Revision Total Knee Arthroplasty – Assistance provided by Michael Berend MD – PreOperative Considerations and Implant Selection: – work up of the painful TKR: – Surgical Approach: (Surgical Approach for Primary TKR); – Component Removal: – prior to component removal, take the knee thru a range of motion and evaluate patellar tracking and … Read more
– Discussion: – for cemented femoral revisions to be successful it is imperative to debride and remove the medullary soft tissue membrane and neocortex in the medullary canal, and to also use modern cementing techniques – consider addition of antibiotics to cement to prevent infection; – revision femoral stem … Read more
– See: Unstable Intertrochanteric Fractures – Discussion: – in reverse oblique fractures, the major frx line extends from proximal-medial to distal-lateral through intertroch-subtrochanteric region; – marked tendency toward medial dispacement of shaft 2nd hip adductors; – tendency for medial shaft migration may result in … Read more
– Discussion: – indicated for disruption of anterior pelvic ring frx: (APC II)when conditions for open forms of fixation are not optimal; – serve as an alternative to standard plating techniques for pubic ramus fixation; – in the case of pubic ramus frx in addition to symphysis dislocation, the retrograde screw is … Read more
– Discussion: – may be indicated for: – combined fractures of the femoral neck and shaft and for distal femoral fractures; – multi-trauma patient (procedure can be performed in supine position on regular flouro table); – obese patients (starting hole is not a problem); – advantages: – avoids damage to the blood supply to the … Read more
– Discussion: – Ascending Cervical Branches travel proximally under the hip capsule and continue proximally along neck deep to synovial membrane toward the femoral head; – these arteries are known as retinacular arteries; – as cervical arteries traverse superficial surface of femoral neck, they send many … Read more
– See: Total Hip Replacement Menu: – Discussion: – in most pts w/ chronic infection, surgeons continue to advocate complete removal of the prosthesis and the cement; – in especially difficult cases, resection arthroplasty is an effective means of controlling infection; – as expected patients will have … Read more
– Rotator Cuff Tear – Discussion: – arthroscopic repair techniques – clinical outcomes of repair – indications for RTC tear: – shoulder pain (especially night pain); – symptoms which cause loss of function or quality of life; – failure of NSAIDS and formal physical therapy; – failure of series of marcaine / steroid injections; – full passive ROM pre-op is necessary … Read more
Aminoglycosides Bacitracin IV contrast Chemotherapy Myoglobulin Uric Acid Oxalate Amyloid Bence Jones Protein Amphotericin B Acute renal failure after total hip replacement.
– PreOp Planning: – Proximal Exposure: – if there is extreme difficulty in dislocating the hip, attempt to perform a wide capsulotomy or perform a trochanteric osteotomy; – it is essential to avoid a proximal femoral frx while extracting the stem; – before attempting prosthesis removal, remove granulation tissue … Read more