This document summarizes shoulder arthroplasty. It discusses that shoulder lesions requiring arthroplasty are less common than hip and knee lesions. It outlines the indications for shoulder arthroplasty, which include osteoarthritis, rheumatoid arthritis, rotator cuff tear arthropathy, avascular necrosis, post-traumatic arthritis, and severe proximal humeral fractures. The options for shoulder arthroplasty procedures are hemiarthroplasty, total shoulder arthroplasty, and reverse total shoulder arthroplasty. Complications that can occur include instability, infection, heterotopic ossification, stiffness, periprosthetic fractures, and axillary nerve injury.
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.
3 d printing in orthopaedics seminar_mukul jain_12.10.2019MukulJain81
3D printing has applications in orthopaedics such as creating anatomical models for surgical planning, custom cutting guides and implants. There are various 3D printing technologies like fused deposition modeling (FDM), stereolithography (SLA) and selective laser sintering (SLS) that use materials like plastics, metals and ceramics. 3D printed models and custom guides help improve surgical accuracy and reduce time. Metal 3D printing allows customized implants. Tissue engineering aims to 3D print cartilage and bone grafts but remains a research area. 3D printing is revolutionizing orthopaedics by enabling personalized surgical tools and implants.
The document discusses reverse total shoulder arthroplasty (rTSA), including:
- The procedure reverses the ball and socket of the shoulder joint.
- It was approved for use in the US in 2004.
- The new design moves the center of rotation medially and inferiorly, increasing deltoid tension and function as the primary shoulder elevator.
- Indications include severe rotator cuff deficiency or previous TSA failure. Contraindications include infection or inadequate bone stock. Potential complications range from minor issues like stiffness or hematoma to more serious problems like prosthesis loosening or nerve damage.
The document describes the Modified Broström Procedure for treating unstable ankles. It discusses how ankle instability is graded from I to III based on the amount of instability present. It notes that grade I and some grade II ankles may be treated conservatively through physical therapy and bracing, while grade III typically requires surgical reconstruction. The Modified Broström Procedure is described as restoring stability through anatomic repair of the ligaments while preserving range of motion and the peroneal tendons. It involves attaching the extensor retinaculum to reinforce the repaired ligaments and correct subtalar instability.
A review of the reverse total shoulder replacement surgery and it's clinical implications for both physical rehabilitation and functional anatomy.
Objectives:
Understand basic anatomy of the shoulder complex and its implications for shoulder replacement
Understand indications for shoulder replacement
Understand differences between standard and reverse total shoulder replacements
Understand precautions following rTSA
Understand important concepts in rehabilitation following rTSA
This document summarizes shoulder arthroplasty. It discusses that shoulder lesions requiring arthroplasty are less common than hip and knee lesions. It outlines the indications for shoulder arthroplasty, which include osteoarthritis, rheumatoid arthritis, rotator cuff tear arthropathy, avascular necrosis, post-traumatic arthritis, and severe proximal humeral fractures. The options for shoulder arthroplasty procedures are hemiarthroplasty, total shoulder arthroplasty, and reverse total shoulder arthroplasty. Complications that can occur include instability, infection, heterotopic ossification, stiffness, periprosthetic fractures, and axillary nerve injury.
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.
3 d printing in orthopaedics seminar_mukul jain_12.10.2019MukulJain81
3D printing has applications in orthopaedics such as creating anatomical models for surgical planning, custom cutting guides and implants. There are various 3D printing technologies like fused deposition modeling (FDM), stereolithography (SLA) and selective laser sintering (SLS) that use materials like plastics, metals and ceramics. 3D printed models and custom guides help improve surgical accuracy and reduce time. Metal 3D printing allows customized implants. Tissue engineering aims to 3D print cartilage and bone grafts but remains a research area. 3D printing is revolutionizing orthopaedics by enabling personalized surgical tools and implants.
The document discusses reverse total shoulder arthroplasty (rTSA), including:
- The procedure reverses the ball and socket of the shoulder joint.
- It was approved for use in the US in 2004.
- The new design moves the center of rotation medially and inferiorly, increasing deltoid tension and function as the primary shoulder elevator.
