Rule Out Infection » probably every revision joint procedure should have frozen sections sent prior to insertion of the components in order to determine whether acute inflammation is present (indicating infection); references: Failed total hip replacement: assessment by plain radiographs, arthrograms, and aspiration of the hip joint. The value of aspiration of the hip joint before … Read more
See: Total Hip Replacement Menu: revision arthroplasty menu Femoral Revision exposure of femur it is essential that prior to attempted femoral component removal, that there is a clear retrograde path for stem removal; this means that any trochanteric overhang is removed, either with a high speed bur or with an trochanteric osteotomy: some recommend routine … Read more
– Component Insertion: – tibial insertion: – cement is applied to the proximal tibial surface, and the surgeon uses gloved fingers to manually press cement into proximal tibial surface; – subsequently additional cement is applied to the proximal tibial surface; … Read more
– See: Characteristics of Metals and Implants: – Discussion: – titanium is often selected as a materalial for metal plates or femoral stem implants due to its lower modulus of elasticity (as compared to other alloys); – elastic modulus of stainless steel is 12 times EM of cortical whereas EM of titanium is 6 … Read more
– Discussion: – it has long been recognized that following any significant trauma or elective surgery, the body undergoes a catabolic state, which means that the body’s ability to withstand further stress (such as additional surgery) diminishes with time; – add to this, the effect of immobilization due to pain (pressure sores, atelectasis, poor diet) and … Read more
– see: anesthesia menu – Discussion: – assessment of perfusion: damage control orthopaedics – the most common situation is how to manage the femur fracture in the brain injured patient; – some authors have expressed concern that intraoperative hypoxia and hypotension may commonly occur w/ early IM nail stabilization; … Read more
– PreOp Planning: – tendon transfer is chiefly indicated for stage II tenosynovitis; – subtalar joint must demonstrate nearly a full range of inversion; – early synovectomy of the tendon sheath not only relieves discomfort but will possibly delay or prevent attenuation or rupture; – in … Read more
– Discussion: – considerations for graft placement – optimal graft angle – land marks for graft entry point – determination of graft length – retention of remnant ligament: – ref: Anterior cruciate ligament reconstruction with remnant preservation: a prospective, randomized controlled study. – Transtibial Technique: – tibial tunnel guide is … Read more
– See: Anterior Compartment: – Anatomy: – origin: lateral condyle of tibia, proximal 2/3 of lateral surface of tibia, interosseous membrane, deep fascia and lateral intermuscular septum; – insertion: plantar surface on base of first metatarsal and medial plantar surface of 1st cuneiform; – action: dorsiflexes and inverts foot at the ankle; … Read more
– Discussion: – 60% of plataue frxs involve lateral plateau. – this probably is result of valgus alignment of lower extremity and fact that most injuring forces are directed laterally to medially; – frxs of medial plateau make up 15% & bicondylar lesions 25% of plateau frx; – bicondylar frxs combine any of unicondylar … Read more