Bernese periacetabular osteotomy
•Download as PPSX, PDF•
1 like•884 views
This document discusses the Bernese periacetabular osteotomy (BPO) procedure for treating hip dysplasia. The BPO was developed in 1984 to reorient the acetabulum and increase hip contact area and stability through a minimally invasive technique. Studies have shown good functional outcomes following BPO, with 18 out of 24 patients in one study showing a high functional level at a mean 3.5 years post-op. Another study found that 14 out of 26 patients who underwent unilateral BPOs had no or mild arthritis at 7-15 years post-op. The BPO allows for appropriate correction of hip coverage while maintaining version and causes less damage than other procedures.
Report
Share
Report
Share
Recommended
Evolution of Total Hip Replacement
This document discusses the history and evolution of total hip arthroplasty (THA) and hip replacement component designs. It outlines key developments from the late 19th century experiments with ivory and tissue replacements, to modern THA pioneered by Professor Charnley in the 1960s using bone cement and low friction materials. Current designs aim to restore normal hip biomechanics and include cemented or cementless femoral and acetabular components with various fixation methods and bearing surfaces to reduce wear. Future advances focus on minimally invasive techniques, computer navigation, and developing more durable and compliant bearing materials to improve implant longevity.
PRE OPERATIVE TEMPLATING IN TOTAL HIP ARTHROPLASTY
Templating in total hip replacement involves using preformed templates during preoperative planning to estimate implant size and position. The goals of templating include restoring hip biomechanics, predicting implant size, and recognizing potential difficulties. A standard approach involves assessing radiographs, identifying anatomical landmarks, mechanical references, and optimizing implant position. Careful templating allows surgeons to achieve successful, reproducible results while minimizing complications.
High tibial osteotomy- All you need to know
This document discusses high tibial osteotomy (HTO), a surgical procedure to treat varus deformity and medial compartment osteoarthritis of the knee. It outlines the indications, contraindications, surgical techniques, preoperative planning, alignment goals, and complications of HTO. The goals of HTO are to relieve pain, improve function, and extend the life of the knee joint for active patients who are too young for knee replacement surgery. Attention to patient selection, preoperative planning, surgical accuracy, and rehabilitation are important for achieving successful outcomes.
Masquelet technique for management of large bone defects.
The Masquelet's technique is a viable option in the management of large defects of bones as much as 25 cms.
Safe surgical dislocation for femoral head fractures.dr mohamed ashraf,dr rah...
This study evaluates the outcomes of 18 patients who underwent surgical dislocation of the hip using Ganz's technique to treat Pipkin fractures of the femoral head. Pipkin fractures are rare fractures that occur when the femoral head fractures as a result of a posterior hip dislocation. Traditional approaches provide limited exposure, while Ganz's technique allows 360 degree visualization through an anterior dislocation of the femoral head. The study found statistically significant improvements in functional scores at 1 year follow up, with no cases of avascular necrosis, demonstrating that Ganz's technique is an effective and safe method for treating these complex fractures.
Evolution of Intramedullary Nails
This document summarizes the evolution of intramedullary nails for long bone fracture fixation from the 16th century to modern times. It describes the early use of wooden sticks and ivory implants, the introduction of metallic rods during WWI, and the development of modern locked intramedullary nails in the mid-20th century. Key figures who advanced nail design include Kuntscher, who introduced reamed nailing in 1940, and Russell and Taylor, who developed the first closed section interlocking nail in the 1980s. The document outlines the progression from first to fourth generation nails, incorporating improvements in materials, locking mechanisms, and designs to optimize stability and healing.
Implant Selection In Revision T.K.R
This document discusses implant selection considerations for revision total knee replacement (TKR) surgery. It begins by outlining common causes for revision TKR such as aseptic loosening and polyethylene wear. Key challenges in revision TKR are managing bone defects from osteolysis, compromised soft tissues, and restoring proper limb alignment. Implant options discussed include metaphyseal sleeves and stems to provide fixation in bone defect zones, as well as augmentations. Constraint levels from unconstrained to fully constrained implants are reviewed. Clinical cases demonstrate approaches for addressing instability, significant bone loss, and peri-prosthetic fractures in revision TKR.
Triple arthrodesis seminar by Dr Chirag Patel
This seminar mainly useful for all post graduates of orthopeadics and helpful for theory and practical examination.
Recommended
Evolution of Total Hip Replacement
This document discusses the history and evolution of total hip arthroplasty (THA) and hip replacement component designs. It outlines key developments from the late 19th century experiments with ivory and tissue replacements, to modern THA pioneered by Professor Charnley in the 1960s using bone cement and low friction materials. Current designs aim to restore normal hip biomechanics and include cemented or cementless femoral and acetabular components with various fixation methods and bearing surfaces to reduce wear. Future advances focus on minimally invasive techniques, computer navigation, and developing more durable and compliant bearing materials to improve implant longevity.
PRE OPERATIVE TEMPLATING IN TOTAL HIP ARTHROPLASTY
Templating in total hip replacement involves using preformed templates during preoperative planning to estimate implant size and position. The goals of templating include restoring hip biomechanics, predicting implant size, and recognizing potential difficulties. A standard approach involves assessing radiographs, identifying anatomical landmarks, mechanical references, and optimizing implant position. Careful templating allows surgeons to achieve successful, reproducible results while minimizing complications.
High tibial osteotomy- All you need to know
This document discusses high tibial osteotomy (HTO), a surgical procedure to treat varus deformity and medial compartment osteoarthritis of the knee. It outlines the indications, contraindications, surgical techniques, preoperative planning, alignment goals, and complications of HTO. The goals of HTO are to relieve pain, improve function, and extend the life of the knee joint for active patients who are too young for knee replacement surgery. Attention to patient selection, preoperative planning, surgical accuracy, and rehabilitation are important for achieving successful outcomes.
Masquelet technique for management of large bone defects.
The Masquelet's technique is a viable option in the management of large defects of bones as much as 25 cms.
Safe surgical dislocation for femoral head fractures.dr mohamed ashraf,dr rah...
This study evaluates the outcomes of 18 patients who underwent surgical dislocation of the hip using Ganz's technique to treat Pipkin fractures of the femoral head. Pipkin fractures are rare fractures that occur when the femoral head fractures as a result of a posterior hip dislocation. Traditional approaches provide limited exposure, while Ganz's technique allows 360 degree visualization through an anterior dislocation of the femoral head. The study found statistically significant improvements in functional scores at 1 year follow up, with no cases of avascular necrosis, demonstrating that Ganz's technique is an effective and safe method for treating these complex fractures.
Evolution of Intramedullary Nails
This document summarizes the evolution of intramedullary nails for long bone fracture fixation from the 16th century to modern times. It describes the early use of wooden sticks and ivory implants, the introduction of metallic rods during WWI, and the development of modern locked intramedullary nails in the mid-20th century. Key figures who advanced nail design include Kuntscher, who introduced reamed nailing in 1940, and Russell and Taylor, who developed the first closed section interlocking nail in the 1980s. The document outlines the progression from first to fourth generation nails, incorporating improvements in materials, locking mechanisms, and designs to optimize stability and healing.
