Medical Malpractice Insurance for orthopaedic surgeons

Initial Exposure for THR:

    – positioning and prepping        – posterolateral skin incision      – incise thru iliotibial band      – split gluteus maximus      – peel back the trochanteric bursa:           – divide trochanteric bursa and sweep it posteriorly to expose vastus lateralis, short external rotators and posterior border of gluteus medius; … Read more

THR: Osteolysis

– See: Total Hip Replacement Menu – Discussion:     – most common complication in total hip arthroplasty and most common cause of component failure;     – osteolysis is a time dependent process which arises from inflammatory reaction against polyethylene particulate debris;     – patho-biology:            – osteolysis is … Read more

THR: Femoral Neck Resection

         – See:     – radiographic templating of femoral neck cut      – femoral component offset  – Discussion:     – femoral neck cut will influence leg length, caput collum diaphysis (CCD) angle, and offset;      – base of the femoral neck (“the shoulder”) is used as a reference for appropriate level of osteotomy; – Exposure:     … Read more

THR: Periprosthetic Femur Fractures

– See: Total Hip Replacement Menu: – IntraOperative Frx: – frx may occurr early while the attempt to dislocate hip is made; – most postoperative femoral fractures can be prevented by avoiding injury to the bone during the original THR procedure; – bone lysis from secondary aseptic loosening may significantly compromise strength of the femur … Read more

THR in the Dysplasic Hip

– See: Total Hip Replacement Menu: – Discussion:     –  natural history of DDH:      – acetabular rim syndrome:           – results from dysplastic hip, which stresses the labrum, resulting in labral degeneration;           – hip arthroscopy and debridement in these patients may provide the patient w/ a few … Read more

THR: Cemented Acetabular Component

  – See: Total Hip Replacement Menu:            – cementless components            – cement technique            – acetabular component revision            – operative considerations for hip dyplasia            – protrusio – Discussion:     – technical considerations:     – in the report by Crites BM, et al (2000), the effect of porosity reduction            cementing techniques with respect to radiolucent lines … Read more