Hip
•
6 likes•396 views
This document discusses considerations for performing total hip arthroplasty in patients with sickle cell disease. Key points include that these patients are at high risk for infection, osteonecrosis of the femoral head, and marrow hyperplasia leading to thin cortices and enlarged medullary canals. The surgery requires special attention to bleeding risks, bone quality issues, and prevention of post-operative sickle cell crises or infections. While THA can relieve pain, these patients remain at risk for long-term complications.
Report
Share
Report
Share
Recommended
Management of femoral head osteonecrosis
This document summarizes current concepts in the management of osteonecrosis of the femoral head. Nonoperative treatments for early-stage disease include restricted weight bearing, bisphosphonates, anticoagulants, and extracorporeal shock wave therapy or pulsed electromagnetic therapy, which may prevent progression. Surgical options include core decompression or bone grafting to preserve the hip for precollapse stages, while hip replacement is used for advanced collapse. The goals are to improve hip function, relieve pain, and prevent or delay further progression and need for replacement surgery.
Vertebroplasty and Kyphoplasty Techniques
This document discusses vertebroplasty and kyphoplasty techniques. It describes:
1. Vertebroplasty involves injecting bone cement like PMMA into a vertebral body to treat osteoporotic fractures, while kyphoplasty also involves cavity creation before injection.
2. The document outlines the procedure for vertebroplasty, including patient selection, anesthesia, needle placement using fluoroscopy guidance, cement mixing and injection, and monitoring for complications like leakage.
3. Key aspects of the procedure discussed are pedicle definition, approaches like transpedicular, cement properties, and ensuring the needle and cement stay within the vertebral body to avoid issues. Safety and complications are emphasized throughout.
Technical aspects of percutaneous vertebroplasty & kyphoplasty
This document discusses technical aspects of vertebroplasty (VP) and kyphoplasty (KP) procedures from a neurosurgeon's perspective. It provides details on the steps for VP and KP, approaches for needle insertion, techniques for special cases like osteoporotic fractures or tumors, and tips to avoid complications like cement leakage. Predictors of further fractures are discussed, as are differences between VP and KP in terms of risks, benefits, and cost justification.
Endoleaks 1, 3
This document discusses endoleaks, which occur when blood flows outside the endoluminal graft used to treat an aneurysm but remains within the aneurysm sac. It classifies endoleaks into types 1-4 based on their cause. Type 1 endoleaks are graft-related due to issues at fixation sites, while type 2 is due to retrograde branch vessel flow. Type 3 results from graft integrity issues. The document outlines diagnosis and management strategies for different endoleak types, noting that types 1 and 3 can often be treated endovascularly. It also presents statistics on endoleak incidence and risk factors like proximal neck length, diameter and angulation.
Gct of distal radius
1. The document discusses treatment options for giant cell tumor of the distal radius, including extended curettage with adjuvant therapies like phenol or bone cement for lower grade tumors, and en bloc resection with reconstruction using osteochondral allograft or arthrodesis for higher grade tumors.
2. Studies have found that extended curettage with cement has a high local control rate and good functional outcomes compared to wide resection.
3. Reconstruction options after tumor resection include osteoarticular allograft, vascularized fibular graft, or arthrodesis depending on the extent of bone loss and need to preserve wrist or forearm function.
"GIANT CELL TUMOR" : CASE PRESENTATION- At Shaheed Suhrawardy Medical College...
"GIANT CELL TUMOR" : CASE PRESENTATION- At Shaheed Suhrawardy Medical College...Shaheed Suhrawardy Medical College
"GIANT CELL TUMOR" : CASE PRESENTATION- At Shaheed Suhrawardy Medical College Hospital, Dhaka, BangladeshVERTEBROPLASTY
Percutaneous cementoplasty involves injecting acrylic cement into vertebral bodies to prevent collapse and relieve pain in patients with pathologic or compressed vertebrae. It can be used to treat osteoporotic fractures, tumors, and metastases. The procedure is performed under local anesthesia and fluoroscopy guidance. Cement is injected during its viscous phase to prevent leaks. Potential complications include cement leaks into the epidural space, veins, or disk, which can cause cord compression or embolism. The procedure provides pain relief but risks include leak-related complications and infection.
Mangled extremity and it’s management
A mangled extremity refers to severe limb injury where viability is questionable. Emergent management prioritizes life-saving care. The decision to salvage or amputate is complex, considering scoring systems, nerve function, bone/joint integrity, and patient factors. If salvaged, options include debridement, fixation, flaps, and bone reconstruction. Amputation may provide better function than some salvaged limbs, especially with vascular/major injuries. The child's growth is also a key consideration.
Recommended
Management of femoral head osteonecrosis
This document summarizes current concepts in the management of osteonecrosis of the femoral head. Nonoperative treatments for early-stage disease include restricted weight bearing, bisphosphonates, anticoagulants, and extracorporeal shock wave therapy or pulsed electromagnetic therapy, which may prevent progression. Surgical options include core decompression or bone grafting to preserve the hip for precollapse stages, while hip replacement is used for advanced collapse. The goals are to improve hip function, relieve pain, and prevent or delay further progression and need for replacement surgery.
Vertebroplasty and Kyphoplasty Techniques
This document discusses vertebroplasty and kyphoplasty techniques. It describes:
1. Vertebroplasty involves injecting bone cement like PMMA into a vertebral body to treat osteoporotic fractures, while kyphoplasty also involves cavity creation before injection.
2. The document outlines the procedure for vertebroplasty, including patient selection, anesthesia, needle placement using fluoroscopy guidance, cement mixing and injection, and monitoring for complications like leakage.
3. Key aspects of the procedure discussed are pedicle definition, approaches like transpedicular, cement properties, and ensuring the needle and cement stay within the vertebral body to avoid issues. Safety and complications are emphasized throughout.
Technical aspects of percutaneous vertebroplasty & kyphoplasty
This document discusses technical aspects of vertebroplasty (VP) and kyphoplasty (KP) procedures from a neurosurgeon's perspective. It provides details on the steps for VP and KP, approaches for needle insertion, techniques for special cases like osteoporotic fractures or tumors, and tips to avoid complications like cement leakage. Predictors of further fractures are discussed, as are differences between VP and KP in terms of risks, benefits, and cost justification.
