

In this study, we report the case of a 76-year-old Japanese woman who underwent corrective spinal fusion surgery for spinal scoliosis secondary to hip contracture. The patient exhibited post-operative complications, such as unexpected difficulty in walking and standing up and PJF. The patient underwent a revision spinal surgery with an extension of spinal fusion for PJF and muscle release around the hip for hip contracture which resulted in improved walking and standing movements with no reports of pain.

Spinal fusion surgeries performed on patients with severe hip pathology could cause early PJFs and unexpected decline in activities of daily living. Patients with such risks often do not complain of hip symptoms before spinal correction surgery. Surgeons should routinely evaluate hip joints and be cautious about the indication for spinal fusion which inevitably affects spinal mobility.

Spinal fusion surgeries performed on patients with severe hip pathology could cause early PJFs and unexpected decline in activities of daily living. Patients with such risks often do not complain of hip symptoms before spinal correction surgery. Surgeons should routinely evaluate hip joints and be cautious about the indication for spinal fusion which inevitably affects spinal mobility.