The document discusses total hip replacement and dislocation as a complication. It covers the anatomy of the hip joint, movements, biomechanics, the Charnley concept, and factors that can contribute to dislocation such as surgical approach, component malposition, and patient factors like age and prior surgery. Contributory factors are divided into epidemiological, surgical, and anatomical categories. Treatment depends on whether dislocation is acute or recurrent, and may involve closed or open reduction as well as revision surgery in some cases.
High tibial osteotomy (HTO) is a common and widely accepted procedure in orthopaedic surgery. In the literature, we find descriptions of the technique dating back to the 50s, with Jackson (Jackson, 1958). However, it was not until the 70s, with the publications of Conventry (Coventry, 1969 and 1973) and Insall (Insall, 1975), that proximal tibial osteotomy became common practice as a treatment option for medial compartment osteoarthritis of the knee usually associated to varus deformity. At that time, closing wedge osteotomies were performed, despite the greater technical difficulty and risks involved, as there were no fixation materials available that could enable opening wedge osteotomy. Only after the development of medial wedge plate fixation that opening wedge osteotomy became applicable (Puddu, 2004).
The goals of HTO are:
1. To reduce knee pain by transferring weight-bearing loads to the relatively unaffected compartment;
2. To increase the life span of the knee joint, by slowing or stopping the destruction of the medial joint compartment. This could delay the need of a joint replacement.
Safe surgical dislocation for femoral head fractures.dr mohamed ashraf,dr rah...drashraf369
femoral head fractures are very complex fractures that need immediate and prompt surgical intervention.conventional surgical appproaches to hip may lead to short and long term complications.dr mohamed ashraf ,dr rahul thampi et al are presenting their experience with gantz safe surgical dislocation approach to surgical management of femoral head fractures
High tibial osteotomy (HTO) is a common and widely accepted procedure in orthopaedic surgery. In the literature, we find descriptions of the technique dating back to the 50s, with Jackson (Jackson, 1958). However, it was not until the 70s, with the publications of Conventry (Coventry, 1969 and 1973) and Insall (Insall, 1975), that proximal tibial osteotomy became common practice as a treatment option for medial compartment osteoarthritis of the knee usually associated to varus deformity. At that time, closing wedge osteotomies were performed, despite the greater technical difficulty and risks involved, as there were no fixation materials available that could enable opening wedge osteotomy. Only after the development of medial wedge plate fixation that opening wedge osteotomy became applicable (Puddu, 2004).
The goals of HTO are:
1. To reduce knee pain by transferring weight-bearing loads to the relatively unaffected compartment;
2. To increase the life span of the knee joint, by slowing or stopping the destruction of the medial joint compartment. This could delay the need of a joint replacement.
Safe surgical dislocation for femoral head fractures.dr mohamed ashraf,dr rah...drashraf369
femoral head fractures are very complex fractures that need immediate and prompt surgical intervention.conventional surgical appproaches to hip may lead to short and long term complications.dr mohamed ashraf ,dr rahul thampi et al are presenting their experience with gantz safe surgical dislocation approach to surgical management of femoral head fractures
A short and descriptive presentation on total hip replacement surgery. This presentation gives brief idea about the causes of arthritis of hip and its management. This presentation also provides information on total hip replacement procedure.
Dr.A.Mohan krishna
Consultant orthopedic surgeon
Apollo hospitals,
Hyderabad
Appointments: 9247258989
9441184590
www.drmohankrishna.com
www.bonesandjointsclinic.com
www.healthyjointclub.com
Knee injuries for MBBS (undergraduate students). This presentation deals with injuries to the bones and ligaments around the knee as well as gives a brief overview on the dislocations of the knee and patella.
Shoulder joint Bio-Mechanics and Sports Specific RehabilitationFabiha Fatima
Shoulder joint Bio-Mechanics and Sports Specific Rehabilitation.
What does the PPT consists of ?
General Biomechanics of Shoulder joint as well as the Bio-mechanics of certain specific sports such as Throwing, Swimming and Racket Sports.
along with a comprehensive rehabilitation of shoulder injuries.
** Above uploaded document has been made as a study material for classroom presentation. it is powered by .gif files which may not be working in this format.**
Spine/Vertebral column comprises 33 vertebrae divided into 5 sections:
• Cervical (7):
Upper Cervical (C1-C2) Lower Cervical (C3-C7)
• Thoracic (12)
• Lumbar (5)
• Sacral (5)
• Coccygeal (4)
• Sacral and Coccygeal Vertebrae Fused so 24 mobile joints.
• Each mobile vertebral body increases in size moving cranial to caudal.
