Introduction:. Intraoperative cell salvage involves the collection of blood directly from the operative field. The purpose of this study was to determine if its use reduces the need for postoperative allogenic blood transfusion, assess any adverse events and its effect on duration of postoperative stay in
Structural bulk autografts restore the severe bone loss at
With an increasing ageing population and a rise in the number of
Introduction. This is a retrospective review of the incidence of deep venous thrombosis (DVT) in 679 consecutive unilateral
We report the clinical and radiological outcome of consecutive
This session will be practically oriented, focusing on important surgical decisions and on technical tips to avoid complications. The panel will be polled concerning individual preferences as regards the following issues in primary total hip arthroplasty: 1. Perioperative antibiotics; 2. Blood management and tranexamic acid protocols; 3. Surgical indications: high BMI patients; 4. Surgical approach for primary total hip arthroplasty: indications or preferences for direct anterior, anterolateral, posterior; 5. Acetabular fixation; 6. Tips for optimizing acetabular component orientation; 7. Femoral fixation: (a) Indications for cemented and uncemented implants. Case examples will be used.; (b) Is there still a role for hip resurfacing?; 8. Femoral material and size: (a) Preferred head sizes and materials in different situations.; (b) Is there a role for dual mobility implants in primary THA?; 9. Bearing surface: present role of different bearings. Case examples will be used. 10. Tips for optimizing intraoperative hip stability; 11. Tips for optimizing leg length; 12. Postoperative venous thromboembolism prophylaxis; 13. Heterotopic bone prophylaxis; 14. Postoperative pain management; 15. Hospital discharge: is there a role for outpatient surgery?; 16. Postoperative rehabilitation protocol: weight bearing, role of physical therapy; 17. Postoperative activity restrictions; hip dislocation precautions; 18. Is there value to physical therapy as outpatient after THA?; 19. Long-term antibiotic prophylaxis for procedures.
This session will be practically oriented, focusing on important surgical decisions and on technical tips to avoid complications. The panel will be polled concerning individual preferences as regards the following issues in primary total hip arthroplasty: 1.) Peri-operative antibiotics; 2.) Blood management and tranexamic acid protocols; 3.) Surgical indications: High BMI patients; 4.) Surgical approach for primary total hip arthroplasty: indications or preferences for direct anterior, anterolateral, posterior; 5.) Acetabular fixation; 6.) Tips for optimizing acetabular component orientation; 7.) Femoral fixation: Indications for cemented and uncemented implants. Is there still a role for hip resurfacing?; 8.) Femoral material and size: Preferred head sizes and materials in different situations. Is there a role for dual mobility implants in primary THA?; 9.) Bearing surface: Present role of different bearings; 10.) Tips for optimizing intra-operative hip stability; 11.) Tips for optimizing leg length; 12.) Post-operative venous thromboembolism prophylaxis; 13.) Heterotopic bone prophylaxis; 14.) Post-operative pain management; 15.) Hospital discharge: Is there a role for outpatient surgery?; 16.) Post-operative rehabilitation protocol: weight bearing, role of physical therapy; 17.) Post-operative activity restrictions; hip dislocation precautions; 18.) Is there value to physical therapy as outpatient after THA?; 19.) Long-term antibiotic prophylaxis for procedures.
This session will be practically oriented, focusing on important surgical decisions and on technical tips to avoid complications. The panel will be polled concerning individual preferences as regards the following issues in primary total hip arthroplasty: 1.) Peri-operative antibiotics; 2.) Blood management and tranexamic acid protocols; 3.) Surgical indications: High BMI patients; 4.) Surgical approach for primary total hip arthroplasty: indications or preferences for direct anterior, anterolateral, posterior; 5.) Acetabular fixation; 6.) Tips for optimizing acetabular component orientation; 7.) Femoral fixation: (a) Indications for cemented and uncemented implants. (b) Is there still a role for hip resurfacing?; 8.) Femoral material and size: (a) Preferred head sizes and materials in different situations. (b) Is there a role for dual mobility implants in primary THA?; 9.) Bearing surface: Present role of different bearings. 10.) Tips for optimizing intra-operative hip stability; 11.) Tips for optimizing leg length; 12.) Post-operative venous thromboembolism prophylaxis; 13.) Heterotopic bone prophylaxis; 14.) Post-operative pain management; 15.) Hospital discharge: Is there a role for outpatient surgery?; 16.) Post-operative rehabilitation protocol: weight bearing, role of physical therapy; 17.) Post-operative activity restrictions; hip dislocation precautions; 18.) Is there value to physical therapy as outpatient after THA?; and 19.) Long-term antibiotic prophylaxis for procedures.
This session will be practically oriented, focusing on important surgical decisions and on technical tips to avoid complications. The panel will be polled concerning individual preferences as regards the following issues in primary total hip arthroplasty: Perioperative antibiotics/blood management/preferred anesthetics, Surgical approach for primary total hip arthroplasty, Acetabular fixation, Tips for optimizing acetabular component orientation, Femoral fixation, Femoral head size, Bearing surface, Tips for optimizing intraoperative hip stability, Tips for optimizing leg length, Postoperative venous thromboembolism prophylaxis, Heterotopic bone prophylaxis, Postoperative pain management, Postoperative rehabilitation protocol, Postoperative activity restrictions, and Postoperative antibiotic prophylaxis for procedures.