- Indications include severe rotator cuff deficiency or previous TSA failure. Contraindications include infection or inadequate bone stock. Potential complications range from minor issues like stiffness or hematoma to more serious problems like prosthesis loosening or nerve damage.
The document describes the Modified Broström Procedure for treating unstable ankles. It discusses how ankle instability is graded from I to III based on the amount of instability present. It notes that grade I and some grade II ankles may be treated conservatively through physical therapy and bracing, while grade III typically requires surgical reconstruction. The Modified Broström Procedure is described as restoring stability through anatomic repair of the ligaments while preserving range of motion and the peroneal tendons. It involves attaching the extensor retinaculum to reinforce the repaired ligaments and correct subtalar instability.
A review of the reverse total shoulder replacement surgery and it's clinical implications for both physical rehabilitation and functional anatomy.
Objectives:
Understand basic anatomy of the shoulder complex and its implications for shoulder replacement
Understand indications for shoulder replacement
Understand differences between standard and reverse total shoulder replacements
Understand precautions following rTSA
Understand important concepts in rehabilitation following rTSA
The document discusses the Cast Index, which is the ratio of the anteroposterior (A-P) diameter to the mediolateral (M-L) diameter of a limb. An ideal Cast Index matches these ratios, preventing slipping or displacement of fractures under plaster casts. Specific ideal Cast Index ratios are provided for different parts of the upper and lower limbs. Maintaining the proper Cast Index through a well-contoured, lightweight cast is the most important factor in ensuring fractures remain reduced and heal properly.
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.
CURRENT TRENDS IN MANAGEMENT OF PERTHES DISEASE BY DR.GIRISH MOTWANIGirish Motwani
This document discusses Perthes disease and its management. It begins with an overview of the 4 stages of the disease based on the evolution: avascular necrosis, revascularization/fragmentation, ossification/healing, and remodeling. It then examines various classification systems used to assess the extent of involvement, including Catterall, Salter-Thompson, Herring, and Elizabethtown classifications. Containment methods like bracing and surgical options like femoral and pelvic osteotomies are covered. The talk emphasizes the importance of assessing the structural integrity of the femoral head, especially the lateral pillar, when determining treatment and prognosis.
The document discusses the Kocker-Langenbeck surgical approach for hip fractures. It provides a brief history of the approach's development. The key steps of the classic approach are described, including indications, positioning, incision, exposure of anatomical structures, fracture reduction techniques, and potential complications. Modifications like trochanteric osteotomy are also covered. The approach remains a workhorse for treating posterior hip fractures but requires careful exposure and identification of structures to minimize risks.
Bioabsorbable Implants in Orthopaedics - Dr Chintan N PatelDrChintan Patel
This document discusses bioabsorbable implants used in orthopaedics. It defines bioabsorbable implants as those that gradually degrade through biological processes and are absorbed and excreted by the body. Common materials used include polyglycolic acid and polylactic acid. Bioabsorbable implants offer advantages over metallic implants by eliminating the need for removal surgery and avoiding problems like stress shielding. While offering promise, bioabsorbable implants also have drawbacks like inadequate strength and stiffness. Future areas of development include implants that degrade at medium time periods and ability to deliver drugs locally.
This document provides an overview of classical shoulder arthroplasty versus reverse shoulder arthroplasty. It discusses the history, anatomy, biomechanics, prosthesis designs, surgical approaches, complications, and outcomes of both procedures. Key points include that total shoulder arthroplasty generally provides better outcomes than hemiarthroplasty, especially long-term. Reverse shoulder arthroplasty is primarily used for nonfunctional rotator cuff tears, while classical arthroplasty requires an intact rotator cuff. Complications can occur years after surgery and include loosening, infection, and fractures.
The document discusses different types of knee prostheses from least to most constrained, including cruciate-retaining, posterior-stabilized, constrained non-hinged, and constrained hinged designs. It covers indications, advantages, disadvantages, and key design aspects such as femoral rollback and radiographic appearance for each type. Mobile bearing and all-polyethylene designs are also briefly discussed.
