Multidisciplinary Team-based Amputee Care: Level Sparing Surgical Techniques and Treatment of Chronic Pain
Careful consideration of a multitude of factors including vascular status, soft tissue envelope, functional status, and goals are integral in determining optimal amputation technique. For patients undergoing a secondary or revision amputation, those same factors, in addition to frequently encountered issues such as poor prosthetic fit, unstable soft tissues, neuromatous pain, and poor overall function should be evaluated. A multidisciplinary team including orthopedics, musculoskeletal radiology, plastic and reconstructive surgery, vascular interventionists, infectious disease, physical medicine and rehabilitation specialis...
Source: Techniques in Orthopaedics - December 1, 2021 Category: Orthopaedics Tags: Symposium Source Type: research
Advanced Adjunctive Techniques in Amputation and Limb Restoration
No abstract available (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - December 1, 2021 Category: Orthopaedics Tags: Preface Source Type: research
Is it Possible to Treat Insert Dislocation With a Fixed Insert Tibial Component After Primary Oxford Phase 3 Mobile Unicompartmental Knee Arthroplasty?
Conclusions:
In this study, we found that there was no worsening in the clinical scores of the patients in the mid-term and no revision was required following the treatment of redislocation through tibial component revision. It was concluded that partial revision treatment with a fixed insert tibial component in the case of insert redislocation does not increase morbidity and could be an ideal treatment option. However, this conclusion should be further supported by multicenter studies along with the high number of cases.
Level of Evidence:
Level IV—retrospective case-control study. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - September 1, 2021 Category: Orthopaedics Tags: Tips and Pearls Source Type: research
Ultrasound-guided Cubital Tunnel Injection: A Review and Exploration of Utility as a Diagnostic Aid in Mild or Nonclassic Cubital Tunnel Patients
Cubital tunnel syndrome (CuTS) is a common and potentially debilitating neuropathy that results from chronic forces on the ulnar nerve at the elbow. First-line treatment options such as physiotherapy and nighttime splinting are effective in many patients, with refractory patients often benefiting from in situ ulnar nerve decompression or ulnar nerve decompression and transposition. However, identification of the most ideal surgical candidates can often present a clinical challenge, particularly in patients with a nonclassic presentation, significant comorbidities, or a negative nerve conduction study. Current literature su...
Source: Techniques in Orthopaedics - September 1, 2021 Category: Orthopaedics Tags: Tips and Pearls Source Type: research
Reduction of Posterior Column in Displaced Acetabular Fractures Using Bone Holding Forceps
This article reports a new technique for reduction of these fractures anatomically using the large bone holding forceps. This has the advantage of other instruments, correcting displacement and rotation in one step without using an adjuvant instrument or narrowing the corridor for the plate application on the posterior surface. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - September 1, 2021 Category: Orthopaedics Tags: Tips and Pearls Source Type: research
A Simple Device and Biplanar Technique to Improve Precision When Templating for Total Joint Arthroplasty
Accurate templating for arthroplasty procedures depends on reliably estimating image magnification. The authors designed a simple device and technique to accomplish this. It is a wedge with four 25-mm balls staggered at different heights, each representing a potential marker. The proper ball to use as the scaling marker is identified on an orthogonal view on the basis of its relationship with the anatomic feature of interest. Reviewing x-rays with known acetabular component diameters, the authors found that the staggered balls technique had a scaling error of 1.48±0.89%. Assuming a constant 20% magnification for all x-ray...
Source: Techniques in Orthopaedics - September 1, 2021 Category: Orthopaedics Tags: Special Technical Article Source Type: research
“Locking the Head Technique” For Femoral Head Removal in Intracapsular Neck Femur Fractures
Discussion:
Improves accuracy of corkscrew fitting in the head and retaining the contour of the head and thereby easing the removal of the head and making the technique easier. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - September 1, 2021 Category: Orthopaedics Tags: Special Technical Article Source Type: research
Removal of a Well-Fixed Cementless CLS Expansion Cup
The purpose of this technical note is to present a novel technique to remove a well-fixed uncemented cementless System expansion acetabular cup; the technique is on the basis of its 6 flaps design. The use of metal cutting high-speed burr allows to dismantle the cup, piece by piece, by cutting each of the flaps from the dome portion of the implant, this facilitates the extraction of each piece from the bone bed while preserving host bone. Because the bone bed of the acetabulum is carefully prepared a new uncemented hemispherical cup may be implanted after removal of the cementless System expansion cup. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - September 1, 2021 Category: Orthopaedics Tags: Special Technical Article Source Type: research
Outcomes of Tension Band Fixation in Olecranon Fractures and Osteotomies With Sutures: A Metal-free Solution
To restore the extensor function of the elbow, tension band wiring is a commonly used technique in managing stable olecranon fractures and osteotomies with excellent results. However, the outcome and patient satisfaction are marred with high rates of hardware-related complications requiring reoperation. To diminish the risk of these complications, we employed sutures for tension band fixation instead of wires in open reduction and internal fixation of Mayo types IA and IIA olecranon fractures and olecranon osteotomies in 15 of our patients. All patients achieved the radiologic union of the fractures and osteotomies by 12 w...