Implant Selection In Revision T.K.R
This document discusses implant selection considerations for revision total knee replacement (TKR) surgery. It begins by outlining common causes for revision TKR such as aseptic loosening and polyethylene wear. Key challenges in revision TKR are managing bone defects from osteolysis, compromised soft tissues, and restoring proper limb alignment. Implant options discussed include metaphyseal sleeves and stems to provide fixation in bone defect zones, as well as augmentations. Constraint levels from unconstrained to fully constrained implants are reviewed. Clinical cases demonstrate approaches for addressing instability, significant bone loss, and peri-prosthetic fractures in revision TKR.
Triple arthrodesis seminar by Dr Chirag Patel
This seminar mainly useful for all post graduates of orthopeadics and helpful for theory and practical examination.
Bearing surfaces THR
The document discusses the history and evolution of bearing surfaces used in total hip arthroplasty. Early designs from the 1910s-1950s used materials like glass, vitallium, and acrylic, which caused issues like fragmentation, tissue reactions, and bone destruction. Modern designs include conventional and cross-linked polyethylene, metal-on-metal, ceramic-on-ceramic, and ceramic-on-metal combinations. Design characteristics like material hardness, lubrication, and wear properties were improved but each bearing surface still carries some risks like wear debris, metal ions, fracture, or noise. Future directions include advanced polyethylenes and larger metal-on-metal designs to reduce wear. No single ideal bearing exists and patient factors help
Masquelet Technique
The document discusses the Masquelet technique, a two-stage procedure for treating bone defects and non-unions. In the first stage, radical debridement is performed followed by placement of an antibiotic-loaded cement spacer to form an induced membrane. In the second stage 6-8 weeks later, the membrane is preserved while removing the spacer and filling the defect with bone graft for reconstruction. Studies reported successful outcomes using this technique for various bone defects up to 25cm in length. Key factors for success include thorough debridement, maintaining the induced membrane, adequate stabilization and soft tissue management.
THR
Total hip replacement (THR) is a common procedure to treat arthritis of the hip. Prof. John Charnley pioneered THR in the 1960s using low-friction arthroplasty with polyethylene and acrylic bone cement. THR aims to reduce joint reaction forces by recentering the femoral head and lengthening muscle lever arms. Surgeons select implants and fixation methods based on patient factors and bone quality. Outcomes depend on restoring normal hip biomechanics and long-term implant fixation to bone.
Autologous chondrocyte implantation
This document discusses autologous chondrocyte transplantation (ACT), a treatment for cartilage defects. It covers the stages of ACT healing, indications, prerequisites, investigations, the implantation procedure, and rehabilitation goals. The proliferative, transition, and remodeling stages of healing are described. Advantages include producing hyaline-like cartilage to fill defects of any size. Disadvantages include being more invasive and expensive with a longer recovery than other options.
Principles of locking compression plates
This document discusses the principles of absolute and relative stability in fracture fixation, as well as locking compression plates. It describes how absolute stability aims to reduce strain below a critical level for primary healing without callus formation, while relative stability allows some motion and secondary bone healing through callus formation. Locking compression plates provide angular stability through locking head screws in the plate and bone, maintaining blood supply while providing fixation. They can be used for compression of reduced fractures or for splinting in multifragmentary fractures.
High Tibial Osteotomies
High tibial osteotomies are a surgical procedure used to treat unicompartmental osteoarthritis of the knee caused by malalignment. There are several types of high tibial osteotomies including medial opening wedge, lateral closing wedge, medial opening hemicallotasis, and dome osteotomies. Complications can include recurrence of deformity, irritation or failure of implants, nerve palsy, nonunion, infection, or stiffness. Outcomes of high tibial osteotomies are generally good, though some patients may eventually require total knee arthroplasty. High tibial osteotomies can be combined with cartilage restoration procedures, though long-term outcomes of graft survival are mixed.
Radial head replacement best evidence
This document discusses treatment options for radial head fractures, including conservative treatment, fixation, excision, partial excision, and replacement. It provides guidelines for treating different Mason types of fractures, noting that Mason type 1 fractures can be treated conservatively, Mason type 2 fractures should be fixed, and Mason types 3 and 4 may require fixation with ligament repair or replacement depending on associated injuries. Reasons for replacing versus fixing the radial head are discussed. While there is a lack of level 1 evidence, studies at lower levels generally show better outcomes with replacement compared to fixation for complex injuries or fractures with three or more fragments. Precise sizing and avoiding overstuffing are important with replacement.
Bone grafting
Bone grafting involves using bone material to fill bony defects. There are several types of grafts including autografts harvested from a patient's own body, allografts from cadavers, and synthetic grafts. Autografts are most osteoinductive but require a donor site, while allografts avoid donor site morbidity but carry infection risks. Common graft sources are the iliac crest, tibia, and fibula. Grafts can be cortical, cancellous, or vascularized. Proper graft incorporation depends on its osteoconductivity, osteoinductivity and osteogenicity as well as local and systemic patient factors.
Osteotomies around the hip
The document discusses osteotomies around the hip, including pelvic and proximal femoral osteotomies. It covers indications, classifications, principles, techniques for various osteotomies like Salter, Steel, Ganz, Pemberton, Dega, Chiari, Schanz, Lorenz, and femoral osteotomies for conditions like slipped capital femoral epiphysis, Perthes disease, congenital coxa vara and non-unions. Post-operative principles and complications of osteotomies are also discussed.
Cementless acetabular cups
This document summarizes the history and evolution of cementless acetabular cups used in total hip replacements. It discusses the various materials used, cup shapes, surface coatings, liner designs, fixation methods, and long-term survivorship outcomes. Specifically, it traces the development from early threaded cups in the 1960s-1970s, to hemispherical cups in the 1980s, to improvements in polyethylene liners and modularity in the 1990s-2000s that have led to 10-20 year survivorship rates of 85-96% for current cementless cup designs, comparable to outcomes for cemented cups. Press-fit fixation is emphasized as the primary method of stabilization, with supplemental screws as needed.
Basics of total hip replacement by DR. D. P. SWAMI
BASICS OF THR WITH CLINICAL ANATOMY, BIO-MECHANICS, INSTRUMENTS, IMPLANTS ANS SURGICAL TECHNIQUE WITH POST OPERATIVE RADIOLOGICAL EVALUATION
Bone cement
Bone cement is a misnomer as it does not bond bone, but rather fills space to secure prosthetic implants. Originally developed for dentistry, it has been used in orthopedics for over 40 years. It is made of PMMA powder and MMA liquid that polymerize during mixing to form a hardened mass. Precise techniques are used for mixing and delivering the cement to reduce porosity and ensure a secure fit. Cemented joint replacements can loosen over time from debris at cement-bone interfaces. Antibiotics can be added to prevent infection. Potential issues include temperature rise and release of substances that can cause hypotension during surgery.
osteotomies around hip
This document discusses various osteotomies around the hip joint, including their objectives, indications, and procedures. Proximal femoral and pelvic osteotomies are classified. Key points include that osteotomies are used to correct biomechanical alignment and load transmission across the hip joint. Procedures discussed in detail include Salter innominate osteotomy, Sutherland double innominate osteotomy, Steel triple innominate osteotomy, Ganz periacetabular osteotomy, and Pemberton osteotomy.
