– Exposure of the Subscapularis: – the upper portion of the subscapularis tendon is exposed by partial release of the CA ligament off the coracoid, by placement of a Homan retractor directly above the coracoid, and by abduction and external rotation of the arm; – the upper portion of the … Read more
– Discussion: – up to 80 % of patients w/ traumatic DJD may expect a good to excellent result at 5 years; – up to 30 % of patients will sustain a major complication over 5 years, which often will require and additional operation; – indications: – end stage rheumatoid arthritis; – severe intractable pain … Read more
– PreOp Planning – Local Analgesia Infiltration Techniques – THA/TKA and Datatrace TKR Teaching Video- Surgical Technique – Arthrodesis – Arthroscopy following TKR – Axis for TKR – Axis – Alignment – mechanical axis – anatomic axis – Bilateral Knee Replacement – Biomechanics of the Joint – Bone Grafting & Wedges – Collateral ligaments – … Read more
– Diff Dx: in Infants: – pterygium colli; – bronchial cleft cysts; – tumor: – cystic hygroma; – thyroid teratomas; – tumors of spinal cord and or posterior cranial fossa; … Read more
– See: aminoglycosides and addition of aminoglyocides to cement – Discussion: – adult dose w/ normal renal F(x) & serious infection: 1mg/kg q8hr; – peds: 7.5 mb/kg/day q8hr (Levels: trough <2; peak: 4-8 hr) – for life threatening infection may use 1.66mg/kg q8hr (reduce dose as soon as possible); … Read more
– Discussion: – anterior longitudinal incision allows full exposure of the proximal tibia; – this incision allows exposure of both medial & lateral aspects of joint w/o the necessity for large skin flaps; – this incsion has advantage that … Read more
– Tibial Component Preparation: – ACL is resected, w/ or w/o PCL preservation; – Extramedullary Guides – alignment is made w/ jig parallel to ant crest of tibia shaft. – referencing was taken off the lateral tibial plateau. – Proximal Tibial Resection – Determine appropriate Posterior Slope – Depth of Tibial … Read more
– Trial Components: – component fit: – evaluate femoral and tibial trial components and determine areas that will need additional cement; – flexion & extension gaps – range of motion: use the largest polyethylene spacer that allows full extension; … Read more
– Optimize the Exposure: – it is important to fully expose the proximal tibial surface inorder to avoid iatrogenic injury to the collateral ligaments, the PCL, or even the posterior neurovascular structures; – soft tissue stripping: (see medial and lateral capsular exposure) … Read more
– Techique: – preparation and exposure for the proximal tibial cut: – hyperflexion of the knee to allows the vessels to fall more posteriorly; – curved knee retractors are positioned anterior to mid-coronal plane, so that patella tendon and MCL will not be injured; – inadvertent transection of the lateral patellar tendon … Read more