Ortho Oracle - orthopaedic operative atlas

Internet Driven Form Generator for Brief Op note, Orders, Prescriptions, and Patient Education Sheet.

Problem:  1) The busy surgeon is faced with a mounting amount of documentation challenges which interferes with already hardpressed time constraints. (Any surgeon that disputes the increasing amount of documentation is probably not aware of current CMS guidelines).  Most surgeons are probably not aware of what CMS requires and does not require (and has not felt … Read more

TKR – Posterior Cruciate Ligament Retaining Prosthesis

– See: – TKR Menu – Joint Line Position: – Posterior Stabilized Prosthesis: – Function of Posterior Cruciate Ligament: (see PCL) – as the knee flexes, eccentric postion of the PCL femoral orgin prodecues a tensile force in the ligament; – because of nonconforming low friction articlation, this tensile force is converted into a translatory … Read more

TKR: Valgus Deformity

– See: – TKR Menu: – Collateral ligaments: – Medial Collateral Ligament – Lateral Collateral Ligament – Discussion: – more common in females; – in valgus knee, ligament balancing is more difficult to fix; – the anatomic deformity is usually larger in valgus than in varus, and it is on the femoral side; – femur … Read more

Total Knee Replacement – Patient Saftey Packet

How We Are Committed to Protecting Your Safety:          How We Protect You From Infection          How We Protect You From  Blood Clots: What you should know before your surgery?         your laboratory results                 your hematocrit should be between 30 and 45%                         – if your hematocrit drops below 25-26% during your surgery, we may recommend a … Read more

Total Knee Replacement – Day 1

           blood draw: A blood drawing technician will draw your blood at 6 AM (will test for your red blood cell level          – hematocrit – and possibly chemitry level).  Ask your nurse about your hematocrit (should be above 30 and if          the hematocrit is below 26 we may recommend a transfusion)          vitals … Read more

Wound Closure for TKR

 – Discussion:         – Should Subcuticular Sutures be Avoided in TKR?               – references:                       – Modality of wound closure after total knee replacement: are staples as safe as sutures? A retrospective study of 181 patients.                       – Wound complications in joint arthroplasty: comparing traditional and modern methods of skin closure                       – Staple vs. … Read more

Wound Complications following TKR – Hematoma, Necrosis, Infection

– Management of Complications:     – see open debridement and retention of components;     – wound complications: (Dennis, ICLS 1997) (see contaminated wound care)            – wound complications include prolonged post-operative drainage, superficial soft tissue necrosis, and full thickness soft tissue necrosis;            – wound drainage and hematoma: … Read more

Work Up of the Painful Total Knee Arthroplasty

– See: TKR Menu: (Function and Activity after TKR) – Natural History of Painful TKR:     – references:               – Pain and Depression Influence Outcome 5 Years after Knee Replacement Surgery.               – Impact of Psychological Distress on Pain and Function Following Knee Arthroplasty – Potential Causes of TKR failure:     – early failures:     … Read more