Bone graft substitutes
Dr. Paudel discussed bone graft substitutes, which are used to fill bone defects and promote healing. They discussed various types including allografts, ceramics, polymers, and composites. Allografts have disadvantages like immune reactions and disease transmission. Ceramics are osteoconductive but not structural. Composites combining materials like ceramics, cells, and growth factors may provide better fusion than any component alone. The ideal bone graft substitute would be osteoconductive, osteoinductive, and provide structural support like autografts, but without their disadvantages.
High tibial osteotomy
High tibial osteotomy (HTO) is a common and widely accepted procedure in orthopaedic surgery. In the literature, we find descriptions of the technique dating back to the 50s, with Jackson (Jackson, 1958). However, it was not until the 70s, with the publications of Conventry (Coventry, 1969 and 1973) and Insall (Insall, 1975), that proximal tibial osteotomy became common practice as a treatment option for medial compartment osteoarthritis of the knee usually associated to varus deformity. At that time, closing wedge osteotomies were performed, despite the greater technical difficulty and risks involved, as there were no fixation materials available that could enable opening wedge osteotomy. Only after the development of medial wedge plate fixation that opening wedge osteotomy became applicable (Puddu, 2004).
The goals of HTO are:
1. To reduce knee pain by transferring weight-bearing loads to the relatively unaffected compartment;
2. To increase the life span of the knee joint, by slowing or stopping the destruction of the medial joint compartment. This could delay the need of a joint replacement.
Cora
This document discusses the concept of CORA (Center of Rotation of Angulation) in orthopedic surgery. It defines CORA as the point where the proximal and distal axis lines of a deformed bone intersect. CORA is important for measuring angular deformity, planning correction, and determining if a deformity is uniapical or multiapical. The bisector line passes through CORA and bisects the angle between axes. Angulation Correction Axis (ACA) is perpendicular to the plane of deformity and passes through CORA for complete correction without translation. The location of CORA, ACA, and osteotomy determine if correction is through angulation alone, angulation with translation, or with an iatrogenic
Osteotomies around the hip
Osteotomies are surgical procedures used to correct biomechanical alignment of the extremities. There are several types of osteotomies around the hip joint classified by anatomic location including femoral and pelvic osteotomies. Common indications are to correct deformities, obtain stability, relieve pain, and obtain union. Key pelvic osteotomies discussed include Salter, Pemberton, Steel, Ganz, shelf, and Chiari osteotomies. Careful pre-operative planning including x-rays and range of motion assessment is important for determining the appropriate procedure.
Medial Opening Wedge High Tibial Osteotomy
This document summarizes a presentation on medial opening wedge high tibial osteotomy. Key points include:
1) Preoperative planning is critical to determine the appropriate correction and wedge size.
2) Wedge geometry is complex, as the correction depends on both coronal and sagittal plane alignment.
3) Intraoperative assessment of alignment is challenging, and while the bovie cord provides a reasonable estimate, alternatives like radiolucent grids may improve accuracy by reducing parallax error.
Autologous condrocyte implantation
Autologous chondrocyte implantation (ACI) is a two-stage procedure to repair articular cartilage defects using a patient's own cartilage cells. In the first stage, a cartilage biopsy is taken and cells are cultured. In the second stage, the expanded cells are implanted under a periosteal flap over the prepared defect. Following implantation, the new tissue undergoes proliferation, transition, and remodeling phases over several months to years to mature into hyaline cartilage. ACI provides successful, durable outcomes for treating symptomatic cartilage defects.
Chondrolysis
Chondrolysis is the progressive destruction of articular cartilage resulting in joint space narrowing and stiffness. It can be caused by infection, trauma, following slipped capital femoral epiphysis (SCFE), or idiopathically. In SCFE cases, chondrolysis risk is higher with osteotomy or casting versus percutaneous pinning. The accepted theory is that chondrolysis results from an autoimmune response in genetically susceptible individuals. Treatment involves supportive care, identifying potential causes like pin penetration, and surgery like traction or hip replacement for severe cases.
Osteotomies around the hip joint
Osteotomies around the hip can involve the femur or pelvis. Femoral osteotomies include intertrochanteric, subtrochanteric, and greater trochanteric osteotomies. Pelvic osteotomies involve the acetabulum. Indications include non-union of the femoral neck, osteoarthritis of the hip, osteonecrosis of the femoral head, and acetabular dysplasia. Specific procedures discussed include varus, valgus, extension, Pauwels, and periacetabular osteotomies. Complications can include non-union, heterotopic ossification, and loss of fixation.
Hip osteotomy
This document provides an overview of hip osteotomies and femoral acetabular impingement (FAI). It discusses various types of osteotomies used to treat conditions like developmental dysplasia of the hip, slipped capital femoral epiphysis, and avascular necrosis. Key points include that pelvic osteotomies are best for primary acetabular dysplasia, while femoral and combined procedures are often needed in older children. The document also outlines common radiographic findings associated with pincer and cam FAI, including pistol grip deformity, acetabular retroversion, and decreased femoral head-neck offset. Risk factors and typical patient presentations are also summarized.
More Related Content
What's hot
Bearing surfaces THR
The document discusses the history and evolution of bearing surfaces used in total hip arthroplasty. Early designs from the 1910s-1950s used materials like glass, vitallium, and acrylic, which caused issues like fragmentation, tissue reactions, and bone destruction. Modern designs include conventional and cross-linked polyethylene, metal-on-metal, ceramic-on-ceramic, and ceramic-on-metal combinations. Design characteristics like material hardness, lubrication, and wear properties were improved but each bearing surface still carries some risks like wear debris, metal ions, fracture, or noise. Future directions include advanced polyethylenes and larger metal-on-metal designs to reduce wear. No single ideal bearing exists and patient factors help
Masquelet Technique
The document discusses the Masquelet technique, a two-stage procedure for treating bone defects and non-unions. In the first stage, radical debridement is performed followed by placement of an antibiotic-loaded cement spacer to form an induced membrane. In the second stage 6-8 weeks later, the membrane is preserved while removing the spacer and filling the defect with bone graft for reconstruction. Studies reported successful outcomes using this technique for various bone defects up to 25cm in length. Key factors for success include thorough debridement, maintaining the induced membrane, adequate stabilization and soft tissue management.
THR
Total hip replacement (THR) is a common procedure to treat arthritis of the hip. Prof. John Charnley pioneered THR in the 1960s using low-friction arthroplasty with polyethylene and acrylic bone cement. THR aims to reduce joint reaction forces by recentering the femoral head and lengthening muscle lever arms. Surgeons select implants and fixation methods based on patient factors and bone quality. Outcomes depend on restoring normal hip biomechanics and long-term implant fixation to bone.