Recent advancements in shoulder arthroplasty were discussed. Charles Neer pioneered modern shoulder replacement in the 1950s. Since then, total shoulder replacement and reverse total shoulder arthroplasty were developed. The shoulder joint anatomy and biomechanics were described. Clinical indications for various arthroplasty procedures like hemiarthroplasty, total shoulder arthroplasty, and reverse shoulder arthroplasty were provided. Potential complications of arthroplasty and post-operative rehabilitation protocols were also summarized.
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.
Arthroscopic management of rotator cuff tears larissa 2016Aaron Venouziou
Rotator cuff tears are a spectrum of conditions ranging from asymptomatic partial tears to symptomatic rotator cuff arthropathy. The document discusses the anatomy and biomechanics of the rotator cuff and shoulder. It describes the classification, incidence, etiology, and treatment options for partial and full-thickness rotator cuff tears. Surgical techniques for repairing tears are outlined, including considerations for different tear patterns. Post-operative healing rates and functional outcomes are addressed. The conclusion emphasizes the importance of the rotator cuff for shoulder function and discusses factors influencing tear symptoms, healing after repair, and restoration of biomechanical equilibrium.
This document discusses osteotomies around the hip that are used to treat developmental dysplasia of the hip (DDH). It describes various femoral and pelvic osteotomies, including their objectives, indications, advantages, and disadvantages. For femoral osteotomies, it discusses femoral shortening, derotation, and varus osteotomies. For pelvic osteotomies, it discusses Salter's, Pemberton, Dega, Steel, Sutherland, Tonnis, Ganz, and salvage osteotomies such as Chiari and shelf procedures. The appropriate procedure depends on factors like the patient's age and whether concentric reduction of the hip is possible.
Total Knee Arthroplasty | Knee Replacement | South Windsor, Rocky Hill, Glast...James Mazzara
https://hartfordsportsorthopedics.com/
In this presentation, Dr. Mazzara discusses total knee arthroplasty. His presentation highlights:
The anatomy of the knee
Normal articular cartilage
Causes and symptoms of osteoarthritis
Diagnosis of osteoarthritis
Non-surgical treatment for osteoarthritis
Candidates for total knee arthroplasty
Surgical approach to knee replacement
Potential complications of knee arthroplasty
Computer-assisted total knee replacement
Post-operative protocol
To learn more about total knee arthroplasty, please visit: https://hartfordsportsorthopedics.com/computer-guided-total-knee-replacement-south-windsor-rocky-hill-glastonbury-ct/
CORA (center of rotation of angulation)Morshed Abir
This document discusses the concept of the center of rotation of angulation (CORA) in orthopedic surgery. The CORA is the point about which a deformed bone may be rotated to achieve correction of an angular deformity without introducing a translational deformity. Proper identification of the CORA allows selection of the optimal correction axis and type of osteotomy, such as opening, closing, or dome osteotomy, to realign the bone. Correction along the bisector line passing through the CORA ensures pure angular correction without residual translation. Identification of multiple CORAs indicates more complex multi-apical or translational deformities requiring different surgical techniques.
This video explains Lumbar Disc Replacement in Detail. When degenerative disc disease begins to affect the spine this is called degenerative disc disease. This video highlights the history, epidemiology, and treatment options both conservative and surgical. If you or someone you know needs to be seen in regards to Lumbar Disc Replacement feel free to look us up online www.beverlyspine.com or www.santamonicaspine.com OR call toll free 1-8SPINECAL-1
This document discusses shoulder instability, including the normal anatomy, causes of instability, classifications, clinical evaluation, radiographic evaluation, and treatment options. The glenohumeral joint has the highest mobility of any joint but lacks stability. Instability can be caused by excessive ligament laxity, bone defects, or trauma. Clinical exams include special tests like the apprehension and relocation tests. Treatment may involve arthroscopic or open stabilization surgery like Bankart repair, with post-op rehabilitation progressing from immobilization to strengthening and return to activity.
This document discusses shoulder instability, including definitions, anatomy, evaluation, and treatment. It defines instability as the inability to maintain the humeral head in the glenoid fossa, ranging from dislocation to laxity. Static stabilizers include the labrum and ligaments, while dynamic stabilizers are the rotator cuff and scapulothoracic muscles. Evaluation involves history, exam, and imaging to classify instability by direction, degree, and etiology. Treatment depends on classification but may include immobilization, rehabilitation, or surgical repair of labral tears or bone defects.
