Ortho Oracle - orthopaedic operative atlas

Arthroscopic Distal Clavicle Excision

– Discussion: – general discussion: clinical and radiographic findings     – in contrast to open excision, arthroscopic excision allows preservation of the superior AC capsular ligaments; – stability of the AC joint comes from capsular ligaments (anterior, posterior, superior, and inferior) – capsular ligaments provide anteroposterior (horizontal) stability of the distal clavicle; – superior AC ligament is … Read more

Arthroscopic Acromioplasty: Discussion and Outcomes:

Discussion:     – objective good to excellent results may be achieved in over 70% of patients, and subjective satisfactory results are achieved in over 90% of patients;     – shoulder arthroscopy is indicated in cases of impingement syndrome and questionable rotator cuff tear repair, since the shoulder scope will be able to determine the status of … Read more

Arthroscopic Acromioplasty

– Discussion, Indications and Outcomes:       – impingement syndrome        – open acromioplasty       – what exactly does an acromioplasty do?                  – [Subacromial denervation as a treatment modality for patients with subacromial pathology] – Radiographs – Initial Set Up:        – prior to inserting instruments into subacromial space it is helpful to prevent subacromial bleeding                 … Read more

Arthroscopic Acromioplasty / Cuff Debridement

– See: Open Acromioplasty – Discussion and Indications:     – objective good to excellent results may be achieved in over 70% of patients, and subjective satisfactory results are achieved in over 90% of patients;     – shoulder arthroscopy is indicated in cases of impingement syndrome and questionable rotator cuff tear repair, since the shoulder … Read more

Arthroplasty of the Shoulder

– Discussion: – Total Shoulder Arthroplasty:    (considerations: hemiarthroplasty vs TSA) – Reverse arthroplasty   – Indications: – indicated for end stage DJD or RA shoulder involvement; – contra-indications to shoulder arthroplasty include combined rotator cuff / deltoid paralysis and recent joint infection; – in these rare circumstances, arthrodesis may be considered; – may occur as … Read more

Arthrogram following THR

– See:       – Total Hip Replacement Menu:       – Puncture of Hip Joint – Discussion:     – most useful for assessment of loosening of acetabular component;     – for acetabular component, contrast at the cement bone interface in all zones or in zones I and II or II … Read more

Arthrofibrosis from ACL Injuries

– Discussion:     – need to determien whether the fibrous has primarily affected flexion or extension;     – need to determine either from radiographs or from MRI, whether incorrecttunnel placement, is the cause of the decrease motion and             fibrosis;     – also evaluate for patella baja;            – … Read more

Arthrodesis / Osteotomy

Discussion in older pts (3-10 yo), medial opening or lateral column shortening osteotomies or cubital decancelization is recommended; for children who present w/ refactory clubfoot late (8-10 yo), triple arthrodesis is only procedure possible to elminate assoc pain; triple arthrodesis is contraindicated in patients with insensate feet because it causes a rigid foot that may lead to ulceration; … Read more

Arthrodesis of the Shoulder

– See: Brachial Plexus Injury – Indications: – shoulder paralysis: – may include paralytic dislocation or combined rotator cuff / deltoid paralysis (in which case shoulder arthroplasty would be contra-indicated); – as a requirement for shoulder fusion, the muscles of forearm and hand need to be functional as do the serratus anterior and trapezius; – the … Read more