3
Sagittal plane Curve
• Cervical Lordosis (20°-40°) • Thoracic Kyphosis (20°-40°) • Lumbar Lordosis (30°-50°) • Sacral Kyphosis
4
Parts of a typical vertebra
• Anterior: Body
• Posterior: Neural/Vertebral Arch
that encloses the Vertebral canal
• Vertebral Arch composed of: 2 Pedicles laterally
2 Laminae posteriorly
1 Spinous process
Either side of arch is Transverse process and Superior and Inferior Articular process
Cervical vertebrae
• Body: small and broader
• Pedicle: directed backwards and
laterally
• Laminae: long and narrow
• Transverse process: pierced by
foramina transversaria
• Spine: short and bifid
6
7
Thoracic vertebrae
• Body: progressive increase in
mass from T1 to T12, heart shaped
• Pedicles: directed straight backwards
• Laminae: vertical, with “roof tile” arrangement
• Transverse process: large and directed laterally and backwards
• Spinous processes: long,
overlapping and projected downward
8
Lumbar vertebrae
• Body: progressive increase in mass
• Pedicles: short and strong
• Lamina: short, thick and broad
• Transverse processes: thin and
tapering
• Spinous processes: horizontal and
square shaped
• Intervertebral foramen: large,
triangular in shape
9
Sacral vertebrae
• Body: like lumbar region • Pedicle: short
• Lamina: oblique
• Base of lateral mass
forms broad sloping surface called Ala of sacrum
10
Coccyx
• Small triangular
• Four rudimentary coccygeal vertebrae
11
Inter-vertebral Disc
• Forms fibro-cartilaginous joint at each vertebral level
• Found throughout vertebral column except between 1st and 2nd
cervical vertebrae
• Accommodate movement, weight bearing and shock
• Each disc contains a pair of vertebral end plates, central nucleus pulposus and peripheral ring of anulus fibrosus.
12
13
• Annulus Fibrosus
Outer portion
Great tensile strength and withstand multidirectional strain
Made up of 12 concentric lamellae with alternating orientation
60-70% water, 50-60% collagen and 20% proteoglycan of dry weight
• Nucleus Pulposus
Inner structure
Resists axial forces
Semisolid mass of mucoid material
70-90% water, 15-20% collagen and 65% proteoglycan of dry weight
14
Joints
• Joint between vertebral bodies: secondary cartilaginous joint or symphysis between pair of vertebral body with pair of vertebral endplates and one intervertebral discs
• Joint between vertebral arches: Facet joints or zygapophyseal joints
• Others:
1. Costovertebral joints
2. Costotransverse joint
3. Sacroiliac joint
4. Atlantoaxial Joint
5. Uncovertebral Joints/ Joint of Luska
15
• Facet joints: Synovial joint between
Similar to Total hip arthroplasty, dislocation (20)
classification of soft tissue injuries. gustilo anderson classification, tscheren classification, hanover fracture scale and ao soft tissue grading system, types of wounds. orthopedic open fracture classification for management of soft tissue injuries
TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardso...rightmanforbloodline
TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardson, Verified Chapters 1 - 18, Complete Newest Version
TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardson, Verified Chapters 1 - 18, Complete Newest Version
TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardson, Verified Chapters 1 - 18, Complete Newest Version
ALKAMAGIC PLAN 1350.pdf plan based of door to door delivery of alkaline water...rowala30
Alka magic plan 1350 -we deliver alkaline water at your door step and you can make handsome money by referral programme
we also help and provide systematic guideline to setup 1000 lph alkaline water plant
Stem Cell Solutions: Dr. David Greene's Path to Non-Surgical Cardiac CareDr. David Greene Arizona
Explore the groundbreaking work of Dr. David Greene, a pioneer in regenerative medicine, who is revolutionizing the field of cardiology through stem cell therapy in Arizona. This ppt delves into how Dr. Greene's innovative approach is providing non-surgical, effective treatments for heart disease, using the body's own cells to repair heart damage and improve patient outcomes. Learn about the science behind stem cell therapy, its benefits over traditional cardiac surgeries, and the promising future it holds for modern medicine. Join us as we uncover how Dr. Greene's commitment to stem cell research and therapy is setting new standards in healthcare and offering new hope to cardiac patients.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
About this webinar: This talk will introduce what cancer rehabilitation is, where it fits into the cancer trajectory, and who can benefit from it. In addition, the current landscape of cancer rehabilitation in Canada will be discussed and the need for advocacy to increase access to this essential component of cancer care.
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
PET CT beginners Guide covers some of the underrepresented topics in PET CTMiadAlsulami
This lecture briefly covers some of the underrepresented topics in Molecular imaging with cases , such as:
- Primary pleural tumors and pleural metastases.
- Distinguishing between MPM and Talc Pleurodesis.
- Urological tumors.
- The role of FDG PET in NET.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
Rate Controlled Drug Delivery Systems, Activation Modulated Drug Delivery Systems, Mechanically activated, pH activated, Enzyme activated, Osmotic activated Drug Delivery Systems, Feedback regulated Drug Delivery Systems systems are discussed here.
Under Pressure : Kenneth Kruk's StrategyKenneth Kruk
Kenneth Kruk's story of transforming challenges into opportunities by leading successful medical record transitions and bridging scientific knowledge gaps during COVID-19.
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
Chandrima Spa Ajman is one of the leading Massage Center in Ajman, which is open 24 hours exclusively for men. Being one of the most affordable Spa in Ajman, we offer Body to Body massage, Kerala Massage, Malayali Massage, Indian Massage, Pakistani Massage Russian massage, Thai massage, Swedish massage, Hot Stone Massage, Deep Tissue Massage, and many more. Indulge in the ultimate massage experience and book your appointment today. We are confident that you will leave our Massage spa feeling refreshed, rejuvenated, and ready to take on the world.
