The options of navigated and robotic replacement were offered. Settled for a simpler local custom made distal cutting jig , followed by gap method for a Varus valgus stabilised knee
Thursday, 23 June 2022
Friday, 11 March 2022
Sunday, 6 March 2022
16 years post revision with alumina ceramic on poly THR
has some pain Rt thigh . bloods normal/ bone scan below. waiting for a 3 month review to repaet bloods and clinical assesment.lass="separator" style="clear: both;">
74 year gentle man with periprosthetic fracture 2 years post fracture
had 3 attempts at union surgically with 2 scars. Decided to do distal femoral repalcement to get him back to his feet after 2 tears. nil infection. the risk of skin issues was discussed and had plastic backup which luckily was not needed
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Friday, 3 December 2021
2 months of dislocated Knee repalcement in an elderly lady with high BMI
Allleged history of fall 2 months back. Knee lying dislocated when reviewed by usTKR done 5 years ago with no issues till the fall Bloods and knee aspiration - - normal Options of RHKif frozen section was negative or Fusion if infected was discussed. 2 stage was ruled out by patientThe decision had to be one stage and no external fixation as per patients families request . So a fusion was done as frozen section showed probable infection as per fieldman's criteria, Survived the surgery and mobilised FWB day 2 day before discharge went into renal shutdown at day 12 and after a month of ICU and stay we lost her
Wednesday, 3 November 2021
squatting leading to dislocation in TKR
Conventional TKR is not designed for squatting. Even high flexion designs are reported to lead to earlier PF problems and wear.
Sunday, 5 September 2021
meniscal repair augmented with synovial to improve the healing in a complex degenerate tear
Menisectomy have been clearly shown to give poor long term results. Hence methods to augment and enchance repair by multiple sutures, BMAC, VGF's have been tried. we seemed to have some early good results so far with synovialaugmented repair. it is too early to be sure so we are following up the consented patients for the same.
Saturday, 4 September 2021
2 MONTH OLD DISLOCATED KNEE WITH CELLULITIS IN THE SHIN
fell 2 months after TKR and dislocated the knee. pt (BmI 35) with recurrant cellulitis on the ipsilateral tibial shin shin which is asymptomatic. esr was 110 with a crp of 20. Repeated knee aspiration was negative. incidently a gram negative UTI and large supraclavicular LN was found on admission
planned for a supraclavicular biopsy, frozen section , HPE, cultures and Rotating hinge knee with arthrodesis back up.
frozen section as per fieldmans criterioa showed too many PMNL in more than 5 power field, A modular titanium fusion nail and stimulan with antibiotic polymyxcin and vancomycin was inserted . Pt made to wt bear the same day evening and mobilised
b haemolytic strep grew for which minimum 4 weeeks IV antibiotics is planned.
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About Me
- Dr Jacob Varghese
- VPS lakeshore Hospital, Kochi, Burjeel Hospital Muscat oman, kerala, India
- orthopedic surgeon - with interests in sports injuries, joint preservation, primary and revision joint replacement