– Surgical Considerations for Specific Diseases and Conditions: – Medical Assesment: – surgical risk assessment – risk factors for infection: are taken into consideration; – anesthesia consult and posting – anesthesia, medical consderations, and timing for … Read more
– See: Radiology of the Hip: – Discussion: – obtain view w/ 15 deg of internal rotation; – draw a line at level of, & parallel to, ischial tuberosities and intersecting the lesser trochanter on each side; – compare 2 points of intersection & measure difference to determine the amount of … Read more
– Debridement: – all foreign material must be removed from the knee; – retained frags of cement can act as nidus for residual infection; – infected granulation tissue & scar tissue should be excised to provide healthy vascularized soft tissue surrounding the knee. – number of debridements needed before wound closure depends … Read more
– IM Nailing Technique – Open Femur Frx – Radiographs: – look for evidence of a pathologic lesion on x-ray, noting that it would be disasterous if a nail were driven through an occult osteosarcoma or chondroscaroma; – AP pelvis: (rule out concomitant injuries) – Hip Dislocation … Read more
– Evaluate Proximal Stem: – decide whether trochanteric osteotomy is required; – it is essential to avoid a proximal femoral frx while extracting the stem; – direct extraction of a femoral stem can be blocked by excessive cement or proximal bony overgrowth medial to the greater trochanter; … Read more
– Anatomy: – radiographic teardrop: – true floor of acetabulum corresponds to the radiographic teardrop; – teardrop lies in the inferomedial portion of the acetabulum, just above the obturator foramen; – the lateral and medial lips corresponds to … Read more
– Discussion: – is apparent when with stress testing lateral tibial plateau rotates posteriorly in relation to the femur with lateral opening of joint; – atraumatic type: – presents as chronic laxity, often with a varus knee deformity; – this ligamentous laxity often … Read more
– See: – Biomechanics of TKR – Joint Line Position – PCL Retaining TKR – Discussion: – cruciate ligaments are needed for running atheletes, but are not as important to resist forces in thesagittal plane in reconstructed arthritic knee; – theoretically, PCL-substituting TKR allow exposure & ligament correction of PCL-sacrificing prosthesis while reproducing kinematic effects of PCL; … Read more
– Discussion: – thickening of the medial capsular ligament attached proximally to adductor tubercle of femur and distally to tibia & posterior aspect of the capsule; – anatomically this is the third (deep) layer of the medial compartment; – parts of the distal arm: … Read more
– Discussion: – diagnosis: limb is shortened, internally rotated, and adducted; – Thompson and Epstein Classification: – Type I: w/ or w/o a minor fracture – Type II: w/ large single frx of post. acetabular rim; … Read more