Ortho Oracle - orthopaedic operative atlas

Plates for Fracture Repair

– See: Orthopaedic Trauma Implants: Know Your Implants (from Synthes web site) – Discussion:      – Bone Healing w/ Plates     – Characteristics of Metal Implants      – concepts:           – tension side of the fracture:                  – when plating a fracture the plate should be applied to tension … Read more

Revision Femoral Component Arthroplasty

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

Pre Op Planning for Revision Total Hip Arthroplasty

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

THR Revision: Removal of Femoral Stem

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

Revision Total Hip Arthroplasty

(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

TKR: Distal Femoral Resection

– See: Femoral Component  – Resection of the Distal Femur:     – cushing rongeur is used to remove osteophytes in medial & lateral aspects of the femoral condyles as well as the intercondylar space;            – this avoids, possible mis-sizing of the femoral component;     – femoral IM alignment rod: (discussion) … Read more