Source: Techniques in Orthopaedics - September 1, 2021 Category: Orthopaedics Tags: Special Technical Article Source Type: research
Multispecialty Intraoperative Approach for Treatment of Intra-Articular Knee Venous Malformations
Intra-articular venous malformations (IAVMs) pose a treatment dilemma for a variety of specialties. Here, we discuss a multispecialty approach between orthopedic surgery and interventional radiology to treat pediatric knee IAVMs in a 4 patient case series. The technique involved the use of arthroscopy along with ultrasonography for direct visualization of the lesions for the purpose of sclerotherapy. The combined approach with both radiologic imaging and arthroscopic techniques provided the opportunity for diagnosis and therapeutic intervention in a single procedure. In our patient series, we noted significant qualitative ...
Source: Techniques in Orthopaedics - September 1, 2021 Category: Orthopaedics Tags: Special Technical Article Source Type: research
Modification in Unicompartmental Knee Replacement Technique: Saving the Tibial Bone
This article describes a technique of performing conservative tibial cut with commensurate adjustments on the femoral side while performing Oxford UKR, which is in variation to what has been described by the designer group. This may prevent early to midterm failures seen owing to tibial loosening. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - September 1, 2021 Category: Orthopaedics Tags: Special Technical Article Source Type: research
Robotic-assisted Spine Surgery: A Review of its Development, Outcomes, and Economics on Practice
Conclusions:
Higher-level studies (level I and II) have demonstrated similar clinical outcomes and pedicle screw accuracy when compared with the free-hand technique. As with most new technology, a learning curve is apparent, with the potential for a decrease in radiation exposure and economic benefit over time. (Source: Techniques in Orthopaedics)
Source: Techniques in Orthopaedics - September 1, 2021 Category: Orthopaedics Tags: Special Technical Article Source Type: research
Treatment of Infectious Sacroiliitis in Pregnant Patients: A Case for Surgical Debridement
We report 3 cases of pregnant patients with infectious sacroiliitis, describe the surgical technique used to debride the sacroiliac joint in pregnant patients, report their outcomes, and provide a treatment algorithm for management of this condition in this patient population. All patients failed initial conservative treatment with antibiotics and underwent surgical debridement. All 3 had history of intravenous drug use, which is one of the predisposing factors. All 3 patients had favorable outcomes after surgery. Surgical debridement of infectious sacroiliitis is a viable treatment option in the pregnant patient with infe...
Source: Techniques in Orthopaedics - September 1, 2021 Category: Orthopaedics Tags: Special Technical Article Source Type: research
Efficacy and Economics of Arthroscopic Surgical Treatment of Femoroacetabular Impingement Syndrome
Hip arthroscopy has emerged as a highly popular and minimally invasive treatment of femoroacetabular impingement syndrome and labral tears by correcting the femoral and acetabular morphology and addressing the chondrolabral pathology. It has been reported to lead to significant improvements of patient-reported outcomes with minimal complications at short-term, mid-term, and long-term follow-up in addition to having low rates of secondary surgeries. As a result, rates of hip arthroscopy have increased dramatically, both in the United States and worldwide. Albeit these favorable outcomes of hip arthroscopy have been well-est...
Source: Techniques in Orthopaedics - September 1, 2021 Category: Orthopaedics Tags: Symposium Source Type: research
Prehab and Rehab for Femoroacetabular Impingement (FAI): Clinical Pearls
Current literature supports the benefits of nonoperative conservative treatment with physical therapy along with activity modification for femoroacetabular impingement. Despite this fact, there is a gap in the literature detailing appropriate physical therapy management of this injury. The goal of this article is to present conservative physical therapy treatment options for femoroacetabular impingement. Improving joint mobility through posterior and lateral joint glide of the femur, strengthening the surrounding hip musculature, and re-educating functional movement to limit excessive adduction/internal rotation during hip...
Source: Techniques in Orthopaedics - September 1, 2021 Category: Orthopaedics Tags: Symposium Source Type: research