Endoleaks 1, 3
This document discusses endoleaks, which occur when blood flows outside the endoluminal graft used to treat an aneurysm but remains within the aneurysm sac. It classifies endoleaks into types 1-4 based on their cause. Type 1 endoleaks are graft-related due to issues at fixation sites, while type 2 is due to retrograde branch vessel flow. Type 3 results from graft integrity issues. The document outlines diagnosis and management strategies for different endoleak types, noting that types 1 and 3 can often be treated endovascularly. It also presents statistics on endoleak incidence and risk factors like proximal neck length, diameter and angulation.
Gct of distal radius
1. The document discusses treatment options for giant cell tumor of the distal radius, including extended curettage with adjuvant therapies like phenol or bone cement for lower grade tumors, and en bloc resection with reconstruction using osteochondral allograft or arthrodesis for higher grade tumors.
2. Studies have found that extended curettage with cement has a high local control rate and good functional outcomes compared to wide resection.
3. Reconstruction options after tumor resection include osteoarticular allograft, vascularized fibular graft, or arthrodesis depending on the extent of bone loss and need to preserve wrist or forearm function.
"GIANT CELL TUMOR" : CASE PRESENTATION- At Shaheed Suhrawardy Medical College...
"GIANT CELL TUMOR" : CASE PRESENTATION- At Shaheed Suhrawardy Medical College...Shaheed Suhrawardy Medical College
"GIANT CELL TUMOR" : CASE PRESENTATION- At Shaheed Suhrawardy Medical College Hospital, Dhaka, BangladeshVERTEBROPLASTY
Percutaneous cementoplasty involves injecting acrylic cement into vertebral bodies to prevent collapse and relieve pain in patients with pathologic or compressed vertebrae. It can be used to treat osteoporotic fractures, tumors, and metastases. The procedure is performed under local anesthesia and fluoroscopy guidance. Cement is injected during its viscous phase to prevent leaks. Potential complications include cement leaks into the epidural space, veins, or disk, which can cause cord compression or embolism. The procedure provides pain relief but risks include leak-related complications and infection.
Mangled extremity and it’s management
A mangled extremity refers to severe limb injury where viability is questionable. Emergent management prioritizes life-saving care. The decision to salvage or amputate is complex, considering scoring systems, nerve function, bone/joint integrity, and patient factors. If salvaged, options include debridement, fixation, flaps, and bone reconstruction. Amputation may provide better function than some salvaged limbs, especially with vascular/major injuries. The child's growth is also a key consideration.
MIA in Thoraco-lumbar Trauma (SPINE 2009)
In thoracolumbar spine trauma, the biomechanical goals in minimally invasive fracture treatment include decompression of the spinal canal, reduction of spinal deformities, and maintenance of stable fixation of the spine to permit early mobilization.
This was a teaching lecture given by Prof. Mohamed Mohi Eldin, professor of neurosurgery, in the Multi- Institutional Neurosurgical Meeting, Kasr El Aini Hospital, Cairo University, April 2nd, 2009.
Sponk ppt
Spontaneous osteonecrosis of the knee (SPONK) was first described in 1968, and most commonly affects the medial femoral condyle in older women through impaired blood supply. SPONK presents with sudden onset knee pain similar to a meniscal tear. Diagnosis is made through x-rays showing bone changes or MRI showing bone edema and articular surface involvement. Treatment options include conservative management with medications and weight reduction or surgical interventions like core decompression, bone grafting, or knee replacement for advanced arthritis. Early detection of SPONK is important as it can be cured without needing knee replacement.
IATROGENIC GROIN PSEUDOANEURYSM MANAGEMENT
IATROGENIC GROIN PSEUDOANEURYSM ECHODOPPLER MANAGEMENT WITH FIBRIN GLUE: OUR EXPERIENCE
PSEUDOANEURISMA INGUINALE IATROGENO-TRATTAMENTO PERCUTANEO ECOGUIDATO CON COLLA DI FIBRINA: NOSTRA ESPERIENZA
(Angiologia-Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Angiology- Vascular Surgery -ULSS 15 Alta Padovana)
1362462786 amputation in diabetic foot
- Major amputations should be considered as an option for all patients with diabetic foot disease from the outset. While local treatments aim to preserve the foot, many patients ultimately require amputation due to factors like poor circulation and previous failed treatments.
- The choice between a local amputation and major amputation depends on factors like the patient's age, circulation, mobility, expectations, and preferences. Younger patients with good circulation may be candidates for local treatments, though many will still require subsequent major amputations if local treatments fail.
- Major amputations have advantages like avoiding further surgery and allowing for shorter hospital stays and rehabilitation. However, they also carry disadvantages like reducing independence and being more difficult and expensive to rehabilitate from
Vertebroplasty Grand Rounds
Vertebroplasty is an effective, minimally invasive spine procedure where acrylic bone cement is injected into a painful pathologically compressed vertebral body.
Nmt631 skeletal anat, phys, bone scinti principles
The document provides an overview of bone scintigraphy (bone scan), including:
1. Clinical indications for bone scans include evaluating bone pain, metastatic disease, and bone abnormalities found on other imaging tests.
2. Bone scans use radiotracers such as technetium-99m medronate that are absorbed by bone during periods of increased bone formation to identify areas of abnormal bone metabolism.
3. A normal bone scan shows symmetrical tracer uptake in bones, while abnormal scans reveal increased or decreased uptake that can indicate fractures, tumors, or other bone diseases.
Calcific Tendinitis of the Rotator Cuff
Calcific tendinitis is a degenerative condition involving calcium deposits within the rotator cuff tendons. It typically affects middle-aged individuals and is more common in females. While the majority of cases resolve spontaneously with conservative care, some patients experience persistent pain requiring needle decompression, shockwave therapy, or surgery to remove the deposits. Imaging like x-ray, ultrasound, CT and MRI are used to classify the deposits and guide treatment.