Autologous chondrocyte implantation
This document discusses autologous chondrocyte transplantation (ACT), a treatment for cartilage defects. It covers the stages of ACT healing, indications, prerequisites, investigations, the implantation procedure, and rehabilitation goals. The proliferative, transition, and remodeling stages of healing are described. Advantages include producing hyaline-like cartilage to fill defects of any size. Disadvantages include being more invasive and expensive with a longer recovery than other options.
Principles of locking compression plates
This document discusses the principles of absolute and relative stability in fracture fixation, as well as locking compression plates. It describes how absolute stability aims to reduce strain below a critical level for primary healing without callus formation, while relative stability allows some motion and secondary bone healing through callus formation. Locking compression plates provide angular stability through locking head screws in the plate and bone, maintaining blood supply while providing fixation. They can be used for compression of reduced fractures or for splinting in multifragmentary fractures.
High Tibial Osteotomies
High tibial osteotomies are a surgical procedure used to treat unicompartmental osteoarthritis of the knee caused by malalignment. There are several types of high tibial osteotomies including medial opening wedge, lateral closing wedge, medial opening hemicallotasis, and dome osteotomies. Complications can include recurrence of deformity, irritation or failure of implants, nerve palsy, nonunion, infection, or stiffness. Outcomes of high tibial osteotomies are generally good, though some patients may eventually require total knee arthroplasty. High tibial osteotomies can be combined with cartilage restoration procedures, though long-term outcomes of graft survival are mixed.
Radial head replacement best evidence
This document discusses treatment options for radial head fractures, including conservative treatment, fixation, excision, partial excision, and replacement. It provides guidelines for treating different Mason types of fractures, noting that Mason type 1 fractures can be treated conservatively, Mason type 2 fractures should be fixed, and Mason types 3 and 4 may require fixation with ligament repair or replacement depending on associated injuries. Reasons for replacing versus fixing the radial head are discussed. While there is a lack of level 1 evidence, studies at lower levels generally show better outcomes with replacement compared to fixation for complex injuries or fractures with three or more fragments. Precise sizing and avoiding overstuffing are important with replacement.
Bone grafting
Bone grafting involves using bone material to fill bony defects. There are several types of grafts including autografts harvested from a patient's own body, allografts from cadavers, and synthetic grafts. Autografts are most osteoinductive but require a donor site, while allografts avoid donor site morbidity but carry infection risks. Common graft sources are the iliac crest, tibia, and fibula. Grafts can be cortical, cancellous, or vascularized. Proper graft incorporation depends on its osteoconductivity, osteoinductivity and osteogenicity as well as local and systemic patient factors.
Osteotomies around the hip
The document discusses osteotomies around the hip, including pelvic and proximal femoral osteotomies. It covers indications, classifications, principles, techniques for various osteotomies like Salter, Steel, Ganz, Pemberton, Dega, Chiari, Schanz, Lorenz, and femoral osteotomies for conditions like slipped capital femoral epiphysis, Perthes disease, congenital coxa vara and non-unions. Post-operative principles and complications of osteotomies are also discussed.
Cementless acetabular cups
This document summarizes the history and evolution of cementless acetabular cups used in total hip replacements. It discusses the various materials used, cup shapes, surface coatings, liner designs, fixation methods, and long-term survivorship outcomes. Specifically, it traces the development from early threaded cups in the 1960s-1970s, to hemispherical cups in the 1980s, to improvements in polyethylene liners and modularity in the 1990s-2000s that have led to 10-20 year survivorship rates of 85-96% for current cementless cup designs, comparable to outcomes for cemented cups. Press-fit fixation is emphasized as the primary method of stabilization, with supplemental screws as needed.
Basics of total hip replacement by DR. D. P. SWAMI
BASICS OF THR WITH CLINICAL ANATOMY, BIO-MECHANICS, INSTRUMENTS, IMPLANTS ANS SURGICAL TECHNIQUE WITH POST OPERATIVE RADIOLOGICAL EVALUATION
Bone cement
Bone cement is a misnomer as it does not bond bone, but rather fills space to secure prosthetic implants. Originally developed for dentistry, it has been used in orthopedics for over 40 years. It is made of PMMA powder and MMA liquid that polymerize during mixing to form a hardened mass. Precise techniques are used for mixing and delivering the cement to reduce porosity and ensure a secure fit. Cemented joint replacements can loosen over time from debris at cement-bone interfaces. Antibiotics can be added to prevent infection. Potential issues include temperature rise and release of substances that can cause hypotension during surgery.
osteotomies around hip
This document discusses various osteotomies around the hip joint, including their objectives, indications, and procedures. Proximal femoral and pelvic osteotomies are classified. Key points include that osteotomies are used to correct biomechanical alignment and load transmission across the hip joint. Procedures discussed in detail include Salter innominate osteotomy, Sutherland double innominate osteotomy, Steel triple innominate osteotomy, Ganz periacetabular osteotomy, and Pemberton osteotomy.
Bone graft substitutes
Dr. Paudel discussed bone graft substitutes, which are used to fill bone defects and promote healing. They discussed various types including allografts, ceramics, polymers, and composites. Allografts have disadvantages like immune reactions and disease transmission. Ceramics are osteoconductive but not structural. Composites combining materials like ceramics, cells, and growth factors may provide better fusion than any component alone. The ideal bone graft substitute would be osteoconductive, osteoinductive, and provide structural support like autografts, but without their disadvantages.
High tibial osteotomy
High tibial osteotomy (HTO) is a common and widely accepted procedure in orthopaedic surgery. In the literature, we find descriptions of the technique dating back to the 50s, with Jackson (Jackson, 1958). However, it was not until the 70s, with the publications of Conventry (Coventry, 1969 and 1973) and Insall (Insall, 1975), that proximal tibial osteotomy became common practice as a treatment option for medial compartment osteoarthritis of the knee usually associated to varus deformity. At that time, closing wedge osteotomies were performed, despite the greater technical difficulty and risks involved, as there were no fixation materials available that could enable opening wedge osteotomy. Only after the development of medial wedge plate fixation that opening wedge osteotomy became applicable (Puddu, 2004).
The goals of HTO are:
1. To reduce knee pain by transferring weight-bearing loads to the relatively unaffected compartment;
2. To increase the life span of the knee joint, by slowing or stopping the destruction of the medial joint compartment. This could delay the need of a joint replacement.
