Revision TKR Surgical Approach
– Assistance provided by … Read more
Knee
Revision TKR: Revision of Tibial Component:
– Discusssion: – remove 1-2mm of bone using the intramedullary guide. – be aware of the preoperative flexion stability and ROM in choosing posterior slope; – for example, if the knee was unstable in flexion preoperatively, 0 degrees posterior slope may help reduce some of the flexion gap; … Read more
Revision TKA: Femoral Component
– Discussion: – quick femoral bone cuts by eye: – usually the femoral bone under the prosthesis will be soft, and will impact when the femoral trial is applied; – therefore, there is no need for time consuming bone cuts, when “eyed cuts” are just as good; – the main issue … Read more
Revision Total Knee Replacement:
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
Reversed Obliquity Intertroch Frx
– 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
Revision of Patellar Component:
– references: – Secondary resurfacing of the patella for persistent anterior knee pain after primary knee arthroplasty. – Fate of the unrevised all-polyethylene patellar component in revision total knee arthroplasty. – Isolated revision of the patellar component in total … Read more
Revision TKR: Revision of Patellar Component:
one should consider not resurfacing the patella if less than 12mm of native bone remains (fx or early loosening may result); obviously, if sepsis is present then patellar component removal is required; if patellar component is to be retained, then it is necessary to surgically remove the peripatellar “meniscal” tissue that typically grows around patellar component; … Read more
Retrograde Nailing of Femoral Shaft Fracture
– 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
Reverse Pivot Shift Test
– Discussion: – this sign is positive in pts with acute or chronic posterolateral instability of the knee; – knee begins in flexion while an external rotation and valgus stress are applied; – supine – valgus stress … Read more
Resection Arthroplasty of the Hip
– 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