Case report iliac aneurysm
This case report describes a 69-year-old male patient who presented with an isolated right common iliac artery aneurysm measuring 8 cm in diameter. During pre-operative workup for planned open surgical repair, the patient's condition deteriorated and imaging showed rupture of the aneurysm. The patient underwent an emergency retroperitoneal surgical procedure to ligate the right iliac artery, perform an extra-anatomic femorofemoral bypass, and repair the ruptured aneurysm. Post-operatively, the patient recovered well with all pulses intact. Isolated iliac artery aneurysms are rare but can rupture with high mortality if not repaired. Both open surgical and endovascular techniques are used for treatment.
Xlif in the treatment of ddd
This document discusses lumbar interbody fusion using the XLIF technique. It begins by describing the anatomy of the lumbar disc, including the central nucleus pulposus containing proteoglycans and water, and the peripheral annulus fibrosus containing concentric collagen rings. As discs degenerate over time, the nucleus loses water content and the annulus develops tears, allowing nitrogen and nucleus material to expand outward. This can cause nerve and blood vessel ingrowth, leading to back pain. The document then summarizes the XLIF surgical technique and outcomes from a study of 15 patients who underwent the procedure. Common minor complications included temporary leg weakness and numbness, while major complications such as implant disruption occurred in a small percentage of cases
Minimal invasive techniques in lumbar degenerative diseases
Minimally invasive techniques (MIT) are increasingly used to treat lumbar disc disease. They offer advantages over open surgery such as smaller incisions, less tissue damage, shorter recovery times, and lower risks. MITs include discography, epidural injections, facet/nerve blocks, nucleoplasty, kyphoplasty, tumor debulking, and interspinous spacers. They aim to diagnose and treat back pain conditions under local anesthesia or mild sedation using fluoroscopy guidance. MITs are generally low risk and allow many patients to be treated as outpatients or with only overnight hospitalization.
mandibular orthognathic procedures II- ih
Complications in orthognathic surgery can be presurgical, intraoperative, or postoperative. Presurgical complications include lack of pre-treatment objectives, laboratory errors, and inadequate orthodontics. Intraoperative complications involve hemorrhage, nerve injuries, unwanted fragmentation, and vascular or neural damage. Postoperative issues consist of loss of vascularity, infection, nonunion, occlusal disturbances, TMJ dysfunction, relapse, and rarely resorption. Careful planning, execution of surgery, and postoperative management can help reduce complication rates in orthognathic procedures.
Vertebral Augmentation by Vertebroplasty and Kyphoplasty: Introductory concerns
Vertebral Augmentation by Vertebroplasty and Kyphoplasty: Introductory concernsProf. Dr. Mohamed Mohi Eldin
Vertebroplasty and kyphoplasty are minimally invasive procedures used to treat painful vertebral compression fractures. Vertebroplasty involves injecting bone cement into the fractured vertebra to stabilize it, while kyphoplasty first uses an inflatable balloon to restore vertebral height before cement injection. Both procedures provide effective pain relief, though kyphoplasty may reduce risks of new fractures and cement leakage compared to vertebroplasty. Candidate selection, technical execution, and post-procedure management are important to achieve optimal outcomes and minimize complications.The Bone Scan
The bone scan shows normal uptake in kidneys, joints, and growing bones in children. Increased uptake elsewhere can indicate metastatic bone disease, hyperparathyroidism, or renal failure. Soft tissue uptake may be seen in tumors, necrosis, breast tissue in young women, and radiotracer impurities collecting in other organs. While bone scans can detect abnormalities, further testing is needed to differentiate between benign and malignant causes. Interpretation requires correlating scan findings with clinical history and other imaging results.
Management of Femoral Head Osteonecrosis.
The document discusses management of femoral head osteonecrosis, including its causes, diagnosis, classification systems, and treatment options. MRI is highlighted as the most sensitive diagnostic tool. Conservative treatments are recommended for early stages, while hip replacement is usually needed once collapse or secondary degeneration occurs. The key is early diagnosis and treatment to preserve the hip joint.
Ewings sarcoma- BONE TUMORS
Ewing sarcoma is a rare cancer that develops in bone or soft tissue. It is most common in children and young adults between ages 10-20. The cancer cells are small, round cells and are usually found in the bones of the legs, pelvis, ribs, or spine. Ewing sarcoma is treated with a combination of chemotherapy, radiation therapy, and surgery. Prognosis depends on factors like tumor size, location, and whether the cancer has spread. With current multi-agent chemotherapy regimens, long-term survival rates are around 60-70%.
urethroplasty
This document discusses urethral stricture disease, including its definition, risk factors, presentation, diagnosis, and various treatment options. It provides details on endoscopic treatments like dilation and urethrotomy, as well as surgical options like urethroplasty repairs using grafts, flaps, and anastomoses. Five case examples are presented and management options discussed. Key points covered include techniques for anastomotic repairs, the use of buccal mucosa grafts, and monitoring after treatment. Current controversies regarding urethroplasty utilization and outcomes are also noted.
Diskitis
This document discusses the investigation and management of discitis/diskitis. Key points include:
- Elevated ESR, CRP, and procalcitonin levels can indicate discitis, along with abnormal findings on imaging like MRI and X-rays. Blood and sputum cultures help identify the infection source.
- MRI is the most sensitive test for discitis, showing abnormalities in the disc space and vertebrae on T1 and T2 weighted images. CT also shows bone destruction.
- Treatment involves intravenous antibiotics for 6-8 weeks, immobilization, and pain management. Surgery may be needed for neurological complications, non-response to treatment, or deformity correction.
-
Patients with myelomeningocele and
Kyphosis as a sequel of myelomeningocele is a malformation that may result in many problems including ulcers, limited use of the arms for support purposes, and reduced pulmonary function. Treatment is complex and demanding. In 1998 the authors started treating 15 patients using the Alfredo Cardoso Monterrubio (ACM) plate for an average of 2.9 years. On average, the ACM plate provided 67.4 degrees of correction initially, with some loss of correction over time. Complications included infections and plate loosening, but patients reported improved posture and functionality.