This document discusses the biomechanics of the hip joint. It begins by defining biomechanics as the science examining forces acting on biological structures. It then describes the hip as both mobile and stable due to its strong bones, powerful muscles, and ligaments. The document goes on to discuss topics such as the femoral neck angle, acetabular version, muscles, joint reaction forces, gait biomechanics, and the effects of conditions like osteoarthritis. It concludes by covering the history and principles of hip biomechanics in total hip arthroplasty, including how procedures aim to decrease joint reaction forces.
Poller or blocking screws are used to stabilize fractures treated with small diameter intramedullary nails. They guide the nail like "poller" traffic devices guide vehicles. Blocking screws increase stability of distal and proximal metaphyseal fractures after nailing and can help manage malunited fractures. They work by narrowing the canal to guide the nail anteriorly and prevent sagittal plane deformity. Blocking screws are typically placed medially and laterally as close to the fracture as possible for optimal stabilization. Their placement on the concave side of deformities helps improve reduction by deflecting the nail.
Discuss approaches to the knee and Describe in detail TKRSoliudeen Arojuraye
This document discusses approaches to the knee joint and describes the operation of total knee arthroplasty (TKA) in detail. It outlines various approaches to the knee including medial para-patellar, subvastus anteromedial, and anterolateral approaches. It then describes the operative technique of TKA, including preoperative planning, bone cuts of the femur and tibia using cutting guides, and the importance of soft tissue balancing and implant fixation for achieving good results.
This document discusses femoroacetabular impingement (FAI), a condition where the femoral head and acetabulum abnormally contact each other, from the perspective of a sports physiotherapist. It describes the two main types of FAI - cam impingement caused by a nonspherical femoral head, and pincer impingement caused by excessive acetabular coverage. Most cases involve a mix of both. Conservative physiotherapy management focuses on reducing inflammation, strengthening muscles, and gentle stretching. Surgical intervention like arthroscopy may be considered if conservative treatment fails to allow athletes to return to play.
i prepared this presentation for our hospital monthly clinicopathological conference. our experience with TKR is not so vast but v are satisfied with what v have done till date.
Latest advances in Joint replacements higlkights rane of procedures currently performed by Dr. Venkatachalam. This list is not exhaustive and newer procedures are introduced frequently. Patients seeking value medical care abroad will benefit from this knowledge
The document discusses the Cast Index, which is the ratio of the anteroposterior (A-P) diameter to the mediolateral (M-L) diameter of a limb. An ideal Cast Index matches these ratios, preventing slipping or displacement of fractures under plaster casts. Specific ideal Cast Index ratios are provided for different parts of the upper and lower limbs. Maintaining the proper Cast Index through a well-contoured, lightweight cast is the most important factor in ensuring fractures remain reduced and heal properly.
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.
CURRENT TRENDS IN MANAGEMENT OF PERTHES DISEASE BY DR.GIRISH MOTWANIGirish Motwani
This document discusses Perthes disease and its management. It begins with an overview of the 4 stages of the disease based on the evolution: avascular necrosis, revascularization/fragmentation, ossification/healing, and remodeling. It then examines various classification systems used to assess the extent of involvement, including Catterall, Salter-Thompson, Herring, and Elizabethtown classifications. Containment methods like bracing and surgical options like femoral and pelvic osteotomies are covered. The talk emphasizes the importance of assessing the structural integrity of the femoral head, especially the lateral pillar, when determining treatment and prognosis.
The document discusses the Kocker-Langenbeck surgical approach for hip fractures. It provides a brief history of the approach's development. The key steps of the classic approach are described, including indications, positioning, incision, exposure of anatomical structures, fracture reduction techniques, and potential complications. Modifications like trochanteric osteotomy are also covered. The approach remains a workhorse for treating posterior hip fractures but requires careful exposure and identification of structures to minimize risks.
