The Hip - book

Knee

Morphine Sulfate

– Discussion:     – adult:           – 0.1-0.3 mg/kg/dose IM/IV/SC           – 8-20mg PO q4hr, 30mg (MS Contin) PO q8-12 hr / 5-15 mg SQ/IM q4hr           – IM/SC: Max. analgesic effect at 45-60 min; duration 3-4 hrs; t/2: 2-3 hr;   … Read more

Modified Weaver Dunn Procedure

– See: AC Joint – Distal Clavicle Excision:     – is often included in the distal clavicular stabilization;     – note that in younger patients the AC joint cartilage (and meniscus) is normally wide and therefore, it is not necessary to resect the usual 1 to 1.5 cm of distal clavicle; – Case Examples: … Read more

Misc. THR Articles

Contralateral total hip arthroplasty or ipsilateral total knee arthroplasty in patients who have a long-standing fusion of the hip. Intrapelvic migration of total hip prostheses. Operative treatment The use of the McKeever metallic hemiarthroplasty for unicompartmental arthritis. Serum CK-MB is useful in diagnosis of acute myocardial infarction after total hip arthroplasty. Cardiac isoenzyme values after total joint … Read more

Misc. TKR articles

Contralateral total hip arthroplasty or ipsilateral total knee arthroplasty in patients who have a long-standing fusion of the hip. Total knee arthroplasty in Charcot and Charcot-like joints. Total knee arthroplasty for tuberculous arthritis Retrieval analysis of porous-coated components for total knee arthroplasty. A report of two cases. Segmental total knee arthroplasty after distal femoral resection … Read more

Microscopic features of the Meniscus

– Discussion:     – meniscal cells while typical chondrocytes, are called fibrochondrocytes because they synthesize fibrocartilage matrix, rather than hyaline               cartilage matrix typical of articular cartilage;     – menisci are composed of circumferentially oriented collagen fibers, which are parallel to its peripheral border;     – orientation of type I collagen fiber bundles is the major determinant … Read more

Methods to Prevent Infection

– See: Orthopaedic Infection Menu: and risk factors for TJR infection – Pre-Admission Considerations:         – removal of hardware prior to joint arthroplasty:                 – High incidence of early periprosthetic joint infection following THA with concomitant or previous hardware removal – Hospital and OR Considerations:          – perioperative oxygen          – normothermia:                  – Perioperative normothermia to … Read more

Metatarsus Adductus

– Discussion:     – a condition in which the there is medial displacement of the metatarsals on the cuneiform;     – forefoot is adducted at the tarsal metarsal joint;     – usually seen in the first year;     – is bilateral in 50% of patients may be associated with hip displasia … Read more

Metastastic Lymphoma

– Discussion:     – bone scans tend to be hot (unlike multiple myeloma);     – bone lesion may be less likely to cause pathologic fractures than other metatsatic lesions;     – if bone lesions are asymptomatic, consider non operative treatment;     – associated features include lymphadenopathy or splenomegaly;            – evaluate cervical, … Read more

Metallurgy: TKR

– Discussion:  – femoral component is made of chrome colbalt alloy w/ its proven wear characteristics articulating with high density poly ethylene;  – tibial & patella components are metal backed w/ titanium alloy;  – enhance fatigue strength of titanium decreases potential for stress fracture of the metallic tibial tray;  – in metal back patella component, the … Read more