Cora
This document discusses the concept of CORA (Center of Rotation of Angulation) in orthopedic surgery. It defines CORA as the point where the proximal and distal axis lines of a deformed bone intersect. CORA is important for measuring angular deformity, planning correction, and determining if a deformity is uniapical or multiapical. The bisector line passes through CORA and bisects the angle between axes. Angulation Correction Axis (ACA) is perpendicular to the plane of deformity and passes through CORA for complete correction without translation. The location of CORA, ACA, and osteotomy determine if correction is through angulation alone, angulation with translation, or with an iatrogenic
Osteotomies around the hip
Osteotomies are surgical procedures used to correct biomechanical alignment of the extremities. There are several types of osteotomies around the hip joint classified by anatomic location including femoral and pelvic osteotomies. Common indications are to correct deformities, obtain stability, relieve pain, and obtain union. Key pelvic osteotomies discussed include Salter, Pemberton, Steel, Ganz, shelf, and Chiari osteotomies. Careful pre-operative planning including x-rays and range of motion assessment is important for determining the appropriate procedure.
Medial Opening Wedge High Tibial Osteotomy
This document summarizes a presentation on medial opening wedge high tibial osteotomy. Key points include:
1) Preoperative planning is critical to determine the appropriate correction and wedge size.
2) Wedge geometry is complex, as the correction depends on both coronal and sagittal plane alignment.
3) Intraoperative assessment of alignment is challenging, and while the bovie cord provides a reasonable estimate, alternatives like radiolucent grids may improve accuracy by reducing parallax error.
Autologous condrocyte implantation
Autologous chondrocyte implantation (ACI) is a two-stage procedure to repair articular cartilage defects using a patient's own cartilage cells. In the first stage, a cartilage biopsy is taken and cells are cultured. In the second stage, the expanded cells are implanted under a periosteal flap over the prepared defect. Following implantation, the new tissue undergoes proliferation, transition, and remodeling phases over several months to years to mature into hyaline cartilage. ACI provides successful, durable outcomes for treating symptomatic cartilage defects.
Chondrolysis
Chondrolysis is the progressive destruction of articular cartilage resulting in joint space narrowing and stiffness. It can be caused by infection, trauma, following slipped capital femoral epiphysis (SCFE), or idiopathically. In SCFE cases, chondrolysis risk is higher with osteotomy or casting versus percutaneous pinning. The accepted theory is that chondrolysis results from an autoimmune response in genetically susceptible individuals. Treatment involves supportive care, identifying potential causes like pin penetration, and surgery like traction or hip replacement for severe cases.
What's hot (20)
Basics of total hip replacement by DR. D. P. SWAMI
Basics of total hip replacement by DR. D. P. SWAMI
Viewers also liked
Osteotomies around the hip joint
Osteotomies around the hip can involve the femur or pelvis. Femoral osteotomies include intertrochanteric, subtrochanteric, and greater trochanteric osteotomies. Pelvic osteotomies involve the acetabulum. Indications include non-union of the femoral neck, osteoarthritis of the hip, osteonecrosis of the femoral head, and acetabular dysplasia. Specific procedures discussed include varus, valgus, extension, Pauwels, and periacetabular osteotomies. Complications can include non-union, heterotopic ossification, and loss of fixation.
Hip osteotomy
This document provides an overview of hip osteotomies and femoral acetabular impingement (FAI). It discusses various types of osteotomies used to treat conditions like developmental dysplasia of the hip, slipped capital femoral epiphysis, and avascular necrosis. Key points include that pelvic osteotomies are best for primary acetabular dysplasia, while femoral and combined procedures are often needed in older children. The document also outlines common radiographic findings associated with pincer and cam FAI, including pistol grip deformity, acetabular retroversion, and decreased femoral head-neck offset. Risk factors and typical patient presentations are also summarized.
Osteotomies around the hip
Osteotomies around the hip are surgical procedures used to correct biomechanical alignment and load transmission across the hip joint. They involve removing a portion of bone. The goals are to improve femoral head coverage, containment, motion, relieve pain, and correct leg length discrepancies. Different types of osteotomies target the proximal femur or pelvis. Proximal femoral osteotomies are classified based on anatomical location and degree of displacement. Pelvic osteotomies aim to redirect the acetabulum and include Salter, Sutherland, Steel/Tonnis, and Ganz/Bernese procedures. Key considerations for each procedure include indications, approach, osteotomy cuts made, advantages/disadv
Ostetomies around hip by hemant mamc
1. The document discusses various types of osteotomies performed around the hip joint to correct deformities and improve biomechanics. It describes pelvic osteotomies like Pemberton, Salter, and Ganz osteotomies which reorient the acetabulum.
2. Femoral osteotomies discussed include varus, valgus, and rotational osteotomies. Varus osteotomies elevate the greater trochanter medially to improve joint congruity. Valgus, or abduction osteotomies, tilt the distal fragment away from the midline to increase femoral neck angle.
3. The principles, indications, techniques and outcomes of
osteotomies around hip by dr gandhi
This document outlines details from a seminar on osteotomies around the hip presented by Dr. Vaibhav Gandhi at Gandhi Medical College, Bhopal. It includes definitions of osteotomy procedures, classifications based on anatomic location and indications, as well as overviews and details of specific osteotomies such as the Salter, Pemberton, triple innominate, Ganz, and shelf (Staheli) procedures. Force diagrams and biomechanical principles relating to the hip are also discussed.
DDH
This document discusses developmental dysplasia of the hip (DDH), including its pathogenesis, clinical features at different ages, diagnostic imaging tools, and management approaches. DDH is a spectrum of hip disorders that can present from birth through childhood. Management involves both non-surgical and surgical techniques depending on the age of presentation and severity, with the goal of achieving and maintaining a stable, concentric reduction to allow normal hip development. Surgical options range from closed or open reduction to osteotomies to improve acetabular coverage. Careful long-term follow up is important to monitor for residual dysplasia or deformity.
total hip arthroplasty
Total Hip Arthroplasty involves replacing the hip joint with prosthetic components. The history of hip replacement began in the early 20th century using biological materials to resurface joints. Professor John Charnley pioneered modern hip replacement in the 1960s using a femoral stem and acetabular cup. Successful hip replacement requires restoring the biomechanics of the hip with appropriate implant fixation and stress transfer to bone. Complications can include dislocation, infection, loosening and osteolysis.
Total hip replacement
This document provides information about total hip replacement surgery. It discusses the history, principles, indications, contraindications, implants, surgical techniques, postoperative nursing management, health education, exercise guidelines, and potential complications. Total hip replacement involves replacing both the acetabulum and femoral head to relieve pain and restore joint function. Postoperative care focuses on preventing dislocation, thromboembolism, and infection while promoting early ambulation and exercise.
Viewers also liked (9)
Similar to Bernese periacetabular osteotomy
Effect of a_knee_ankle_foot_orthosis_on_knee.10
The KAFO significantly reduced knee varus angle and the first peak of the external knee adduction moment during walking compared to no orthosis. It also reduced the knee adduction angular impulse during stair ascent compared to no orthosis. No significant differences were found between the custom and off-the-shelf knee valgus braces for any measures. The KAFO showed greater improvements in knee alignment and loading than the knee valgus braces for this individual with varus knee alignment.
Hip involvement negatively impact the postoperative radiographic outcomes aft...
