Joint Preservation and Replacement
A collection of complex joint preservation and replacement case studies and random thoughts of a orthopedic surgeon essentially aimed at knowledge dissemination.
Saturday 2 November 2024
ACL repair with MCL proximal repair at 3 weeks post injury both acl and mcl looks near noraml at 14 months
Acute repair of ACL and MCl is the way to go today to get the best results.Clinically and radiologically knee looks normal. Both scopic and MRI visually looks more like normal acl unlike a reconstruction. The recent data on clearing the the knee haematoma to reduce the inflammatory metabolites might decrease the long term incidence of osteoarthritis
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Monday 23 September 2024
Elbow instability of one year duration in a rt handed nurse.
pivot shift was painful. lift off from chair was painful. mri and xray revealed a non union conoid and ? mcUCL thickening. EUA and scopy revealed a conoid fracture as the cause. Arthroscope assisted freshening of fracture surface and fixation cured the instabilty
SIF/ SPONK 6 month post partial menisetomy
The risk of menisectomy is not just wear. the effects of SPONK over time is variable depending on the sixe and location
Saturday 21 September 2024
Tuesday 13 August 2024
17 yrs post bil one stage Ceramic on ceramic THR
28 mm Alumina head and liner with no issues to date. SROM stem was used then to cover for any ceramic fracture and taper damage and in case for easier revision.
Saturday 3 August 2024
Thursday 9 May 2024
Tuesday 14 November 2023
10 yrs post latarjet asymptomatic and played badminton
the bonegraft broke off while sleeping after 10 yrs post op. Did the grqft ever incorporate or did it break off being avascular.
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.
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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
afe and aortic stenosis
narrow canal 10.5. bowed femur absence of curved 10 inch 10.5 mm dia porocqt stem made us use this cemented long wxeter stem z10 mm dia and 240 mm and wired proxmily without cement. in the past a porocoat stem was cemented distally after removing the porocoat i trqop with a burr only distally to cemebt the proximal uncemented stem was witd to the periprosthetic fracture to facilqta e ingrowth or fracture heqling . It make for a quick surgwry in these unfit pts and can mobikise full wt bearing stwt.
Patella dislocation with osteochondral fracture of medial facet
Saturday 16 September 2023
Hypointense ACL
we still do not have a a clear cut correlation between clinical and radialogical data to make an informed decision for return to sport like in fracture union
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