Essay On Cementless Hemiarthroplasty

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.

After obtaining approval from our Institutional Ethics Committee, a prospective double-blind, randomized, controlled study was conducted in El-Minia University Hospital. Ninety patients of both sex undergoing lower extremities surgery their age ranging from 17- 60 years old, ASA physical status I or II. This study was done from December 2010 to December 2011. All patients gave written informed

Once again Dr. Armin Tehrany was asked to share his professional opinion, based on his decade’s long experience and profound orthopedic knowledge.

DOI: 12/28/2014. Patient is a 31-year-old male rebar installer who sustained injury while he was installing a rebar when he twisted his right knee. Per OMNI, he was initially diagnosed with right knee strain/sprain. MRI showed positive for a tear and he underwent surgery on 02/10/15 and subsequent MRI revealed teat versus scar tissue and he underwent right knee arthroscopic lateral meniscal debridement and synovectomy on 12/22/15.

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.

If the swelling is too severe, then the surgery might need to be delayed up to a week. There are two surgeries recommended, but depends on the area fractured. The first one is if the radial head is fractured, can be repaired with or without plates and small screws. If the injury isn’t repairable, they might replace the radial head with a metallic implant. The second one is if the top of the ulna, the coronoid, is fractured then they will repair with sutures or screws. The patient cannot perform any heavy lifting for 6 weeks following the surgery. The first 6 weeks to 3 months, regaining ROM is the key. Exercises are begun after strengthening has occurred which could be after 3 months depending on how severe the injury

The agenda was quite clear that during their observations the recovery showed needs were decreased according to age and BMI. They stated older patients were in need of more assistance and longer stay in the hospital as opposed to younger adults. I found it interesting that they saw patients with bilateral knees had decreased needs and that unilateral were in need of more assistance before discharge. Managing pain was their first priority during research and rehabilitation, followed by instructing care of their own surgical wound. The aim of this study was to actively reinforce assessment and management after this procedure and giving guidance to those in health care.

Mrs. Pink, aged 75 was admitted to the orthopaedic ward after suffering a fall at home, resulting in an intracapsular fracture of the hip at the femoral neck. Mrs. Pink has a history of cancer and cardiac diseases and has severe rheumatoid arthritis. Due to ageing patients putting a great deal of strain on the health care system, the incidences of hip fractures in the elderly are a major concern and requires careful consideration regarding treatment. Known as a major cause of disability in the elderly, hip fractures and their subsequent need for surgery result in chronic pain and an altered quality of life (Strike, Sieber, Gottschalk & Mears, 2013). Although important to improve a patient’s quality of life and physical independence, pain related to a total hip replacement (THR), also known as hip arthroplasty (HA) can lead to delays in ambulation, longer hospital stays, poor functional outcomes and quality of life. The purpose of this essay is to identify the rationale behind nursing interventions provided to post-operative THR patients as well as the pathology of a femoral neck hip fracture and their procedure for assessment and diagnosis.

At last follow up 20 patients remained disease free, 7 patients had no evidence of disease, 5 patients were alive with disease, and 2 patients died of disease. During follow-up, the frozen autografts were removed in 3 cases (8.8%); in two cases, due to local recurrence from residual soft tissue part around the femur and the third case due to deep infection in the tibia. Only one case with local recurrence underwent ablative surgery (hip disarticulation). The five and ten-year survival rates of the patients were 97% and 94.1% respectively (figure 2). The five and ten-year survival rates of the frozen autograft were 91.2 %, (figure 3) with survival rate of 94.4% and 87.5% for pedicled and free frozen autograft respectively (figure 4). The mean ISOLS score for all patients; was 26.1 points (86.79%) with range of30%-100% and for the 31 patients who retained the frozen autograft was 27 points 90%.

2015). Clinical studies have demonstrated that these two graft choices have similar rates of effectiveness in adults, with minor differences in post reconstruction knee stability, muscle strength and activity levels at 2, 3 and 5 years after implantation. (Fu et al. 2000). The bone-patellar tendon-bone graft is often selected for young, high-demand athletes because of this graft’s tendency to failure, stiffness, quality of fixation, durability and success at long-term follow-up. This graft allows for the earliest return to high-demand activities (Biau et al. 2015).

This case report is about total knee arthroplasty in a Rheumatoid patient with both valgus deformity and flexion contracture. Rheumatoid patients still have deformity occurring despite new treatment, hence the need for surgery such as total knee arthroplasty. In this case report we will discuss more about the different techniques in the management of bone defect during surgery and use of the screw and cement method for defect correction. This method has been through several debates about its efficacy and failure and a global consensus has not still been

CBT screw that is inserted through a more medial starting point by following a more vertical trajectory showed greater pullout load[30] and similar ROM to traditional pedicle trajectory screw[18]. CBT technique has four major advantages: 1. Direction with caudocephalad path sagittally and laterally directed path in the transverse plane protects the screw away from the nerve tissue. 2. It needs less tissue trauma and less recovery time.3. Osteopenic or osteoporotic patients will earn more advantage[18-20, 31, 32], 4. The incidence of postoperative radiculitis[33]

Early studies predominately focused on re-rupture rates in surgical and non-surgical patients. Research shows that re-rupture rates are similar in both treatment groups (Jackson et al., 2013) (Soroceanu et al., 2012). I can inform patients that this complication would be unlikely to have an effect on their outcome measures for function and ATRS long-term (Olsson et al., 2013). I would educate patients that those with re-rupture had similar outcomes to those without after 6 and 12 months of re-injury (Olsson et al., 2013). Functional bracing was a common theme in a meta-analysis by Soroceanu et al., (2012) and Olsson et al., (2013). Two patients who experienced re-rupture complications in the latter study were non-compliant with their braces. I would emphasis adherence to wearing their functional braces to shadow previous research and improve patient safety. In addition, I would be aware of complications specific to the chosen treatment. While this population in general is at increased risk of deep vein thrombosis and sural nerve damage, surgical treatment yields more complications than nonsurgical treatment. A systematic review revealed that patients with surgical treatment had higher risk for wound infection, adhesions, and sensorimotor dysfunction especially after open repair (Khan & Smith, 2010). Patients who receive nonsurgical treatment may require more time for rehabilitation (Olsson et al., 2013).

Katz, J. N., Wright, E. A., Polaris, J. J., Harris, M. B., & Losina, E. (2014, May 22). Prevalence and risk factors for periprosthetic fracture in older recipients of total hip replacement: a cohort study. BMC Musculoskeletal Disorders, 15(1), 1-9. http://dx.doi.org/10.1186/1471-2474-15-168Lewis, S. L., Dirksen, S. R., Heitkemper, M. M., Bucher, L., & Camera, I. M. (2011). Medical-surgical nursing: Assessment and management of clinical problems (8th ed.). St. Louis, MO: else

Femoral heads under 46mm result in unacceptable success rates. Women are less likely to be good candidates for hip resurfacing; MoM hip resurfacing is not considered if they would like to have children in the future. Men over 65 and women over 55 as well as those with renal insufficiency and metal allergies are advised against hip resurfacing. Women who would still like to have children and those with metal allergies are advised against MoM hip resurfacing as it has been found to increase metal levels in a persons blood. The group most commonly given hip resurfacing are young active male patients with good bone