Bearing surfaces : Highly cross-linked polyethylene (XLPE) Ceramic-on-ceramic (COC) Metal-on-metal (MOM) Adaptive immune response appear to be more frequent and of greater magnitude in failed metal-on-metal implants CoC bearings had better survival than did MoM bearings at the ten-year follow-up For older, less active patients, traditional metal-on-polyethylene bearings are the appropriate choice MOM causes metallosis and local tissue pseudotumor formation…
Evidence of use of tourniquets in confliting Long duration and short duration tourniquet JBJS 2019 double blinded study concludes routine tourniquet use is “safe and effective, and concerns about the deleterious effects on function and pain may not be justified JBJS Am,2017 study : No-tourniquet group had better early knee function, lower levels of inflammatory biomarkers and higher satisfaction levels…
Sarmiento introduced the concept of functional cast bracing He treated 1000 tibial fractures with non union rate of 1.1% Presence of an intact fibula had both positive and negative effects: it was associated with more rapid union, but it was also associated with an increased risk of angulatory deformity Current non-operative criteria include : stable fracture pattern, as defined by…
Hip is the second most common affected joint after spine Mycobacterium is the leading cause Disease starts in the synovium leading to pannus formation and subsequent rice body formation which results from loss of articular cartilage Children aged 2-5 years present with painful limp and fever with classical night cries TB hip is staged into stage of synovitis, early arthritis,…
Common source of medial-sided elbow pain in overhead/throwing athletes Factors to consider : Injury (acute vs. chronic), Location (humeral origin or ulnar insertion), Severity (partial vs. full thickness), Functional demands, Timing with athletic season, Identification of modifiable risk factors Most commonly utilized reconstruction methods today are the modified Jobe and docking techniques Several large studies have demonstrated favorable outcomes following…
dd Less invasive surgical techniques Types: fixed and mobile bearing Alternative to total knee arthroplasty or osteotomy for uni compartmental disease Reserved for older (>60), lower-demand, and thin (<82 kg) patients Contraindications are younger patient, tricompartmental OA, inflammatory OA, ligamentouslaxity, pronounced deformity BMI >32 predicted failure and was associated with a reduction in survivorship Component failure/loosening, Patella impingement on femoral…
