A collection of complex joint preservation and replacement case studies and random thoughts of a orthopedic surgeon essentially aimed at knowledge dissemination.
Tuesday, 14 November 2023
10 yrs post latarjet asymptomatic and played badminton till this day
This Rt handed OT male nurse (now in UK )was my ? success until this!!. The bone graft broke off while sleeping after 10 yrs post op. Did the graft ever incorporate or did it break off being avascular. i already have an asymptomatic arthritic shoulder i know after 20 years postop in a badminton player.
Increasing attempts at latarjet and its modifications will definitely raise similar complications and osteoarthritic even after ? healing. we migth reduce dislocation rates at best, rest time will tell. Do we need fresh osteoarticular grafts with live chondrocytes or sandwich ACI technique. Just food for thought.
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Intraop fracture in a prior fixed and healed distal femoral fracture
salvage of a porotic intraop fracture ina RA pt thru the cyst poorly stabilised by the plate, revised by the rotating hinge link knee with distal femoral replacement
Periprosthetic fracture in a Octagenerian
Atrial fibrillation and aortic stenosis
narrow canal 10.5. bowed femur
Absence of curved 10 inch 10.5 mm dia porocoat stem made us use this cemented long exeter stem 10 mm dia and 240 mm and wired proxmally without cement. In the past a porocoat stem was cemented distally after removing the porocoat intraop with a burr only distally to cement and the proximal uncemented stem was wired to the periprosthetic fracture to facilitate e ingrowth or fracture healing and immediate mobilisation . It make for a quick surgwry in these unfit pts and can mobilise full wt bearing stwt.
Patella dislocation with osteochondral fracture of medial facet
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