 Today I will be taking you through another interesting journey where we had a visit from 85 year old lady basically an octogenarian who was living alone in her house in Salem and was suffering from pain in the knee on the left side for more than 3 to 4 months of duration. She was referred to as another senior orthopedic surgeon with 11 scans done and what was a bit of issue was that she was not able to put too much weight and walk and carry out a daily activities. When we had a look at the imaging that's one of the x-rays in the MRI what we found that we saw that there was a big area of the bone around the weight bearing part in the around the knee which was basically eaten up. The first thing we suspect in 85 year old is something called as bone metastasis that is a spread of the cancer from any other part of the body to the bone and one of the second points we will see is that is it a manifestation of a blood cancer. So we tried to do our test and immediately I performed a co-needle biopsy basically with a small review and we went through this area and we just took a small chunk of tissue and to a surprise the report came out as something called as giant cell tumor. So what is interesting here is this giant cell tumor we do usually see between 20 years to 40 years of age and there have been very rare the recurrence you know incidents documented in LLE age population. To our knowledge 85 year old with the giant cell tumor is one of the oldest in the world to the literature review which me and my team could both work. So again we tried to go back make sure we're dealing with you know a very benign, aggressive bone tumor that is a non-cancerous tumor and we tried to re-look through the test we tried to only through the biopsy again so that we don't miss anything. We even tried to check the thyroid trying to find out that there's no issue with the thyroid or the parathyroid. So once this was done we actually sat down with the lady and the family and we told them that this is the scenario this is a benign bone tumor and that we need to operate on her so that we can rid of the disease. The two options which we discussed with them was one where we tried to go into the tumor and try to clear up and put a cement at the fixation like this. Let me save the knee joint. Surprisingly her knee was not arthritic even at 85 years of age that means her active lifestyle had helped her you know save her knee quite longer than our other age-related population results which we see. And the other option would have been to actually remove this whole bone and put in a tumor mega prosthesis. So her motivation gave us more impetus to try and go in and clear out the disease. And we did clear it out, put a cement in a plate and as you can see in the post-op net of X trigger she's back to her normal self walking around you know basically going for grocery shopping, going to the bank, taking care of her own need and she still lives alone. So this surgery again was really possible by the help of our Anaseesha team, Cardiology team and basically our geriatric specialist who made sure that even with minor comorbid conditions she had an absolutely comfortable perioperative and post-operative stay and basically she was discharged on the third post-op priority and she was back home taking care of herself. I would like to emphasize that coming early again gives the best of the results and we don't have to do aggressive surgeries to treat the situation or the patient also. Thank you so much.