Acetabular Surgery

PROCEDURE IN DETAIL: The patient was brought into the operating room, after satisfactory anesthesia, was placed in the left lateral dicubitis position. The right hip was prepped and draped. A previous made incision was reopened over the greater trochanter and carried down to Illiotibial (IT) band. The IT band was opened in the direction of the skin incision. The anterior 1/3 of the gluteus medius/minimus group was reflected off the trochanter over to the anterior brim of the pelvis. The hip was dislocated. The femoral component was easily removed. It was loose in the cement. The polyethylene was loose and easily removed. There was a lot of cement in and around the acetabulum. We debridement most of this. There was a wired mesh plug that went medially into the pelvis that was left in place. There was also one in the ishium that was quite stable and it was left in place. There was a large defect in the medial wall of the acetabulum about the size of a silver dollar.

The hip, knee, and thumb joints are places where it tends to happen the

Russell Carrington is a 25 year old right handed relief pitcher for the MLB team the Baltimore Orioles. Carrington has been playing baseball since he was seven years old and this was his third season in the Major Leagues. Carrington was at the mound and in the motion of throwing a fastball, when he felt a “pop” in his overhand motion. He dropped to his knees and clinched his right shoulder in pain. Athletic trainers came onto the field an upon examination Carrington stated his arm felt like it was “dead” and felt like it was “catching”. Carrington was seen by the team physician. She performed ROM exercises, strength, and stability tests on his shoulder and examined his neck and head to ensure pain wasn’t coming from a pinched nerve. She concluded that further testing and imaging was necessary. Carrington had an X-ray and MRI done on his shoulder and he was diagnosed with a type II SLAP (Superior Labrum Anterior and Posterior) lesion. He didn’t want surgery done because he would miss the remainder of the season and possibly the next, so doctors prescribed non-steroid anti-inflammatory medication and five months physical therapy to strengthen the shoulder capsule. After completion of physical therapy, the pain didn’t improve and arthroscopy surgery was recommended.

Baseball players and fans call it Tommy John surgery, after the pitcher who was the first to have the surgery 29 years ago. By any designation, it is one of the major advancements in sports medicine in the last quarter century. Technically it is a ulnar collateral ligament replacements procedure.

Burkhart et. al presented the peel back (posterior superior) mechanism that causes SLAP lesions. The peel back has its origin in a biceps vector change in the position of abduction and external rotation resulting in torsional forces to the labra-bicipital complex.6 Once the posterior superior labrum gets fatigued, it will start to rotate medially over the upper rim of the glenoid. This could happen in a late cocking position of

Snap, crackle, and pop. Those aren't the sound of rice crispies in milk; it’s the sound a pitcher hears after tearing his ulnar collateral ligament. This injury used to be career ending but is now almost standard. This has saved countless dreams for many baseball players of not just playing baseball but to have complete function of their right arm. Today, sports fans and athletes hear the term Tommy John surgery and don't flinch. There are currently 29 active ballplayers in the major leagues who have already have had Tommy John surgery. That includes the Chicago White Sox'

Health History: A 25-year-old male injured his left knee in a recent skiing accident. The patient stated that he lost his balance because the inner edge of his right ski got caught while skiing. This resulted in the right leg being externally rotated followed by and audible “pop” as he lost footing. By evening, the right knee joint had become swollen, causing intense pain. The primary care physician referred the case to an orthopedist.

01/14/16 Progress Report noted that the patient has severe and constant pain. It is associated with numbness, tenderness, and restricted motion. Current pain level is 8/10. The patient is here for injection to the left subtalar joint. The exam of the left ankle revealed intact skin. There was no erythema or abrasion. No signs of infection. NVI distally. Distal sensation intact and brisk capillary refill. Clinical Assessment: The patient would like to go ahead with the

During the weeks of February 7 through February 17, I observed a total hip arthroplasty on a 56-year-old Caucasian female patient who suffered from a femoral neck fracture and damage to the acetabulum. The fracture was a result from a car accident where the patient's knees collided with the dashboard, forcing the femur into the hip and breaking the femur.

The unhappy triad, also known as “blown knee”, “terrible triad”, or “O’Donoghue triad”, is named after Dr DH O’Donoghue, an American orthopaedic surgeon who described this injury back in 1950. This injury includes full or partial tears of the Anterior Cruciate Ligament (ACL), the Medial Collateral Ligament (MCL), and a meniscus. The unhappy triad happens to about 25% of athlete’s knee injuries. The unhappy triad is a very common sports injury, especially in contact sports where the knee can often be hit. It is thought to be the most common knee injury in football and can occur when the knee is clipped during a tackle.

The Anterior Cruciate Ligament also known as the ACL is deemed the most commonly torn ligament in the knee and can result from both contact and noncontact injuries. Most Anterior Cruciate Ligament injuries result from an extreme force on the lateral side of the person’s knee causing a valgus force which pushes the knee inward (Kisner & Colby, 2012, pp. 802-803). This injury to the side of the knee can also cause a “Terrible Triad” injury which also injures both the medial meniscus and the medial collateral ligament (Kisner & Colby, 2012, p. 803). Our textbook further states that “the most common noncontact mechanism is a rotational mechanism in which the tibia is externally rotated on the planted foot….this mechanism can account for as many as 78% of all ACL injuries” (Kisner & Colby, 2012, p. 803). If the person does not seek medical help with this injury they are susceptible to also injuring the remaining support ligaments as well. Patients usually present with joint effusion; possibly 25 degrees of flexion, joint swelling if blood vessels are involved, limited ROM, stress pain and instability along with quads avoidance gait patterns (Kisner & Colby, 2011, p. 208)

Introduction: The glenohumeral joint has the most instability but most range of motion when compared to any other joint in the body. It requires the labrum, ligaments and capsule to maintain stability and function. A glenoid labrum tear disrupts this joint leading to pain and instability (Fitzcharles). Tears in the labrum are common in athletes who use repetitive motions of the shoulder, such as football quarterbacks, baseball pitchers and weightlifters. These tears can sometimes be mistaken as glenohumeral join instability, adhesive capsulitis and shoulder impingement (Painful).

Lastly, there are radiographic erosions and/or Perarticular osteopenia in hand and/or wrist joints (Ryan, pp 57).

Mr. Tovar reported no pain currently in the affected left hip, but noted that when twisting or performing awkward movements he will experience discomfort. Mr. Tovar opined that the left hip injury was a result of repetitive use while performing his usual and customary duties as warehouse person for Southern Wine and

Despite contrary belief, hip replacement is not necessarily negative. Many Americans believe that in order to have a hip replacement, your condition must be terrible. A survey conducted in 2012 said that almost 1/3 of respondents to the hip replacement survey felt they would have benefited from having their surgery done earlier. This procedure has and continues to change the lives’ of many people in our world. Hip replacement, or arthroplasty, is a surgical procedure in which the diseased parts of the hip joint are removed and replaced with new, artificial parts. These artificial parts are called the prosthesis. The goals of hip replacement surgery include increasing mobility, improving the function of the hip joint, and relieving pain. According to the Centers for Disease Control and Prevention, 332,000 total hip replacements are performed in the United States each year. “Hip Replacement.” Questions and Answers about. N.p., n.d. Web. 21 Oct. 2013.