– See: Patella and Patellofemoral Function – Discussion: – chondromalacia describes softening & fissuring of articular hyaline cartilage; – chondromalacia may result from an excessive load on patellofemoral joint, but disuse may be a contributing factor; – most common in yound women; – relationship between chondrosis & … Read more
– See: Bone Tumor Menu – Discussion: – age at presentation: – most common primary epiphyseal tumor in children is chondroblastoma; – most commonly arises between ages 10 to 30; – not infrequently, the tumor will also arise … Read more
(See also: Acetabular Osteotomies) Discussion a acetabular osteotomy salvage procedure which is indicated in patients without a concentrically reducible hip; modified shelf osteotomy above acetabulum w/ medial displacement of acetabulum; distal fragment is displaced medially and upward as osteotomy hinges on the symphysis pubis; hip capsule is interposed between newly formed acetabular roof & femoral head; relies … Read more
– Discussion: – type I, type II, and type III are most common; – type IV: – is also referred to as Refsum disease; – associated w/ excess phytanic acid; – type V: – inherited spastic paraplegia with distal weakness in the limbs; – usually presents in the second decade of life or later; – … Read more
– See: Anesthesia Considerations and Timing – PreOp Management: – Etiology of Fracture: – arrhythmia: consider continuous monitoring – hypoxia – osteoporosis – pathologic hip fractures – seizure – stroke – … Read more
– Discussion: – pattern of hip deformity in cerebral palsy depends on type and extent of neurologic impairment; – non progressive neuromuscular disorder w/ onset before 2 yr resulting from injury to the immature brain; – etiology includes: perinatal infections (TORCH), prematurity (most common), anoxic injuries, … Read more
– First Generation Ceph – 1-2gm q4hr IV or 125mg/kg/4-6hr,t1/2=40min;Inject; – Decrease dose with renal failure; – 60-70 % of dose will be excreted in urine (w/ nl R F(x)) – Contra with cephalo allergy, caution with penicillin allergy; – Good diffusion from blood into CSF only with inflammation; – Note: Ratio of … Read more
– See: Addition of Antibiotics to Cement – Discussion: – full discussion of technique for cementing femoral stems – mixing under vacuum reduces retained air & incr cement strength; – typically 2 bags are needed; – slower mixing of cement over a shorter time decreases air voids within cement and … Read more
– Discussion: – once femoral and acetabular components have been removed, residual cement can be removed from the femoral canal; – it is better to move onto to the acetabular revision prior to cement removal since the cement will prevent blood loss from the canal; – … Read more
– See: Total Hip Replacement Menu: – Cemented Femoral Component: Loosening: – Collar: in THR – Optimal Cementing Technique – Removal of Cemented Femoral Stems: – Indications: – cemented femoral stems probably remain gold standard for total … Read more