Bones & Joints Clinic

28/10/2020

Partial shoulder replacement surgery

12/10/2020

26/08/2020

2. The superoinferior position of cup affects limb length and JRF.

A change in cup height can cause limb length discrepancy. Clinical consequences include gait disturbance, low back pain, neurological symptoms, and instability of hip.

Araised COR causes higher JRF, increasing risk of premature wear, aseptic loosening, and implant failure.

Literature recommends a slight inferomedial position of COR with a slight increase in femoral offset to optimize abductor function.

In dysplastic hips with a superiorly displaced COR, the best outcomes are associated with reconstruction of the anatomic COR. This results in a reduction in JRF and abductor muscle force

knee

24/08/2020

1. Depth of the acetabular cup

Mediolateral position determines the lever arms of body weight and abductor force and thus joint reaction force. It contributes to offset, a reduction, in which can result in a reduced ROM, increased dislocation risk, impaired gait, and accelerated bearing wear.

The traditional Charnley approach20 advocates medialization of acetabular component to reduce JRF. However, medialization can reduce global offset which is the sum of femoral offset and acetabular offset.

Downsides of medialization includes reduced ROM, increased risk of bony impingement, risk of microseparation if global offset is not restored resulting in accelerated wear.

Thus, anatomic positioning of cup, preserving acetabular offset has been proposed.

It is recommended to have individualized approach to each patient, considering each of these factors, rather than routine medialization for all.

While templating , Medial border of cup should approximate the ilioischial line and lie close to the teardrop.


@ Wrightington

22/08/2020

Three important variables in Acetabular cup placement :

Depth or mediolateral position

Height or superoinferior position

Angular placement including inclination and version.

Will discuss each in the Next coming posts

21/08/2020

Total Hip Model- Ceramic on ceramic

06/08/2020

What grade is this femoral notching ??
Comment below

06/08/2020

Femoral notching seen in a post operative TKA Xray

06/08/2020

Femoral Notching Classification