Aneurysmal Bone Cyst of the Spine | Crimson Publishers
A 35yrs young patient, presented to the hospital with lower extremities neurological deficit, radiological investigation showed bony lesion in the posterior elements of T10 causing severe compression on the cord, emergency surgery was performed to decompress the spinal cord, the microscopic examination revealed that lesion was “ aneurysmal bone cyst”.
Peyronie's Disease: a tailored surgical procedure for every patient
Peyronie's Disease: a tailored surgical procedure for every patientMen's Health International Surgical Center
Presentation on "Peyronie's disease: a tailored surgical procedure for every patient" by Carlo Bettocchi, M.D, FECSM (Men's Health International Surgical Center in Switzerland) at the 5th Emirates International Urological Conference in Dubai. (Decembre 2016)Ctev
This document discusses idiopathic clubfoot, including its classification, causes, epidemiology, and treatment options. It focuses on the Ponseti method of manipulation and serial casting as the preferred treatment for idiopathic clubfoot. The Ponseti method involves specific techniques to correct cavus, adductus, varus, and equinus deformities through non-surgical manipulation and casting, sometimes including a percutaneous tenotomy of the Achilles tendon. Compliance with brace wear after treatment is critical to prevent recurrence of the deformity. The document also addresses evaluation methods, examples of clinical cases, common errors in technique, and strategies for managing clubfoot at the public health
Congenital clubfoot
Congenital clubfoot is a deformity of the foot characterized by equinus, inversion, cavus, and adduction. It occurs in 1-2 per 1000 births and is more common in males. The Ponseti technique involving serial casting and Achilles tenotomy has a success rate of 90% and is the preferred treatment. Complications can include relapse, residual deformity, or abnormal gait if not properly corrected.
More Related Content
What's hot
MIA in Thoraco-lumbar Trauma (SPINE 2009)
In thoracolumbar spine trauma, the biomechanical goals in minimally invasive fracture treatment include decompression of the spinal canal, reduction of spinal deformities, and maintenance of stable fixation of the spine to permit early mobilization.
This was a teaching lecture given by Prof. Mohamed Mohi Eldin, professor of neurosurgery, in the Multi- Institutional Neurosurgical Meeting, Kasr El Aini Hospital, Cairo University, April 2nd, 2009.
Sponk ppt
Spontaneous osteonecrosis of the knee (SPONK) was first described in 1968, and most commonly affects the medial femoral condyle in older women through impaired blood supply. SPONK presents with sudden onset knee pain similar to a meniscal tear. Diagnosis is made through x-rays showing bone changes or MRI showing bone edema and articular surface involvement. Treatment options include conservative management with medications and weight reduction or surgical interventions like core decompression, bone grafting, or knee replacement for advanced arthritis. Early detection of SPONK is important as it can be cured without needing knee replacement.
IATROGENIC GROIN PSEUDOANEURYSM MANAGEMENT
IATROGENIC GROIN PSEUDOANEURYSM ECHODOPPLER MANAGEMENT WITH FIBRIN GLUE: OUR EXPERIENCE
PSEUDOANEURISMA INGUINALE IATROGENO-TRATTAMENTO PERCUTANEO ECOGUIDATO CON COLLA DI FIBRINA: NOSTRA ESPERIENZA
(Angiologia-Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Angiology- Vascular Surgery -ULSS 15 Alta Padovana)
1362462786 amputation in diabetic foot
- Major amputations should be considered as an option for all patients with diabetic foot disease from the outset. While local treatments aim to preserve the foot, many patients ultimately require amputation due to factors like poor circulation and previous failed treatments.
- The choice between a local amputation and major amputation depends on factors like the patient's age, circulation, mobility, expectations, and preferences. Younger patients with good circulation may be candidates for local treatments, though many will still require subsequent major amputations if local treatments fail.
- Major amputations have advantages like avoiding further surgery and allowing for shorter hospital stays and rehabilitation. However, they also carry disadvantages like reducing independence and being more difficult and expensive to rehabilitate from
Vertebroplasty Grand Rounds
Vertebroplasty is an effective, minimally invasive spine procedure where acrylic bone cement is injected into a painful pathologically compressed vertebral body.
Nmt631 skeletal anat, phys, bone scinti principles
The document provides an overview of bone scintigraphy (bone scan), including:
1. Clinical indications for bone scans include evaluating bone pain, metastatic disease, and bone abnormalities found on other imaging tests.
2. Bone scans use radiotracers such as technetium-99m medronate that are absorbed by bone during periods of increased bone formation to identify areas of abnormal bone metabolism.
3. A normal bone scan shows symmetrical tracer uptake in bones, while abnormal scans reveal increased or decreased uptake that can indicate fractures, tumors, or other bone diseases.
Calcific Tendinitis of the Rotator Cuff
Calcific tendinitis is a degenerative condition involving calcium deposits within the rotator cuff tendons. It typically affects middle-aged individuals and is more common in females. While the majority of cases resolve spontaneously with conservative care, some patients experience persistent pain requiring needle decompression, shockwave therapy, or surgery to remove the deposits. Imaging like x-ray, ultrasound, CT and MRI are used to classify the deposits and guide treatment.
Case report iliac aneurysm
This case report describes a 69-year-old male patient who presented with an isolated right common iliac artery aneurysm measuring 8 cm in diameter. During pre-operative workup for planned open surgical repair, the patient's condition deteriorated and imaging showed rupture of the aneurysm. The patient underwent an emergency retroperitoneal surgical procedure to ligate the right iliac artery, perform an extra-anatomic femorofemoral bypass, and repair the ruptured aneurysm. Post-operatively, the patient recovered well with all pulses intact. Isolated iliac artery aneurysms are rare but can rupture with high mortality if not repaired. Both open surgical and endovascular techniques are used for treatment.