Bioabsorbable Implants in Orthopaedics - Dr Chintan N PatelDrChintan Patel
This document discusses bioabsorbable implants used in orthopaedics. It defines bioabsorbable implants as those that gradually degrade through biological processes and are absorbed and excreted by the body. Common materials used include polyglycolic acid and polylactic acid. Bioabsorbable implants offer advantages over metallic implants by eliminating the need for removal surgery and avoiding problems like stress shielding. While offering promise, bioabsorbable implants also have drawbacks like inadequate strength and stiffness. Future areas of development include implants that degrade at medium time periods and ability to deliver drugs locally.
This document provides an overview of classical shoulder arthroplasty versus reverse shoulder arthroplasty. It discusses the history, anatomy, biomechanics, prosthesis designs, surgical approaches, complications, and outcomes of both procedures. Key points include that total shoulder arthroplasty generally provides better outcomes than hemiarthroplasty, especially long-term. Reverse shoulder arthroplasty is primarily used for nonfunctional rotator cuff tears, while classical arthroplasty requires an intact rotator cuff. Complications can occur years after surgery and include loosening, infection, and fractures.
The document discusses different types of knee prostheses from least to most constrained, including cruciate-retaining, posterior-stabilized, constrained non-hinged, and constrained hinged designs. It covers indications, advantages, disadvantages, and key design aspects such as femoral rollback and radiographic appearance for each type. Mobile bearing and all-polyethylene designs are also briefly discussed.
Recent advancements in shoulder arthroplasty were discussed. Charles Neer pioneered modern shoulder replacement in the 1950s. Since then, total shoulder replacement and reverse total shoulder arthroplasty were developed. The shoulder joint anatomy and biomechanics were described. Clinical indications for various arthroplasty procedures like hemiarthroplasty, total shoulder arthroplasty, and reverse shoulder arthroplasty were provided. Potential complications of arthroplasty and post-operative rehabilitation protocols were also summarized.
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.
Arthroscopic management of rotator cuff tears larissa 2016Aaron Venouziou
Rotator cuff tears are a spectrum of conditions ranging from asymptomatic partial tears to symptomatic rotator cuff arthropathy. The document discusses the anatomy and biomechanics of the rotator cuff and shoulder. It describes the classification, incidence, etiology, and treatment options for partial and full-thickness rotator cuff tears. Surgical techniques for repairing tears are outlined, including considerations for different tear patterns. Post-operative healing rates and functional outcomes are addressed. The conclusion emphasizes the importance of the rotator cuff for shoulder function and discusses factors influencing tear symptoms, healing after repair, and restoration of biomechanical equilibrium.
This document discusses osteotomies around the hip that are used to treat developmental dysplasia of the hip (DDH). It describes various femoral and pelvic osteotomies, including their objectives, indications, advantages, and disadvantages. For femoral osteotomies, it discusses femoral shortening, derotation, and varus osteotomies. For pelvic osteotomies, it discusses Salter's, Pemberton, Dega, Steel, Sutherland, Tonnis, Ganz, and salvage osteotomies such as Chiari and shelf procedures. The appropriate procedure depends on factors like the patient's age and whether concentric reduction of the hip is possible.
Total Knee Arthroplasty | Knee Replacement | South Windsor, Rocky Hill, Glast...James Mazzara
https://hartfordsportsorthopedics.com/
In this presentation, Dr. Mazzara discusses total knee arthroplasty. His presentation highlights:
The anatomy of the knee
Normal articular cartilage
Causes and symptoms of osteoarthritis
Diagnosis of osteoarthritis
Non-surgical treatment for osteoarthritis
Candidates for total knee arthroplasty
Surgical approach to knee replacement
Potential complications of knee arthroplasty
Computer-assisted total knee replacement
Post-operative protocol
To learn more about total knee arthroplasty, please visit: https://hartfordsportsorthopedics.com/computer-guided-total-knee-replacement-south-windsor-rocky-hill-glastonbury-ct/
CORA (center of rotation of angulation)Morshed Abir
This document discusses the concept of the center of rotation of angulation (CORA) in orthopedic surgery. The CORA is the point about which a deformed bone may be rotated to achieve correction of an angular deformity without introducing a translational deformity. Proper identification of the CORA allows selection of the optimal correction axis and type of osteotomy, such as opening, closing, or dome osteotomy, to realign the bone. Correction along the bisector line passing through the CORA ensures pure angular correction without residual translation. Identification of multiple CORAs indicates more complex multi-apical or translational deformities requiring different surgical techniques.