Visit : https://massagespaajman.com/
Call : 052 987 1315
INFECTION OF THE BRAIN -ENCEPHALITIS ( PPT)blessyjannu21
Neurological system includes brain and spinal cord. It plays an important role in functioning of our body. Encephalitis is the inflammation of the brain. Causes include viral infections, infections from insect bites or an autoimmune reaction that affects the brain. It can be life-threatening or cause long-term complications. Treatment varies, but most people require hospitalization so they can receive intensive treatment, including life support.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
4. MOVEMENTS
• Flexion
• iliopsoas, rectus femoris, and sartorius and also by the adductor muscles.
• Extension
• gluteus maximus and the hamstring muscles.
• Abduction
• gluteus medius and minimus, assisted by the sartorius, tensor fasciae latae, and piriformis.
• Adduction
• adductor longus and brevis and the adductor fibers of the adductor magnus. These muscles are assisted
by the pectineus and the gracilis.
dr.basit@live.com
5. • Lateral rotation
• piriformis, obturator internus and externus, superior and inferior gemelli, and quadratus
femoris, assisted by the gluteus maximus
• Medial rotation
• anterior fibers of the gluteus medius and gluteus minimus and the tensor fasciae latae.
• Circumduction
MOVEMENTS
dr.basit@live.com
6. FEATURES OF AN IDEAL JOINT REPLACEMENT
• Biocompatible
• Well fixed to the host tissue, stable and allowing a good range of movement
• Bearing surfaces should be designed to minimise friction
• Material released from the bearings should be non-toxic
• Remove the minimum amount of bone
• Produce mechanical stability
• Should ideally outlive the patient
dr.basit@live.com
9. • The ratio of the length of the lever arm of the body weight to that of the
abductor musculature is about 2.5 : 1
• The force of the abductor muscles must approximate 2.5 times the body
weight to maintain the pelvis level when standing on one leg
• The estimated load on the femoral head in the stance phase of gait is equal to
three times the body weight
dr.basit@live.com
10. CHARNLEY CONCEPT OF TOTAL HIP ARTHROPLASTY
• Shorten the lever arm of the body weight by deepening the acetabulum and
to lengthen the lever arm of the abductor mechanism by reattaching the
osteotomized greater trochanter laterally
• The lengths of the two lever arms can be surgically changed to make their
ratio approach 1 : 1
• Theoretically, this reduces the total load on the hip by 30%
dr.basit@live.com
13. PEAK CONTACT FORCES
Body position X body weight
Gait 3.5 to 5.0
Single-limb stance 6
Running, jumping 10
dr.basit@live.com
14. • The forces on the joint act not only in the coronal plane but also in the sagittal plane to bend
the stem posteriorly
• The forces acting in this direction are increased when the loaded hip is flexed
• These so-called out-of-plane forces have been measured at 0.6 to 0.9 times body weight.
• These are directed against the prosthetic femoral head from a polar angle between 15 and
25 degrees anterior to the sagittal plane of the prosthesis
dr.basit@live.com
15. • The location of the center of rotation of the hip from superior to inferior also affects the
forces generated around the implant
• Isolated superior displacement without lateralization produces relatively small increases in
stresses in the periacetabular bone
• Placement of the acetabular component in a slightly cephalad position allows improved
coverage or contact with viable bone
dr.basit@live.com
20. EPIDEMIOLOGICAL
• Previous hip surgery
• Female sex
• Advanced age
• Prior hip fracture
• Preoperative diagnosis of osteonecrosis or inflammatory arthritis
dr.basit@live.com
23. ALARMING SIGNS OF DISLOCATION
• Excessive pain on motion of the hip
• Abnormal internal or external attitude of the hip with limited active and
passive motion
• Shortening of the limb
dr.basit@live.com
24. • Reduction usually is not difficult if dislocation occurs in the early postoperative period and
a timely diagnosis is made
• Reduction techniques should always be gentle to minimize damage to the articulating
surfaces
• Open reduction with replacement of the liner or revision of the acetabular component may
be required
dr.basit@live.com
25. • If the components are in satisfactory position, closed reduction is followed by a period of
bed rest
• Mobilization is accomplished in a prefabricated abduction orthosis that maintains the hip
in 20 degrees of abduction and prevents flexion past 60 degrees
• Immobilization for 6 weeks to 3 months is recommended
dr.basit@live.com
26. • If one or both components are malaligned, and dislocation becomes recurrent, revision surgery
usually is required
• If instability is compounded by neurological deficit or abductor insufficiency, revision to a
bipolar prosthesis may be considered
• Constrained socket design can be used in which the femoral head is locked into the socket
• These devices should be used only as a last resort because of their complexity and multiple methods of
mechanical failure
dr.basit@live.com
27. • Noncompliant individuals, elderly debilitated patients, and
patients with several previous failed attempts to stop recurrent
dislocation are best treated by removal of the components
without further reconstruction
dr.basit@live.com