Xlif in the treatment of ddd
This document discusses lumbar interbody fusion using the XLIF technique. It begins by describing the anatomy of the lumbar disc, including the central nucleus pulposus containing proteoglycans and water, and the peripheral annulus fibrosus containing concentric collagen rings. As discs degenerate over time, the nucleus loses water content and the annulus develops tears, allowing nitrogen and nucleus material to expand outward. This can cause nerve and blood vessel ingrowth, leading to back pain. The document then summarizes the XLIF surgical technique and outcomes from a study of 15 patients who underwent the procedure. Common minor complications included temporary leg weakness and numbness, while major complications such as implant disruption occurred in a small percentage of cases
Minimal invasive techniques in lumbar degenerative diseases
Minimally invasive techniques (MIT) are increasingly used to treat lumbar disc disease. They offer advantages over open surgery such as smaller incisions, less tissue damage, shorter recovery times, and lower risks. MITs include discography, epidural injections, facet/nerve blocks, nucleoplasty, kyphoplasty, tumor debulking, and interspinous spacers. They aim to diagnose and treat back pain conditions under local anesthesia or mild sedation using fluoroscopy guidance. MITs are generally low risk and allow many patients to be treated as outpatients or with only overnight hospitalization.
mandibular orthognathic procedures II- ih
Complications in orthognathic surgery can be presurgical, intraoperative, or postoperative. Presurgical complications include lack of pre-treatment objectives, laboratory errors, and inadequate orthodontics. Intraoperative complications involve hemorrhage, nerve injuries, unwanted fragmentation, and vascular or neural damage. Postoperative issues consist of loss of vascularity, infection, nonunion, occlusal disturbances, TMJ dysfunction, relapse, and rarely resorption. Careful planning, execution of surgery, and postoperative management can help reduce complication rates in orthognathic procedures.
Vertebral Augmentation by Vertebroplasty and Kyphoplasty: Introductory concerns
Vertebral Augmentation by Vertebroplasty and Kyphoplasty: Introductory concernsProf. Dr. Mohamed Mohi Eldin
Vertebroplasty and kyphoplasty are minimally invasive procedures used to treat painful vertebral compression fractures. Vertebroplasty involves injecting bone cement into the fractured vertebra to stabilize it, while kyphoplasty first uses an inflatable balloon to restore vertebral height before cement injection. Both procedures provide effective pain relief, though kyphoplasty may reduce risks of new fractures and cement leakage compared to vertebroplasty. Candidate selection, technical execution, and post-procedure management are important to achieve optimal outcomes and minimize complications.The Bone Scan
The bone scan shows normal uptake in kidneys, joints, and growing bones in children. Increased uptake elsewhere can indicate metastatic bone disease, hyperparathyroidism, or renal failure. Soft tissue uptake may be seen in tumors, necrosis, breast tissue in young women, and radiotracer impurities collecting in other organs. While bone scans can detect abnormalities, further testing is needed to differentiate between benign and malignant causes. Interpretation requires correlating scan findings with clinical history and other imaging results.
Management of Femoral Head Osteonecrosis.
The document discusses management of femoral head osteonecrosis, including its causes, diagnosis, classification systems, and treatment options. MRI is highlighted as the most sensitive diagnostic tool. Conservative treatments are recommended for early stages, while hip replacement is usually needed once collapse or secondary degeneration occurs. The key is early diagnosis and treatment to preserve the hip joint.
Ewings sarcoma- BONE TUMORS
Ewing sarcoma is a rare cancer that develops in bone or soft tissue. It is most common in children and young adults between ages 10-20. The cancer cells are small, round cells and are usually found in the bones of the legs, pelvis, ribs, or spine. Ewing sarcoma is treated with a combination of chemotherapy, radiation therapy, and surgery. Prognosis depends on factors like tumor size, location, and whether the cancer has spread. With current multi-agent chemotherapy regimens, long-term survival rates are around 60-70%.
urethroplasty
This document discusses urethral stricture disease, including its definition, risk factors, presentation, diagnosis, and various treatment options. It provides details on endoscopic treatments like dilation and urethrotomy, as well as surgical options like urethroplasty repairs using grafts, flaps, and anastomoses. Five case examples are presented and management options discussed. Key points covered include techniques for anastomotic repairs, the use of buccal mucosa grafts, and monitoring after treatment. Current controversies regarding urethroplasty utilization and outcomes are also noted.
Diskitis
This document discusses the investigation and management of discitis/diskitis. Key points include:
- Elevated ESR, CRP, and procalcitonin levels can indicate discitis, along with abnormal findings on imaging like MRI and X-rays. Blood and sputum cultures help identify the infection source.
- MRI is the most sensitive test for discitis, showing abnormalities in the disc space and vertebrae on T1 and T2 weighted images. CT also shows bone destruction.
- Treatment involves intravenous antibiotics for 6-8 weeks, immobilization, and pain management. Surgery may be needed for neurological complications, non-response to treatment, or deformity correction.
-
Patients with myelomeningocele and
Kyphosis as a sequel of myelomeningocele is a malformation that may result in many problems including ulcers, limited use of the arms for support purposes, and reduced pulmonary function. Treatment is complex and demanding. In 1998 the authors started treating 15 patients using the Alfredo Cardoso Monterrubio (ACM) plate for an average of 2.9 years. On average, the ACM plate provided 67.4 degrees of correction initially, with some loss of correction over time. Complications included infections and plate loosening, but patients reported improved posture and functionality.
Aneurysmal Bone Cyst of the Spine | Crimson Publishers
A 35yrs young patient, presented to the hospital with lower extremities neurological deficit, radiological investigation showed bony lesion in the posterior elements of T10 causing severe compression on the cord, emergency surgery was performed to decompress the spinal cord, the microscopic examination revealed that lesion was “ aneurysmal bone cyst”.
