Happiest of birthdays babe! I love this journey we’re on. Who knows what lies around the turns ahead… all I know is I’m glad to be on this trail with you. @CandiceCodyMD
@jointdocShields I usually use prostalac with a 40mm head, scuffing up the back of the poly with a burr for slightly better acetabular fixation (but not too good).
@CenterRotation In most of these cases, a slightly higher hip center with a medial cup obviates the need for augments (metal or femoral head) most of the time as you show here. This looks great.
@jointdocShields I think it depends on age and patient goals. But honestly, what’s the difference between lengthening the hip 5cm and shortening the femur 2 cm and just lengthening at hip 3cm? I understand high COR concerns but one is a MCUH bigger/more complex surgery than the other.
@SarahNelsonMD@rkh_md I’ve been using it for a month or so now, too short of a time to tell if there is significant difference over standard CSI. I do like the reduced glucose spike in diabetic patients though.
@northwoods1980 Saw it a few times in fellowship. This is almost assuredly due to lifting the patient’s pelvis for the AP in the PACU when the neuraxial blockade is still intact. This motion causes significant extension and ER of the hip which can lever it out anteriorly.
@jointdocShields @nmiladoremd 💯 this. With the stem extractor, this case is much more manageable than without. Worth the extra effort to have them bring it in.
@Bloch_ortho “Let’s take a surgery with incredible, reproducible long term results, nearly unmatched in all of medicine, and try to change everything about it!” 🙄
@MilOrtho@jointdocShields@DrAntoniaChen@djschuett@EdinburghKnee Cup: restore head center and use fem head autograft PRN. Dual mobility on backup but 32 or 36 head likely fine.
Femur: Monoblock conical taper fluted stem vs SROM. Lengthen no more than 4cm. Subtroch shortening osteotomy if necessary.