This video explains Lumbar Disc Replacement in Detail. When degenerative disc disease begins to affect the spine this is called degenerative disc disease. This video highlights the history, epidemiology, and treatment options both conservative and surgical. If you or someone you know needs to be seen in regards to Lumbar Disc Replacement feel free to look us up online www.beverlyspine.com or www.santamonicaspine.com OR call toll free 1-8SPINECAL-1
This document discusses shoulder instability, including the normal anatomy, causes of instability, classifications, clinical evaluation, radiographic evaluation, and treatment options. The glenohumeral joint has the highest mobility of any joint but lacks stability. Instability can be caused by excessive ligament laxity, bone defects, or trauma. Clinical exams include special tests like the apprehension and relocation tests. Treatment may involve arthroscopic or open stabilization surgery like Bankart repair, with post-op rehabilitation progressing from immobilization to strengthening and return to activity.
This document discusses shoulder instability, including definitions, anatomy, evaluation, and treatment. It defines instability as the inability to maintain the humeral head in the glenoid fossa, ranging from dislocation to laxity. Static stabilizers include the labrum and ligaments, while dynamic stabilizers are the rotator cuff and scapulothoracic muscles. Evaluation involves history, exam, and imaging to classify instability by direction, degree, and etiology. Treatment depends on classification but may include immobilization, rehabilitation, or surgical repair of labral tears or bone defects.
This document discusses the biomechanics of the hip joint. It begins by defining biomechanics as the science examining forces acting on biological structures. It then describes the hip as both mobile and stable due to its strong bones, powerful muscles, and ligaments. The document goes on to discuss topics such as the femoral neck angle, acetabular version, muscles, joint reaction forces, gait biomechanics, and the effects of conditions like osteoarthritis. It concludes by covering the history and principles of hip biomechanics in total hip arthroplasty, including how procedures aim to decrease joint reaction forces.
Poller or blocking screws are used to stabilize fractures treated with small diameter intramedullary nails. They guide the nail like "poller" traffic devices guide vehicles. Blocking screws increase stability of distal and proximal metaphyseal fractures after nailing and can help manage malunited fractures. They work by narrowing the canal to guide the nail anteriorly and prevent sagittal plane deformity. Blocking screws are typically placed medially and laterally as close to the fracture as possible for optimal stabilization. Their placement on the concave side of deformities helps improve reduction by deflecting the nail.
Discuss approaches to the knee and Describe in detail TKRSoliudeen Arojuraye
This document discusses approaches to the knee joint and describes the operation of total knee arthroplasty (TKA) in detail. It outlines various approaches to the knee including medial para-patellar, subvastus anteromedial, and anterolateral approaches. It then describes the operative technique of TKA, including preoperative planning, bone cuts of the femur and tibia using cutting guides, and the importance of soft tissue balancing and implant fixation for achieving good results.
This document discusses femoroacetabular impingement (FAI), a condition where the femoral head and acetabulum abnormally contact each other, from the perspective of a sports physiotherapist. It describes the two main types of FAI - cam impingement caused by a nonspherical femoral head, and pincer impingement caused by excessive acetabular coverage. Most cases involve a mix of both. Conservative physiotherapy management focuses on reducing inflammation, strengthening muscles, and gentle stretching. Surgical intervention like arthroscopy may be considered if conservative treatment fails to allow athletes to return to play.
i prepared this presentation for our hospital monthly clinicopathological conference. our experience with TKR is not so vast but v are satisfied with what v have done till date.
Latest advances in Joint replacements higlkights rane of procedures currently performed by Dr. Venkatachalam. This list is not exhaustive and newer procedures are introduced frequently. Patients seeking value medical care abroad will benefit from this knowledge
This document provides an overview of a student project to design a prosthetic knee mechanism. It outlines the problem statement of emulating knee range of motion during gait. It reviews existing single-axis and four-bar prosthetic knee solutions. It then describes the team's modeling, analysis, and building of a four-bar knee prototype, showing drawings and a video of the functional prototype. It concludes by comparing the prototype to real-world prosthetic knees.