Peyronie's Disease: a tailored surgical procedure for every patient
Peyronie's Disease: a tailored surgical procedure for every patientMen's Health International Surgical Center
Presentation on "Peyronie's disease: a tailored surgical procedure for every patient" by Carlo Bettocchi, M.D, FECSM (Men's Health International Surgical Center in Switzerland) at the 5th Emirates International Urological Conference in Dubai. (Decembre 2016)What's hot (20)
Nmt631 skeletal anat, phys, bone scinti principles
Nmt631 skeletal anat, phys, bone scinti principles
Minimal invasive techniques in lumbar degenerative diseases
Minimal invasive techniques in lumbar degenerative diseases
Vertebral Augmentation by Vertebroplasty and Kyphoplasty: Introductory concerns
Vertebral Augmentation by Vertebroplasty and Kyphoplasty: Introductory concerns
Aneurysmal Bone Cyst of the Spine | Crimson Publishers
Aneurysmal Bone Cyst of the Spine | Crimson Publishers
Peyronie's Disease: a tailored surgical procedure for every patient
Peyronie's Disease: a tailored surgical procedure for every patient
Viewers also liked
Ctev
This document discusses idiopathic clubfoot, including its classification, causes, epidemiology, and treatment options. It focuses on the Ponseti method of manipulation and serial casting as the preferred treatment for idiopathic clubfoot. The Ponseti method involves specific techniques to correct cavus, adductus, varus, and equinus deformities through non-surgical manipulation and casting, sometimes including a percutaneous tenotomy of the Achilles tendon. Compliance with brace wear after treatment is critical to prevent recurrence of the deformity. The document also addresses evaluation methods, examples of clinical cases, common errors in technique, and strategies for managing clubfoot at the public health
Congenital clubfoot
Congenital clubfoot is a deformity of the foot characterized by equinus, inversion, cavus, and adduction. It occurs in 1-2 per 1000 births and is more common in males. The Ponseti technique involving serial casting and Achilles tenotomy has a success rate of 90% and is the preferred treatment. Complications can include relapse, residual deformity, or abnormal gait if not properly corrected.
Total hip replacement in sickle cell disease
Total hip replacement in patients with sickle cell disease presents several challenges. Osteonecrosis of the femoral head is a common problem for these patients. Management options range from non-surgical to total hip replacement. Special precautions are needed pre, during, and post-operation to address risks such as increased bleeding, infection, bone fragility, and sickle cell crises. Despite challenges, hip replacement can provide better function than other options, though higher failure rates must be considered. Careful planning and monitoring are necessary for successful outcomes in this high-risk patient population.
Elbow arthroplasty associated with distal humerus fracture -spanish - Hovsepian
Elbow arthroplasty associated with distal humerus fracture -spanish - HovsepianJean Michel Hovsepian
Orthopaedic Surgery Residency Presentation from Universidad Central de Venezuela, Hospital Universitario de Caracas. Seminar about Elbow arthroplasty associated with distal humerus fracture: Biomechanics, Types, Indication, Surgical Procedure, Justification, Complications. Jean Michel Hovsepian. Material in Spanish. Management of club foot
This document discusses the history and management of clubfoot. It describes non-operative treatments from ancient times through modern methods like the Ponseti technique. The Ponseti method, developed in the 1940s, is now the standard first-line treatment as it is safe, effective, and decreases the need for surgery. It involves serial casting and manipulation to correct the deformity, often with a percutaneous Achilles tenotomy. Surgical treatment is reserved for resistant or recurrent cases, with approaches like the Turco or Cincinnati incisions. Postoperative care varies but often involves casting or K-wire fixation followed by exercises. Complications can include injury, infection, stiffness or over/undercorrection. Proper understanding of anatomy and
Club foot
Clubfoot is a birth defect where one or both feet are twisted into an abnormal position. It is caused by genetic and environmental factors and affects males more than females. Treatment involves stretching the feet into correct position with casting or taping and bracing to maintain correction. Parents are taught exercises and bracing is worn long-term to prevent recurrence. Nursing focuses on monitoring for skin issues from casting, teaching parents exercises and brace use, and supporting the child's development.
Viewers also liked (6)
Elbow arthroplasty associated with distal humerus fracture -spanish - Hovsepian
Elbow arthroplasty associated with distal humerus fracture -spanish - Hovsepian
Similar to Hip
Avn of femoral head
Avascular necrosis of the femoral head, also known as osteonecrosis, results from interrupted blood supply to the bone and leads to bone cell death. It has traumatic causes like hip fractures or dislocations and non-traumatic causes like corticosteroid use, alcoholism, or blood disorders. MRI is the most accurate imaging test and stages the disease from pre-collapse to complete joint destruction. Early stages are treated with non-surgical options like protected weight bearing or core decompression surgery, while later stages may require joint replacement. The goal of treatment is to delay or prevent femoral head collapse through reducing pressure and promoting revascularization.
Tensor fascia lata[tfl] muscle pedicle grafting for avn hip dr mohamed ashraf...
slide presentation of a very promising surgical technic for a very elusive condition called avascular necrosis of femoral head.good clinical and surgical demo by dr mohamed ashraf,HOD, govt TD medical college ,alleppey,kerala, india
Avascular Necrosis of Hip
This document discusses osteonecrosis, or bone death caused by interrupted blood flow. It focuses on osteonecrosis of the femoral head, which is the most common site. Key points include:
- The femoral head is particularly vulnerable due to its blood supply. Interruption can be caused by trauma, coagulopathies, alcohol/steroid use.
- Symptoms include hip pain and limping. Imaging like MRI can detect early changes before X-rays.
- Treatment depends on the stage and size of the lesion. Options include core decompression, bone grafting, osteotomy, or hip replacement in advanced cases.
- Porous tantalum rods are a novel minimally
peripherial arterial disease
1) PAD is associated with increased risk of myocardial infarction and ischemic stroke due to shared risk factors of atherosclerosis.
2) Clinical features of PAD range from asymptomatic to intermittent claudication to critical limb ischemia manifested by rest pain, ulcers or gangrene.
3) Diagnosis involves assessment of symptoms and risk factors as well as tests such as ankle-brachial index, duplex ultrasound and angiography. Treatment depends on severity and may include lifestyle modification, medication, angioplasty or bypass surgery.
Spinal stenosis
Spinal stenosis is a degenrative spine disorder in which the AP and transverse diameter are decreased causing neural compression and symptoms of chronic & acute nerve compression
Early results of operative management of acetabular fracture
case series of acetabular fractures treated at Khartoum North Teaching Hospital
Mubarak A KERIM
MBBS MS MCh Orth (UK)FRCSI FRCSEd FRSM(UK)
Avascular necrosis of femoral head 1456920705296
AVascular necrosis of the femoral head is caused by loss of blood supply to the femoral head. It has traumatic causes like hip dislocation or fractures, and non-traumatic causes like steroid use, alcoholism, radiation. Clinically it presents with groin pain and reduced range of motion. It is classified by stages of collapse from intact bone to arthritis. Treatment depends on stage, but includes non-weight bearing, core decompression, bone grafts, osteotomies, hemiarthroplasty or total hip arthroplasty for late stages. The goal is to delay collapse, relieve symptoms, and restore hip function.
