Deepu Bhaskar

Trauma and Orthopaedics consultant. Revision hip and knee.
Glan Clwyd Hospital, Wales.

[Deepu Bhaskar @depurhro]

Failed acetabular cup and custom reconstruction.

At year end I thought I would reflect on a failed acetabular cup and what I learnt.

67 yr lady,  fell Nov 2019 but did not seek medical attention. Independent mobiliser before event, to mobilising with frame and minimal WB.

[The Journal of Arthroplasty @JArthroplasty]

Repeat 2-stage revision for recurrent knee PJI yields low infection control rates and major morbidity, including a 23% amp rate. Younger patients are at greater risk of failure.

https://t.co/V3D82G44g8

[Deepu Bhaskar @depurhro]

You can critique implant position if you want but I don't think you can criticise the results achieved .....

[Deepu Bhaskar @depurhro]

Bilateral sequential total hip replacements in one sitting is something I don't do often, but a strategy for those with bilateral flexion deformities of the hip.
But after watching this patient walk in clinic I decided to adopt this strategy.

[Deepu Bhaskar @depurhro]

While being familiar with good results with this strategy, I still was very happy to see how he bounded in at 6 weeks from surgery. Images and videos reproduced with patient permission.

[LifetimeHip @LifetimeHip]

Obesity v Joint Replacement ⚖️

My Top 8 papers, 3 main points 🟥🟥🟥

Anyone add to these (papers or key points)?:

🧵

[The Journal of Arthroplasty @JArthroplasty]

Corticosteroid injections administered up to 3mo prior to THA increased the risk of PJI within 1yr after THA, with an HR of 2.63; however, injections between 3-6mo before surgery did not have a significantly higher infection rate.

https://t.co/Oa8NZpx3FF

[Liverpool Orthopaedic and Trauma Service @Liverpool_Ortho]

Proud that our @Drlyndonmason was involved in a consensus paper on fragility open ankle fractures published in @BoneJointOpen @BOFAS_UK BLRS BAPRAS https://t.co/Gsk7MyzeuV

[The Bone & Joint Journal @BoneJointJ]

Do patients experience change in health-related quality of life when waiting six to 12 months for THA or KA?

Check out last month's most talked about paper in the #BJJ now!

#Arthroplasty #QualityOfLife #Healthcare @EdinburghKnee @lzyapp @EdinOrthopaedic

https://t.co/r4TJlhOXSc

[Arthroplasty Today @ArthroToday]

How do you counsel pts w/knee OA and a history of extensor mechanism repair? This database study from @MedStarUMH looked at postop complication rates after primary TKA w/ vs w/o preop extensor mechanism repair. @RylandKagan @NanaSarpongMD @Hip_Knee_MD

https://t.co/HOYFjlIXzk

[Arthroplasty Today @ArthroToday]

All conversion THAs are not equal! This study from @BCMOrtho @FondrenOrtho compared outcomes following CRPP vs. IMN, and found that prior IMN was assoc w/worse outcomes. @DrIhekweazu @JustCardenas @DeliaRospi @bethgausdenmd @DrPeterSculco

https://t.co/HS7Xn4C61S

[Bone & Joint Open @BoneJointOpen]

The Coronal Plane Alignment of the Knee classification is a comprehensive system for predicting pre-arthritic knee alignment. However, the classification requires modifications when applied in the Asian population.

#Arthroplasty #Knee #OrthoTwitter #BJO

https://t.co/9IBPMi2bkY

[Mohamed Draz @MSDraz]

If you have IMG doctors in your team

You need to read this

IMGs need more:
- Attention
- Help
- Support
- Empathy

Here is why:

[Liverpool Orthopaedic and Trauma Service @Liverpool_Ortho]

Big paper Thursday: Time for a rethink?
In patients with closed fractures, skin antisepsis with iodine povacrylex in alcohol (duraprep) resulted in fewer surgical-site infections than antisepsis with chlorhexidine gluconate (chloraprep) in alcohol.@NEJM
https://t.co/7gt9W95MUF

[The Journal of Arthroplasty @JArthroplasty]

BMI ≥35 had greater improvements in PROMs compared to patients with lower BMI. Given the significant improvements in PROMs and quality of life in obese patients, they should not be denied a TKA.

https://t.co/7Qc2kOnRVW

#VA by Dr. David Deckey

[The Journal of Arthroplasty @JArthroplasty]

BMI ≥35 had greater improvements in PROMs compared to patients with lower BMI. Given the significant improvements in PROMs and quality of life in obese patients, they should not be denied a TKA.

https://t.co/7Qc2kOnRVW

#VA by Dr. David Deckey

[Deepu Bhaskar @depurhro]

These are expensive too and a lot of hard work goes into getting pt on table. Thank you to YGC theatres & staff for the effort, @BetsiCadwaladr for support, fantastic MDT Wrightington, North Wales MDT, surgical experience @CavendishHip, my colleagues & Mr Kapur for dual operating

[Deepu Bhaskar @depurhro]

Failed acetabular cup and custom reconstruction.

At year end I thought I would reflect on a failed acetabular cup and what I learnt.

67 yr lady,  fell Nov 2019 but did not seek medical attention. Independent mobiliser before event, to mobilising with frame and minimal WB.

[Deepu Bhaskar @depurhro]

Post op – 3 months from surgery. Patient able to weight bear for the first time in 4 years comfortably. But still I am holding my breath, she is not the steadiest person on her feet and the bones have the consistency of butter!!!! 🤞

Story reproduced with patient permission.