Hip involvement negatively impact the postoperative radiographic outcomes aft...Clinical Surgery Research Communications
This study examined whether hip involvement negatively impacts radiographic outcomes after lumbar pedicle subtraction osteotomy (PSO) in ankylosing spondylitis patients with thoracolumbar kyphosis. 44 patients underwent one-level lumbar PSO and were divided into two groups based on their hip involvement scores. Both groups had similar corrections of local kyphosis, but the group with hip involvement had significantly larger sagittal vertical axis and pelvic tilt postoperatively, indicating hip involvement can negatively impact radiographic outcomes after lumbar PSO. Additional osteotomies may be needed for patients with hip involvement to achieve satisfactory correction.Journal bukit
1) Pelvic fractures are associated with significant morbidity and mortality, with the ischiopubic bones, sacroiliac joint, and sacrum being most commonly injured.
2) Pelvic fractures are classified using the Tile or Young-Burgess classifications, with type I injuries usually managed non-operatively and type II and III injuries generally requiring surgical stabilization due to instability.
3) The timing of surgical fixation is dependent on hemodynamic status and associated injuries, with early fixation (<24 hours) associated with lower morbidity but also higher risk of bleeding in unstable patients. External fixation can be used initially in hemodynamically unstable patients before definitive fixation.
Carrying Angle
The carrying angle of the elbow is the angle between the longitudinal axes of the upper arm and forearm. It averages 13.6 degrees in females and 6.7 degrees in males. The carrying angle increases progressively from childhood to age 16 and plays an important role in activities of daily living. Abnormal carrying angles outside of 5-15 degrees can indicate conditions like cubitus valgus or varus. Repetitive overhead motions like throwing can place stress on the medial elbow ligaments and lead to injuries or tears over time. Accurate measurement and assessment of the carrying angle is important for managing elbow injuries and planning reconstructive surgeries.
Proximal fibular osteotomy
This document summarizes a study on using proximal fibular osteotomy (PFO) to treat medial compartment osteoarthritis of the knee. PFO is presented as a simpler, less expensive alternative to procedures like high tibial osteotomy (HTO). The study included one patient who underwent PFO and was followed for 6 months, showing decreased pain scores and improved knee joint space. While PFO provided good short-term outcomes, more research is needed to establish its role compared to procedures like HTO and unicompartmental knee arthroplasty. PFO may be particularly suitable for resource-limited settings due to its low cost and technical simplicity.
ApiFix treatment for Adolescent Idiopathic Scoliosis (AIS): The importance of...
The document discusses the ApiFix treatment for adolescent idiopathic scoliosis and the importance of Schroth method exercises after the minimal invasive operation. It summarizes that ApiFix offers an internal brace option for some scoliosis cases as an alternative to bracing or spinal fusion. It also finds that using Schroth method exercises after the ApiFix operation helped improve scoliosis parameters like Cobb angle and trunk rotation in patients. The document concludes that proper patient selection for ApiFix and use of post-operative Schroth exercises can lead to good treatment outcomes.
Exploring Advances In THA
This document provides an overview of a physical therapy course on total hip rehabilitation. The course objectives are to understand hip surgery and exercises, describe hip biomechanics, and effectively progress patients through rehabilitation. The schedule covers topics like evidence-based practice, anatomy, exercises, and outcome measures. Recent advances in hip rehabilitation include smaller incisions, reduced hospital stays, and early mobilization leading to better short-term outcomes. Assessment tools for hip function include the Lower Extremity Function Scale and Harris Hip Score.
Tendon Loading Program for Long Distance Runner
Case Presentation: Insertional Achilles Tendinopathy- Tendon Loading Program for Long Distance Runner
groin injuries in athletes
groin injuries are common but neglected in orthopaedics and sports injuries field as region is an enigma as too mant structures are present in a small space. the present PPT describes approach and management of groin injuries
Evaluacion de un dolor de cadera
Hip pain is a common presentation that can affect patients of all ages. The differential diagnosis of hip pain is broad and includes both intra-articular and extra-articular pathology that varies by age. A thorough history and physical examination are essential to accurately diagnose the cause of hip pain. Initial imaging should include an x-ray of the pelvis and hip, while MRI is useful for detecting soft tissue injuries. Magnetic resonance arthrography is particularly helpful for diagnosing labral tears within the hip joint.
Hip Arthroscopy in 2013: Inova Annual Sports Medicine Program
This document discusses hip arthroscopy techniques and considerations in 2013. It begins with an overview of the goals of hip arthroscopy which are to relieve pain, improve function, and improve longevity by restoring hip anatomy. It then discusses various pathologies that may be addressed such as CAM lesions, pincer lesions, torn labrums, and cartilage defects. Approaches can be open or arthroscopic. The document emphasizes making the correct diagnosis and understanding concomitant issues. It provides guidance on evaluating patients through history, physical exam including various special tests, and diagnostic injections. Femoroacetabular impingement is discussed as a common cause of labral tears. Techniques for addressing pincer impingement including bony resection are outlined
Mri knee
MRI is commonly used to evaluate the knee joint. The document outlines the standard MRI protocol for the knee, including patient positioning, coil selection, routine sequences, and advanced applications. Parameters such as slice thickness, FOV, and pulse sequences are discussed to optimize visualization of structures like ligaments, cartilage, and menisci.
Achilles Tendon Presentation2013
The Achilles tendon evolved approximately 2 million years ago to allow humans to run faster. It is prone to injury due to its limited blood supply. A rupture typically occurs when a load is applied while the tendon is stretched, often due to pre-existing tendonitis. Treatment options include operative repair through open surgery or minimally invasive surgery, or non-operative casting and rehabilitation. Rehabilitation programs focus on regaining range of motion and strength over 4-6 months. Future research could investigate genetic risk factors, standardized strength testing for different treatment options, and outcomes of surgery for primary versus recurrent ruptures.
Hip oa + itbs
Hip osteoarthritis is a degenerative joint disease that commonly affects the elderly. It causes progressive damage to articular cartilage and surrounding structures in the hip joint. The main symptoms are pain in the groin region that may radiate to the knee, joint stiffness, and functional impairment. Risk factors include age, obesity, previous hip injury or surgery. Diagnosis is based on clinical history, physical exam findings, and radiographic changes. Treatment involves patient education, exercises to increase strength and flexibility, weight loss, and joint replacement surgery for advanced cases.
Beverland D. Surgical Factors Influencing Rom
The document discusses several factors that can influence range of motion (ROM) after knee arthroplasty surgery:
1) Surgical technique factors like thoroughly removing osteophytes, restoring proper joint alignment and posterior condylar offset, avoiding excess release of the medial collateral ligament, and closing the surgical wound in extension rather than flexion.
2) Rehabilitation protocols, including early use of continuous passive motion and adherence to post-operative physical therapy.
3) Patient factors such as pre-operative ROM, obesity, and underlying diagnosis of rheumatoid arthritis or osteoarthritis.