Chronic osteomyelitis
I. Chronic osteomyelitis is an inflammation of bone caused by infection that remains debilitating, especially in developing countries, despite antibiotics.
II. It has multiple presentations and causes, can lead to complications like sequestrum and involucrum formation, and is diagnosed through history, exams, imaging and microbiology.
III. Treatment involves antibiotics, extensive surgical debridement of devitalized tissue, management of dead space, and sometimes reconstruction or amputation in severe cases.
Osteosarcoma.pptx
Osteosarcoma - bone malignancy
Dr. Anu Aggrawal
Musculoskeletal Oncosurgeon
Delhi, India
dranu.isic@gmail.com
Foot ankle trauma 2013
Foot and ankle trauma, common pitfalls, imaging modalities and radiographic occult fractures. The concept of the PITFL or "pitiful injury" an easily overlooked ligamentous injury of the talocrural joint
Spinal infections
Spinal infections can have various causes and presentations. Diagnosis involves imaging like MRI and biopsy to identify the pathogen. Treatment is typically initially non-surgical including immobilization, antibiotics, and pain management, but surgery may be indicated for neurological deficits, abscesses, instability, or treatment failure. Surgical approaches depend on the location and goals but commonly involve anterior approaches. Outcomes depend on factors like neurological involvement, and titanium implants appear safe for reconstruction.
=====CHARCOT NEUROARTHROPATHY===========
This document defines Charcot foot, discusses its pathophysiology and classification, and outlines its clinical presentation, imaging, and management. Charcot foot is a progressive inflammatory condition affecting the bones and joints of the foot, typically in patients with peripheral neuropathy. It is classified based on the affected joints. Imaging can help diagnose and stage the condition. Treatment involves immobilization, offloading, bracing, and sometimes surgery to prevent deformity and ulceration. Surgical options aim to achieve a stable, plantigrade foot alignment. Studies show reconstructive surgery can significantly improve patients' quality of life and foot function.
Anesthetic implications of TOTAL HIP REPLACEMENT and TOTAL KNEE Replacement s...
This document provides an overview of anesthetic considerations for total hip and knee replacement surgeries. It discusses the anatomy of the hip and knee joints and their blood supply and innervation. It outlines common patient populations for these surgeries like the elderly and those with osteoarthritis or rheumatoid arthritis. It also discusses challenges like co-morbid conditions and decreased organ function. Finally, it provides details on preoperative optimization and considerations including screening for conditions like MRSA, assessing cardiopulmonary and musculoskeletal function, and managing comorbidities like diabetes, obesity, cardiovascular disease, anemia, malnutrition, tobacco use, and medications.
Knee pain
This document discusses the diagnosis and management of knee pain. It begins with a long list of potential differential diagnoses for knee pain. It then discusses taking a history, performing a physical exam, and ordering imaging and other tests to arrive at a diagnosis. Common causes of acute knee pain and swelling or chronic knee pain and swelling are outlined. Conservative and interventional treatment options are then discussed in depth, including medications, injections of corticosteroids and platelet-rich plasma, viscoelastic supplementation, exercises, and future/experimental treatments.
Malignant Otitis Externa/ Skull Base osteomyelitis
Malignant otitis externa
Necrotizing otitis externa
skull base osteomyelitis
pyocutaneous osteomyelitis
Ear diseases
base of skull
Cardiac cath complications
The document summarizes various potential complications that can occur during or after cardiac catheterization. The major complications discussed include death, myocardial infarction, stroke, bleeding, vascular injury, and contrast induced nephrotoxicity. Risk factors for complications include patient demographics, cardiovascular anatomy, clinical situation, and operator experience. Local vascular complications like hematoma, pseudoaneurysm, arterial thrombosis are also described. Strategies to prevent complications involve careful technique, minimizing contrast and anticoagulation.
Avascular necrosis of head of femur.pptx
This document discusses avascular necrosis of the hip. It begins by defining avascular necrosis as the death of bone tissue due to interrupted blood supply. It then lists numerous risk factors that can lead to this condition, such as corticosteroid use, alcohol abuse, and blood disorders. The document goes on to describe the pathogenesis and various classification systems used. It details methods for diagnosing avascular necrosis, including x-rays, MRI, and bone scanning. Both non-operative and operative treatment options are outlined, such as core decompression surgery and hip replacement for more advanced cases.
Avascular Necrosis (AVN)
This document discusses avascular necrosis (also known as osteonecrosis), which is the death of bone tissue due to a lack of blood supply. It begins by defining the condition and listing common sites of involvement. It then covers epidemiology, causes, pathogenesis, clinical features, investigations, treatment options and complications. Key points include that the femoral head is the most common site, risk factors include trauma, steroid use and sickle cell disease, and treatment ranges from non-operative options like core decompression to joint replacement surgeries depending on the stage of necrosis.
Vertebroplasty vs Kyphoplasty
Pain from acute vertebral fracture appears to be due in part to instability (non-union or slow union at the fracture site), while more than 1/3 of patients become chronically painful.
Traditional treatment for patients with painful VCFs includes bed rest, narcotic analgesics and bracing, resulting in increased pain because of acceleration bone loss and muscle weakness.
Surgical treatment acute dvt
Venous thrombectomy can help treat acute iliofemoral deep vein thrombosis (DVT) and reduce long-term complications. The procedure removes the thrombus to eliminate obstruction and preserve valve function. Randomized trials found that venous thrombectomy plus anticoagulation led to better long-term outcomes than anticoagulation alone, including lower venous pressures, less venous reflux, fewer symptoms of post-thrombotic syndrome, and better patency rates. Contemporary venous thrombectomy techniques use dual catheter techniques and angiovenous fistulas to effectively clear thrombus and reduce venous hypertension in order to decrease long-term morbidity from extensive DVT.