Primary Total Knee Arthroplasty has evolved since the 19th century with various prosthetic designs introduced over time. Prosthetic design considerations include femoral rollback, modularity, constraint, and whether to retain or sacrifice the cruciate ligaments. Radiographs are important for preoperative planning to assess alignment and bone defects. Surgical goals include restoring mechanical alignment, joint line, balanced soft tissues, and normal patellofemoral tracking. Key steps include femoral and tibial cuts, balancing the knee in flexion and extension, and addressing any flexion contractures or deformities. Complications can include nerve palsies, vascular issues, stiffness, infections, and loosening. With careful patient selection, planning and technique, total knee
The document defines orthotics and prosthetics and describes common devices used for each. Orthotics are devices that support or immobilize parts of the body, like splints or braces, while prosthetics replace missing body parts like limbs. It provides details on various static and dynamic orthoses, including examples like knee braces or back supports. For prosthetics, it outlines the components of lower and upper limb prostheses and different suspension, joint, and terminal device options. The ideal orthosis or prosthesis is described as functional, fitting well, light weight, easy to use, acceptable cosmetically, and easily maintained or repaired.
This document discusses the design and analysis of a femoral component for a total knee replacement. It describes the key features of the natural knee joint and conditions that require knee replacement surgery. The goals of knee replacement surgery and design considerations for the femoral component are outlined. The document then walks through the CAD modeling and finite element analysis of a femoral component, including applying constraints, materials properties, and loads for static stress and fatigue analysis. The analysis shows stress is reduced by adding fillets and chamfers to edge features. References on knee implant design and materials properties are also provided.
This document provides an overview of total hip replacement (THR) including its history, hip anatomy and biomechanics, component designs and selection, surgical procedure, and potential complications. Some key points include: Sir John Charnley introduced the modern concept of THR in the 1960s using a metal femoral stem, polyethylene acetabular component, and bone cement. Component design goals include restoring normal hip biomechanics and providing initial stability for bone ingrowth. Femoral components can be cemented or cementless, and acetabular components can be cemented, cementless, or constrained. Specialized components are used for reconstruction or minimally invasive approaches.
conventional plates including different functions of screws, modes of plate application, Compression Mode.
Neutralization Mode.
Buttress plate.
Antiglide plate.
Bridge plating or span plating.
Tension band.
prebending precountouring
working length
lag screw
AO principles
biological fixation
MIPO
1) Reverse shoulder arthroplasty designs impact joint biomechanics by altering the deltoid moment arm and tension through variations in glenosphere medialization/lateralization and humeral component design.
2) Medializing the glenosphere increases the deltoid moment arm but can increase scapular notching and instability risks, while lateralizing the glenosphere reduces these risks but decreases deltoid efficiency.
3) Lateralizing the humeral component improves deltoid wrapping and compression at the joint while maintaining deltoid efficiency compared to more medial designs.
This document discusses the basic biomechanics of fractures and fracture fixation methods. It covers topics such as the stress-strain properties of bone and implant materials, types of loading that can cause fractures, and how fracture fixation devices like plates, screws, intramedullary nails work to stabilize fractures based on their mechanical design properties. Key factors that influence stability of fixation constructs are discussed, such as plate thickness, screw diameter and number, external fixator pin size and configuration.
The document discusses different types of prostheses used to replace missing limbs. It describes exoskeletal and endoskeletal prosthetic designs, and covers the basic components and classifications of prostheses. Myoelectric prostheses that use muscle signals and various types of feet - including SACH, Jaipur and dynamic response feet - are explained. The document provides details on prostheses for transtibial and transfemoral amputations, including PTB and quadrilateral socket designs and considerations for bilateral transfemoral amputees.