4) Potential treatments for stiff knees after surgery include manipulation under anesthesia and revision procedures to address issues like internal rotation of the femoral component
Osteoarthritis in the young
This document discusses the use of osteotomy procedures, specifically high tibial osteotomy (HTO), for treating osteoarthritis (OA) in younger patients with malalignment. It provides details on the purpose and techniques of HTO, including closed-wedge and open-wedge approaches. Ideal candidates for HTO are identified as those under age 60 with isolated medial compartment OA and varus malalignment of under 15 degrees. Complications of HTO procedures are outlined. Studies have found obesity, inadequate correction, and age over 50 to be negative prognostic factors, while joint line preservation is key to success.
Hip impingement fai
Femoroacetabular impingement (FAI) is a hip condition caused by a mechanical mismatch between the femoral head and acetabulum. There are three types of FAI - cam, pincer, and mixed - which describe deformities of the femoral head or acetabulum that can cause pain and restricted movement. FAI is typically diagnosed based on symptoms like groin pain worsened by activity, and imaging tests may confirm deformities. Treatment starts with rest, modifications to activity, and physical therapy, while surgery can reshape bone structures for severe cases or when other options provide no relief.
Preliminary management of pelvic injury
- High-energy pelvic injuries cause significant morbidity and mortality up to 20% especially with hemodynamic instability.
- Evaluation includes clinical exam for wounds and blood, radiographs, CT scan, and retrograde urethrogram and cystogram to check for injuries.
- Pelvic fractures are classified by their mechanism including lateral compression, anterior-posterior compression, and vertical shear.
- Management focuses on resuscitation, hemorrhage control, and skeletal stabilization. Temporary stabilization is achieved using pelvic binders or MAST while external fixation can provide definitive stabilization. Angioembolization may be needed for persistent bleeding.
Orthoses for shoulder, elbow and forearm
This document discusses various orthoses used for the shoulder, elbow, and forearm. It begins by outlining the main objectives of upper limb orthosis as protection, correction, and assistance. It then describes different types of orthoses categorized by joint covered, function provided, condition treated, appearance, and designer. Examples of specific orthoses are provided like figure-8 axilla orthosis, lateral trunk shoulder-elbow-wrist orthosis, and static shoulder-elbow-wrist sling. Design variations are also covered such as static, serial static, and dynamic. The document provides details on several orthosis like Wilmer carrying orthosis and its standard and hands-free units.
Non union neck of femur
This document discusses the evaluation and management of non-union of neck of femur fractures. It begins by defining non-union and describing the blood supply of the femoral head. It then discusses the causes of non-union in neck of femur fractures, including factors related to the initial fracture and treatment. The document outlines the history, physical exam findings, and investigations for evaluating a suspected non-union. It describes various treatment options for head-preserving or head-sacrificing management, including open reduction and fixation, bone grafting procedures, osteotomies, and arthroplasty. A classification system is presented for predicting the appropriate treatment based on factors like fracture pattern, gap size, and femoral head viability.
Similar to Bernese periacetabular osteotomy (20)
Hip involvement negatively impact the postoperative radiographic outcomes aft...
Hip involvement negatively impact the postoperative radiographic outcomes aft...
ApiFix treatment for Adolescent Idiopathic Scoliosis (AIS): The importance of...
ApiFix treatment for Adolescent Idiopathic Scoliosis (AIS): The importance of...
Hip Arthroscopy in 2013: Inova Annual Sports Medicine Program
Hip Arthroscopy in 2013: Inova Annual Sports Medicine Program
Recently uploaded
KENT'S REPERTORY by dr niranjan mohanty.pptx
its a presentation on Dr kents Repertory by Dr niranjan Mohanty
Foundation of Yoga, YCB Level-3, Unit-1
Unit -1 of Yoga certification board, level 3, all topics covered. An exam conducted by ministry of Ayush for yoga enthusiastic students.
Helminthiasis or Worm infestation in Children for Nursing students
Brief description worm infestation/Helminthiasis for Basic B.Sc Nursing students
Hemodialysis: Chapter 5, Dialyzers Overview - Dr.Gawad
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...Université de Montréal
“Psychiatry and the Humanities”: An Innovative Course at the University of Montreal Expanding the medical model to embrace the humanities. Link: https://www.psychiatrictimes.com/view/-psychiatry-and-the-humanities-an-innovative-course-at-the-university-of-montrealAgeing, the Elderly, Gerontology and Public Health
Challenges associated with ageing from a public health perspective
Travel Clinic Cardiff: Health Advice for International Travelers
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
How to Control Your Asthma Tips by gokuldas hospital.
Respiratory issues like asthma are the most sensitive issue that is affecting millions worldwide. It hampers the daily activities leaving the body tired and breathless.
The key to a good grip on asthma is proper knowledge and management strategies. Understanding the patient-specific symptoms and carving out an effective treatment likewise is the best way to keep asthma under control.
Skin Diseases That Happen During Summer.
Summer is a time for fun in the sun, but the heat and humidity can also wreak havoc on your skin. From itchy rashes to unwanted pigmentation, several skin conditions become more prevalent during these warmer months.
biomechanics of running. Dr.dhwani.pptx
The biomechanics of running involves the study of the mechanical principles underlying running movements. It includes the analysis of the running gait cycle, which consists of the stance phase (foot contact to push-off) and the swing phase (foot lift-off to next contact). Key aspects include kinematics (joint angles and movements, stride length and frequency) and kinetics (forces involved in running, including ground reaction and muscle forces). Understanding these factors helps in improving running performance, optimizing technique, and preventing injuries.
Breast cancer: Post menopausal endocrine therapy
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
Medical Quiz ( Online Quiz for API Meet 2024 ).pdf
This quiz was conducted as a promotional event for the 2024 Annual Meet of Kerala Chapter of API.
More than 20 participants took part everyday !
Call Girls In Mumbai +91-7426014248 High Profile Call Girl Mumbai
Call Girls In Mumbai +91-7426014248 High Profile Call Girl Mumbai
Cervical Disc Arthroplasty ORSI 2024.pptx
Indication and installation of a mobile cervical disc prosthesis. Benefits of the PRODISC C VIVO mobile disc prosthesis (Centinel Spine)
Know the difference between Endodontics and Orthodontics.
Your smile is beautiful.
Let’s be honest. Maintaining that beautiful smile is not an easy task. It is more than brushing and flossing. Sometimes, you might encounter dental issues that need special dental care. These issues can range anywhere from misalignment of the jaw to pain in the root of teeth.
Giloy in Ayurveda - Classical Categorization and Synonyms
Giloy, also known as Guduchi or Amrita in classical Ayurvedic texts, is a revered herb renowned for its myriad health benefits. It is categorized as a Rasayana, meaning it has rejuvenating properties that enhance vitality and longevity. Giloy is celebrated for its ability to boost the immune system, detoxify the body, and promote overall wellness. Its anti-inflammatory, antipyretic, and antioxidant properties make it a staple in managing conditions like fever, diabetes, and stress. The versatility and efficacy of Giloy in supporting health naturally highlight its importance in Ayurveda. At Planet Ayurveda, we provide a comprehensive range of health services and 100% herbal supplements that harness the power of natural ingredients like Giloy. Our products are globally available and affordable, ensuring that everyone can benefit from the ancient wisdom of Ayurveda. If you or your loved ones are dealing with health issues, contact Planet Ayurveda at 01725214040 to book an online video consultation with our professional doctors. Let us help you achieve optimal health and wellness naturally.
