By popular demand, here's the video shown @AAHKS - These just *some* of the cement debonding cases we've done recently: Multiple cements, implant designs, implant materials... Both tibias and femurs. Does cement technique play a role? #orthotwitter@AAHKS_YAG@JArthroplasty
@EdinburghKnee love your paper on periprosthetic fractures around Exeter stems! Did ORIF and cement in cement revision for this hip originally done at the Royal Infirmary several years ago. Distal malunion made things interestingโฆ
@ExeterHipUnit@EdinburghKnee Yeah not sure there are really any other good options - proximal femoral replacement? Not much distal bone and with the varus deformity a total femur might be necessary - both are not ideal
Looking at Figure 1 in the article, it is possible that 'component malposition' may be a large reason for #THA dislocations as well.
https://t.co/IVU9NZne2e
@AAHKS_YAG@CodyWylesMD@womenAAHKS
Though seemingly rare periprosthetic crystalline arthropathy can be challenging to differentiate from PJI. Correctly identifying these patients could save them from revision but this must be balanced against the risk of delaying surgery if they do in fact have PJI.
Should we routinely send periprosthetic aspiration fluid for crystal analysis? Though likely rare, gout can present similar to PJI as shown in this systematic review of 42 cases: https://t.co/Nn3rfp4eh3. Thanks to @connor_kingMD@DrPeterSculco @TBalachMD
Surgery >48hr after periprosthetic hip fracture had increased medical and surgical complications. @AAHKS@womenAAHKS @hssarjr
https://t.co/QU8f4l33Wo
@LArthroplasty@BrianChalmersMD@drmikeast@jointdocShields@CenterRotation@NaanDerthaal Very cool technology- will be interesting to see how this is utilized. At this point itโs still only as good as the data in and the referencing. For THA & TKA there is still some debate about optimal positioning - if only we knew where the target should be for each patient!
If you are using the ESR and CRP as a screening test for possible #PJI, using the standard values of 30mm/hr and 10mg/L may not be ideal @MayoClinic https://t.co/bYZ58CEVjV
@BrianChalmersMD@OrthoThompson @CJFooteMD @jbjs As someone finishing fellowship in 2.5 months, this model and its predicted backlog of cases sound great. But if we've been reminded of anything lately, empirically driven models can be inaccurate. I suspect patient demand which was assumed to be unaltered may play a role?