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Arthroplasty of the Shoulder

– Discussion: – Total Shoulder Arthroplasty:    (considerations: hemiarthroplasty vs TSA) – Reverse arthroplasty – Indications: – indicated for end stage DJD or RA shoulder involvement; – contra-indications to shoulder arthroplasty include combined rotator cuff / deltoid paralysis and recent joint infection; – in these rare circumstances, arthrodesis may be considered; – may occur as a … Read more

Anterior Cruciate Ligament Anterolateral Ligament: Let’s Stick to the Facts!

Anterior Cruciate Ligament ‐ Anterolateral Ligament: Let’s Stick to the Facts! – Discussion:     – anatomy of ACL     – biomechanics of ACL     – epidemiology_of_ACL_injuries     – mechanism: ACL Tear     – natural history of the ACL-deficient knee     – partial ACL injury     – pediatric ACL injuries – Evaluation … Read more

Anterior Cruciate Ligament

– Extra-articular Reconstruction:     – these type of procedures are now no longer used as the primary reconstructive method for ACL tears;     – some authors feel that the extra-articular reconstruction may have a role in augmenting the intra-articular reconstruction;     – references:            – Biomechanics of intra-articular … Read more

Allograft Bone Patellar Bone Reconstruction

– Discussion:     – general discussion of allograft tissue:     – as pointed out by Harner et al. (1996), subjective knee scores were slightly better for knees having ACL – bone patellar bone allograft (as compared to BPB autograft patients)            – objective ratings included normal (or nearly normal) … Read more

Allografts

– see bone graft menu – Discussion of Allografts:     – see autograft menu and bone healing:      – allografts are most indicated when bone grafting is required along with need for mechanical structural support;     – morselized bone graft:     – structural bone grafts:      – fresh allografts            – generally … Read more

Adamantinoma

– See: Bone Tumor Menu                                                                                                                                                                        – Discussion:     – rare tumor of unknown origin;     – occurs primarily in young males between 10 – 30 years of age (most common after skeletal maturity);     – pts present w/ firm, slowly enlarging mass that produces minimal disability;           … Read more

Addition of Antibiotics to Cement

 – See: Infection Menu and Wound Management: and Local Antibiotic Delivery for Septic Joints – Discussion:   – basic science:        – useful in treating biofilm;        – references:              – In vitro characteristics of tobramycin-PMMA beads: compressive strength and leaching.                 – Antibiotic bone cement in THA. An in vivo comparison of the elution properties of … Read more

Acumed Bone Graft System

Autogenous bone graft remains the most effective treatment for fracture non unions, pseudoarthroses and for optimizing the success rate of arthrodesis. It is safer and more effective than artificial hydroxyapatite materials or allograft. The Acumed bone graft harvesting instruments facilitates safe, rapid harvest of morsellized autogenous graft through a small skin incision which minimizes the … Read more

Acetabular Component Revision w/ Gap Cup

Total Hip Replacement Menu » Acetabular Component Revision » Discussion indications: salvage device for use in cases of pelvic discontinuity where a stable socket cannot be wedged between the anterior and posterior columns; classification of bone defects and bone grafting options: in almost every case, bone graft is morcelized and placed behind the cup; in … Read more