Similar to Hip (20)
Tensor fascia lata[tfl] muscle pedicle grafting for avn hip dr mohamed ashraf...
Tensor fascia lata[tfl] muscle pedicle grafting for avn hip dr mohamed ashraf...
Early results of operative management of acetabular fracture
Early results of operative management of acetabular fracture
Anesthetic implications of TOTAL HIP REPLACEMENT and TOTAL KNEE Replacement s...
Anesthetic implications of TOTAL HIP REPLACEMENT and TOTAL KNEE Replacement s...
Malignant Otitis Externa/ Skull Base osteomyelitis
Malignant Otitis Externa/ Skull Base osteomyelitis
Recently uploaded
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...rightmanforbloodline
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.Part II - Body Grief: Losing parts of ourselves and our identity before, duri...
Learn about body grief and ways to cope with it. We will also explore methods to heal from this challenging experience.
Integrating Ayurveda into Parkinson’s Management: A Holistic Approach
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
A Classical Text Review on Basavarajeeyam
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Ketone bodies and metabolism-biochemistry
This slide consists of all the topics of ketone . This can be used for exam purpose for writing about Diabetic keto acidosis etc . Thank you
Cell Therapy Expansion and Challenges in Autoimmune Disease
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Role of Mukta Pishti in the Management of Hyperthyroidism
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Hemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- 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
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Efficacy of Avartana Sneha in Ayurveda
Avartana Sneha is a unique method of Preparation of Sneha Kalpana in Ayurveda, mainly it is indicated for the Vataja rogas.
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kol...
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kol...rightmanforbloodline
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Versio
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest VersionDoes Over-Masturbation Contribute to Chronic Prostatitis.pptx
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
Recently uploaded (20)
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...
Part II - Body Grief: Losing parts of ourselves and our identity before, duri...
Part II - Body Grief: Losing parts of ourselves and our identity before, duri...
Ear and its clinical correlations By Dr. Rabia Inam Gandapore.pptx
Ear and its clinical correlations By Dr. Rabia Inam Gandapore.pptx
Integrating Ayurveda into Parkinson’s Management: A Holistic Approach
Integrating Ayurveda into Parkinson’s Management: A Holistic Approach
Tests for analysis of different pharmaceutical.pptx
Tests for analysis of different pharmaceutical.pptx
Cell Therapy Expansion and Challenges in Autoimmune Disease
Cell Therapy Expansion and Challenges in Autoimmune Disease
Role of Mukta Pishti in the Management of Hyperthyroidism
Role of Mukta Pishti in the Management of Hyperthyroidism
Hemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
Hemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kol...
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kol...
Does Over-Masturbation Contribute to Chronic Prostatitis.pptx
Does Over-Masturbation Contribute to Chronic Prostatitis.pptx
Hip
- 1. Sickle Cell Disease & Total Hip Arthroplasty
- 2. The three principle orthopaedic manifestations • pyogenic infections • marrow hyperplasia • osteonecrosis J Am Acad Orthop Surg 2005;13:208-217
- 3. Organisms • Staphylococcus aureus • Streptococcus pneumoniae • Salmonella typhi, • Klebsiella pneumoniae N Engl J Med 1999;340: 1021-1030 Clin Orthop 1993;294:140-148
- 4. Marrow Hyperplasia • Increased erythropoiesis • widening of the medullary canal and thinning of the trabeculae and cortices, J Bone Joint Surg Br 1989;71: 465-470
- 5. Osteonecrosis • hypoxia-induced erythrocyte sickling, along with extravascular compression of the intraosseous blood supply caused by medullary hyperplasia • bone or marrow infarction, focal and patchy areas
- 6. Patient Evaluation and Natural History • Groin pain • limited ROM • Often bilateral
- 7. Nonsurgical Management • pain management • assistive devices • typically progresses J Bone Joint Surg Am 2003;85:500-504
- 8. Surgical Management • disabling hip pain • severely damaged hip joint • Medically fit
- 9. Surgical Management • THA • Core decompression • Femoral osteotomy • Arthrodesis • Hemiarthroplasty • Resection arthroplasty
- 10. • No Level 1 or 2 evidence • Steinberg stages I and II J Am Acad Orthop Surg 2005;13:208-217
- 11. • it does not address the primary underlying pathophysiology of vaso-occlusion • femoral head involvement usually is diffuse and too large to decompress • chronic nature of the disease makes future infarcts inevitable despite decompression Am J Orthop 1995;24:18-24
- 12. Preoperative Considerations • preventing sickle cell crises • paying careful attention to cardiac status and fluid balance • assessing infection • using preoperative transfusion or plasmapheresis • considering anesthetic modalities and pain management technique
- 13. Preoperative Considerations • hemoglobin S level < 30% Am J Hematol. 1999 Nov;62(3):129-38
- 14. Intraoperative Considerations • wide medullary canal an thin cortices • sclerosis, and canal obliteration
- 15. Accetabular Preparation & Component Insertion • Acetabular bone quality may be poor • patches of densely sclerotic bone (eccentric reaming • acetabular protrusio ( medial reaming, Bone Graft, acetabular support and In-situ Osteotomy) J Am Acad Orthop Surg 2005;13:208-217
- 16. Femoral Canal Preparation • Areas of sclerosis may be so diffuse that the canal becomes completely obliterated • hyperplastic medullary canals, thin cortices • introducing a drill bit under image intensifier until it is possible to insert a guidewire for flexible reamers Int Orthop 2002;26:157-161
- 17. Medical Complications • excessive bleeding (18%) • pulmonary complications • sickle cell crises • cardiac complications (4%) • mental status changes Am J Hematol 1999;62:129-138
- 18. Surgical Complications • Infection (25%) • There are no reported cases of Salmonella osteomyelitis complicating a THA; therefore, prophylactic administration of antibiotics that provide coverage for this gram-negative microorganism is not recommended Am J Orthop 1996;25: 353-356 Clin Orthop 1993;294:140-148
- 19. Surgical Complications • Hip Dislocation (26%) J Arthroplasty 1997;12:420-425