Top Travel Vaccinations in Manchester
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
Full Handwritten notes of RA by Ayush Kumar M pharm - Al ameen college of pha...
Full Handwritten notes of RA by Ayush Kumar M pharm - Al ameen college of pha...ayushrajshrivastava7
Regulatory Affairs
Full hand written notes
M.pharm - 1st year .What are the different types of Dental implants.
Are you looking for a long-lasting solution to your missing tooth?
Dental implants are the most common type of method for replacing the missing tooth. Unlike dentures or bridges, implants are surgically placed in the jawbone. In layman’s terms, a dental implant is similar to the natural root of the tooth. It offers a stable foundation for the artificial tooth giving it the look, feel, and function similar to the natural tooth.
Recently uploaded (20)
Helminthiasis or Worm infestation in Children for Nursing students
Helminthiasis or Worm infestation in Children for Nursing students
Hemodialysis: Chapter 5, Dialyzers Overview - Dr.Gawad
Hemodialysis: Chapter 5, Dialyzers Overview - Dr.Gawad
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...
Ageing, the Elderly, Gerontology and Public Health
Ageing, the Elderly, Gerontology and Public Health
Travel Clinic Cardiff: Health Advice for International Travelers
Travel Clinic Cardiff: Health Advice for International Travelers
How to Control Your Asthma Tips by gokuldas hospital.
How to Control Your Asthma Tips by gokuldas hospital.
Medical Quiz ( Online Quiz for API Meet 2024 ).pdf
Medical Quiz ( Online Quiz for API Meet 2024 ).pdf
Call Girls In Mumbai +91-7426014248 High Profile Call Girl Mumbai
Call Girls In Mumbai +91-7426014248 High Profile Call Girl Mumbai
Know the difference between Endodontics and Orthodontics.
Know the difference between Endodontics and Orthodontics.
Giloy in Ayurveda - Classical Categorization and Synonyms
Giloy in Ayurveda - Classical Categorization and Synonyms
Full Handwritten notes of RA by Ayush Kumar M pharm - Al ameen college of pha...
Full Handwritten notes of RA by Ayush Kumar M pharm - Al ameen college of pha...
Bernese periacetabular osteotomy
- 1. Bernese Periacetabular Osteotomy for Hip Dysplasia - Salomi R. Vora
- 2. Progression of Hip Dysplasia1 Congenital/ acquired mal- alignment Reduced femoral coverage Increased contact stress at hip Degenerative joint disease Total hip Arthroplasty
- 3. Introduction The Bernese Periacetabular Osteotomy (BPO) was developed in 1984 and was published in 1988.2 This minimally invasive technique was developed to address the following needs; - Increased reorientation of acetabulum to increase hip contact area. - Increased stability of hemi- pelvis for immediate weight bearing in the post operative phase.1
- 4. Advantages of Osteotomy: Reorients acetabulum Increases load bearing area of hip. Reduces contact hip stress Prevents or delays progression of OA
- 5. Advantages of BPO:3 BPO • Appropriate correction coverage while maintaining acetabular version. • Single incision – no damage of abductors • No disruption of pelvic or outlet ring. • Allows for capsulotomy to assess the labrum/ any impingement.
- 6. Criteria for performing BPO1,3: Young age (at least < 50- 55 years old) Presence of concentric / internal rotation hip motion. Spherical joint surfaces. No secondary arthrosis (Tonnis Grade 2/ less)
- 9. Functional Measures for Follow up1 WOMAC score Tonnis Classification for OA
- 10. Functional Outcome Study 1: - Population = 24 patients - Follow up duration = mean of 3.5 years - Results = 18 out of 24 patients showed high functional level on follow up.4
- 11. Study 2: - Population = 26 patients with unilateral osteotomies. - Follow up duration = 7-15 years. - Results = 4 patients THA, 8 patients considerable arthrosis and 14 patients no/ mild arthrosis on follow up. 1
- 12. Post –Operative Therapy Recommendations1,3 Mobilization with partial weight bearing (20- 40 pounds)- 3 days. AROM Exercises with > 90° - 4 weeks Total weight bearing – 6-8 weeks.
- 13. Resources WOMAC score: http://www.rheumatology.org/Practice/C linical/Clinicianresearchers/Outcomes_Inst rumentation/Western_Ontario_and_McM aster_Universities_Osteoarthritis_Index_(W OMAC)/ Tonnis classification for OA: http://www.preventivehip.org/hip- scores/tonnis-classification THANK YOU
- 14. References 1. Kralj M, Mavcic B, Antolic V, Iglic A, Kralj-Iglic V. The Bernese periacetabular osteotomy: clinical, radiographic and mechanical 7-15-year follow-up of 26 hips. Acta Orthopaedica. December 2005;76(6):833-840. 2. Ganz R, Klaue K, Vinh T, Mast J. A new periacetabular osteotomy for the treatment of hip dysplasias: technique and preliminary results. 1988. Clinical Orthopaedics And Related Research. January 2004;(418):3-8. 3. Trousdale R, Cabanela M. Lessons learned after more than 250 periacetabular osteotomies. Acta Orthopaedica Scandinavica. April 2003;74(2):119. 1. Badra M, Anand A, Straight J, Sala D, Ruchelsman D, Feldman D. Functional outcome in adult patients following Bernese periacetabular osteotomy. Orthopedics. January 2008;31(1):69.
Editor's Notes
- An osteotomy has been the surgical choice of intervention to improve functional outcomes in individuals with . Patients have been mobilized as soon as the third day post surgery with PWB using crutches.
- It has many advantages: 1) it permits correction coverage medially, laterally, and anteriorly as needed while at the same time maintaining proper acetabular version; 2) it can be performed through a single incision, without damaging the abductors; 3) the pelvic ring and outlet are not disrupted, which per- mits early mobilization, there is no need for cast or brace immobilization, and it allows for future vaginal delivery without complication; and 4) one can perform a capsulotomy to assess the labrum and check for impingement without compromising the acetabular blood supply (Ganz et al. 1988, Trousdale et al. 1995). Intraoperative EMG is used to moniter the peroneal divisions sciatic and femoral nerve.Incisions performed through the inner aspect of the pelvis
- 1. Probably due to increased degenerative changes in elderly patients.2.Many patients do not meet the criteria of No arthrosis (Murphy & Deshmukh, 2002.)
- WOMAC measures for pain functional limitation and stiffness. The WOMAC is among the most widely used assessments in arthritis research.The Western Ontario and McMaster Universities Arthritis Index (WOMAC)