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The document provides an overview of the Tip-edge bracket system created by Dr. Peter Kesling in 1986. It was designed to allow for differential tooth movement by removing corners from conventional edgewise brackets. This allows the crown to tip into place before final torque and positioning. The system uses light forces and a sequence of 3 stages to align, level and torque teeth into the desired positions. A variety of auxiliaries like sidewinders and power pins are used throughout treatment to control individual tooth movements. The Tip-edge bracket is intended to provide controlled three dimensional tooth positioning with light continuous forces.
1. The document discusses a finite element analysis study that analyzed stress distributions in the periodontal ligament under different orthodontic forces and degrees of alveolar bone loss.
2. The study found that stress in the periodontal ligament and tooth displacement increased with decreased alveolar bone support. Stress distribution and tooth movement were also influenced by the direction of applied force.
3. Forces should be lowered for patients with alveolar bone loss to prevent excessive tooth movement and mobility. Low intrusive and extrusive forces are especially important with compromised bone levels.
Screw and plates are most common used devices in orthopedics. However, sometimes we forget their principles, so this presentation hopes to review most their problems. Thank you for your attention!
Osteotomy around the elbow is commonly performed to correct cubitus varus and cubitus valgus deformities. For cubitus varus, the most common cause is a malunited supracondylar fracture. Surgical options include lateral closing wedge osteotomy, oblique osteotomy with derotation, and medial opening wedge osteotomy with bone grafting. For cubitus valgus, causes include nonunion of a lateral condyle fracture. Surgical options are a closing wedge medial osteotomy or opening wedge lateral osteotomy. Complications of elbow osteotomy can include stiffness, persistent deformity, myositis ossificans, loss of fixation, and neurovascular injury.
This document discusses the dynamic hip screw (DHS), used to treat intertrochanteric hip fractures. The DHS provides controlled collapse and dynamic action to reduce complications like screw cut-out. Key steps of the procedure include closed reduction of the fracture, guide pin and plate insertion at 135 degrees, and measuring screw length. Factors like tip-apex distance and screw position are important to prevent complications. The DHS works by creating compression as the lag screw collapses into the barrel post-operatively.
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A gear bearing is a type of rolling-element bearing similar to an epicyclic gear. Gear bearings consist of a number of smaller 'satellite' gears which revolve around the center of the bearing along a track on the outsides of the internal and satellite gears, and on the inside of the external gear.
1) The document describes the technique for performing a total knee replacement, focusing on ensuring proper bone preparation and component alignment through referencing anatomical landmarks.
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This PowerPoint compilation offers a comprehensive overview of 20 leading innovation management frameworks and methodologies, selected for their broad applicability across various industries and organizational contexts. These frameworks are valuable resources for a wide range of users, including business professionals, educators, and consultants.
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2. Common Causes of Knee Pain and Loss of
Knee Function
ARTHRITIS
• Osteoarthritis (wear and tear)
• Rheumatoid arthritis
Post-traumatic arthritis caused by:
• Fractures
• Ligament injuries
• Meniscus tears
3. Knee Prosthesis comprised of
• Femoral- replaces arthritic
portion of thigh bone
• Tibial- replaces arthritic portion
of shin bone
• Tibial insert- replaces cartilage
and acts as shock absorber
• Patella- replaces knee cap
4. Types of Knee Prosthesis
• Fixed Knee Prosthesis : The more traditional fixed
bearing implant which can only flex and extend
• Mobile-Bearing Prosthesis: More advanced the rotating
platform knee implants move almost like a normal knee
joint. They allow the knee to twist and turn (rotation) as
well as flex and extend. The Rotating Platform Knee is
designed to bend and rotate, move back and forth, flex
and extend, helping to accommodate more normal
movement.
5. Design Input
KNEE REPLACEMENT SYSTEM by
Distal Portion of Femur
Amplitude
19. Finite Element Analysis (FEA)
• Test I : Yield tensile strength test
• Test II: Fatigue strength test
• Loads were applied on lateral condyle to checkout the
strenght in extreme situation
20. Material Used
• Co-Cr-Mo
• Material properties
Properties Values
Tensile strength 855 MPa
Yield Strength 650 MPa
Fatigue Strength 510 MPa
Young’s Modulus 230 GPa
Density 8.3 g/Cm^3
21. Constraints
• One end is fixed- Displacement constraint
• Other end force given on lateral condyle- Force constraint