– See: TKR Menu – Distal Femoral Resection – Distal Femoral Sizing Guide (and Rotational Alignment) – Anterior, Posterior, and Chamfer Cuts – Location of Entry Hole: – ideally the starting point is slightly medial and posterior to the center of the notch; – generally the drill needs to be inserted 1 … Read more
– See: – TKR Menu – Distal Femoral Resection – Femoral IM Alignment Rod – Distal Femoral Sizing Guide (and Rotational Alignment) – Anterior, Posterior, and Chamfer Cuts – Femoral Component Notching – Design Considerations: – PCL Retaining Prosthesis – Posterior Stabilized Prosthesis – left & … Read more
– Discussion: – if there is free movement at hip, subtalar & mid-tarsal joints rotation at the knee is not essential for restricted function of prosthetic joint; – in contrast, an arthrodesed ipsilateral hip is a relative contra indication to knee replacement, for it prevents rotation of thigh as … Read more
Presence of Shock Inspection Palplation: symphysis, pubic rami, iliac crests, sacroiliac; bimanual compression & distraction of the iliac wings, & abduction & adduction of the hip should be done to detect instability; manual traction can aid in the determination of vertical instability grasp both legs and pull one caudad while pushing the other cephalad Neurologic Injury … Read more
– See: – Bone Scans following THR: – Post Op Evaluation of THR: – Discussion: – post op AP & lateral x-rays should include entire length of stem & cement mass; – femur and cement column are inspected carefully and compared w/ previous films for changes indicating component loosening, stem failure, trochanteric problems, or infection; – Radiographic … Read more
Discussion results from fibrosis of sternal head; can result from unilateral shortening of sternocleidomastoid, commonly associated with fibrosis of the muscle; may also involve the platysma and scalene muscles; birth trauma, occlussion of venous flow, or hematoma results in fibrosis of muscle & palpable mass noted w/in first 4 wks of life; nontender enlargement may … Read more
Discussion when the innervated ligamentous layer of the outer annulus fibrosis is stretched because of segmental instability, pain results; acute sprain probably represents partial tearing of annular tissue; if annular tissue becomes weakened to the point of allowing nucleus to protrude beyond the normal confines of the annulus, it may actually be a prelude to … Read more
(See also: Total Hip Replacement Menu) Discussion evaluation of the painful THR indications for revision evaluation for loosening outcomes: references: Why revision total hip arthroplasty fails. Revision Hip Arthroplasty: Infection is the Most Common Cause of Failure Examination examination for loosening: previoius incisions; contracture of the flexors and adductors (adds to complexity of the case); … Read more
Discussion removal of broken femoral stems: removal of cementless stems: removal of cemented femoral stems: as noted by Peters, et al. (1997), at the time of acetabular component revision, evidence supports leaving a well fixed cemented component in place; in femoral components inserted w/ first generation cementing techniques, the rate of mechanical failure was 22% … Read more