This session will be practically oriented, focusing on important surgical decisions and on technical tips to avoid complications. The panel will be polled concerning individual preferences as regards the following issues in primary total hip arthroplasty: Perioperative antibiotics/blood management/preferred anesthetics; Surgical approach for primary total hip arthroplasty: indications or preferences for direct anterior, anterolateral, posterior; Acetabular fixation; Tips for optimizing acetabular component orientation; Femoral fixation: Indications for cemented and uncemented implants. Case examples will be used. Is there still a role for hip resurfacing?; Femoral head size: Preferred head sizes and materials in different situations. Is there a role for dual mobility implants in primary THA?; Bearing surface: Present role of different bearings. Case examples will be used.; Tips for optimizing intra-operative hip stability; Tips for optimizing leg length; Post-operative venous thromboembolism prophylaxis; Heterotopic bone prophylaxis; Post-operative pain management; Post-operative rehabilitation protocol: weight bearing, role of physical therapy; Post-operative activity restrictions; Post-operative antibiotic prophylaxis for procedures.
This session will be practically oriented, focusing on important surgical decisions and on technical tips to avoid complications. The panel will be polled concerning individual preferences as regards the following issues in primary total hip arthroplasty: 1. Peri-operative antibiotics/blood management/preferred anesthetics; 2. Surgical approach for primary total hip arthroplasty: indications or preferences for direct anterior, anterolateral, posterior; 3. Acetabular fixation; 4. Tips for optimizing acetabular component orientation; 5. Femoral fixation: (a) Indications for cemented and uncemented implants. (b) Role of hip resurfacing; 6. Femoral head size: Preferred head sizes in different situations; 7. Bearing surface: Present role of different bearings; 8. Tips for optimizing intra-operative hip stability; 9. Tips for optimizing leg length; 10. Post-operative venous thromboembolism prophylaxis; 11. Heterotopic bone prophylaxis; 12. Post-operative pain management; 13. Post-operative rehabilitation protocol: weight bearing, role of physical therapy; 14. Post-operative activity restrictions; and 15. Post-operative antibiotic prophylaxis for procedures.
This session will be practically oriented, focusing on important surgical decisions and on technical tips to avoid complications. The panel will be polled concerning individual preferences as regards the following issues in primary total hip arthroplasty. Perioperative antibiotics/blood management/preferred anesthetics; Surgical approach for primary total hip arthroplasty: indications or preferences for direct anterior, anterolateral, posterior; Acetabular fixation; Tips for optimising acetabular component orientation; Femoral fixation: indications for cemented and uncemented implants, role of hip resurfacing; Femoral head size: preferred head sizes in different situations; Bearing surface: present role of different bearings; Tips for optimising intraoperative hip stability; Tips for optimising leg length; Postoperative venous thromboembolism prophylaxis; Heterotopic bone prophylaxis; Postoperative pain management; Postoperative rehabilitation protocol: weight bearing, role of physical therapy; Postoperative activity restrictions; Postoperative antibiotic prophylaxis for procedures
This session will be practically oriented, focusing on important surgical decisions and on technical tips to avoid complications. The panel will be polled concerning individual preferences as regards the following issues in primary total hip arthroplasty: Peri-operative antibiotics/blood management/preferred anesthetic, Surgical approach for primary total hip arthroplasty: indications or preferences for direct anterior, anterolateral, posterior, less invasive exposures, Acetabular fixation, Tips for optimising acetabular component orientation, Femoral fixation: Indications for cemented and uncemented implants and Role of hip resurfacing, Preferred femoral head size, Choice of bearing surface, Tips for optimising intra-operative hip stability, Tips for optimising leg length, Post-operative venous thromboembolism prophylaxis, Heterotopic bone prophylaxis, Post-operative pain management, rehabilitation protocol, activity restrictions and antibiotic prophylaxis.
This session will be practically oriented, focusing on important surgical decisions and on technical tips to avoid complications. The panel will be polled concerning individual preferences as regards the following issues in primary total hip arthroplasty: 1.) Perioperative antibiotics/blood management/preferred anesthetics, 2.) Surgical approach for primary total hip arthroplasty: indications or preferences for direct anterior, anterolateral, posterior, 3.) Acetabular fixation, 4.) Tips for optimising acetabular component orientation, 5.) Femoral fixation: (a) Indications for cemented and uncemented implants. (b) Role of hip resurfacing, 6.) Femoral head size, 7.) Bearing surface, 8.) Tips for optimising intraoperative hip stability, 9.) Tips for optimising leg length, 10.) Postoperative venous thromboembolism prophylaxis, 11.) Heterotopic bone prophylaxis, 12.) Postoperative pain management, 13.) Postoperative rehabilitation protocol: weight bearing, role of physical therapy, 14.) Postoperative activity restrictions, and 15.) Postoperative antibiotic prophylaxis for procedures.
This session will be practically oriented, focusing on important surgical decisions and on technical tips to avoid complications. The panel will be polled concerning individual preferences as regards the following issues in primary total hip arthroplasty:
Perioperative antibiotics/blood management/preferred anesthetics Surgical approach for primary total hip arthroplasty: indications or preferences for direct anterior, anterolateral, posterior, less invasive exposures Acetabular fixation Tips for optimising acetabular component orientation Femoral fixation: Indications for cemented and uncemented implants. Case examples will be used. Role of hip resurfacing Femoral head size: Preferred head sizes in different situations. Bearing surface: Present role of different bearings. Case examples will be used. Tips for optimising intra-operative hip stability Tips for optimising leg length Post-operative venous thromboembolism prophylaxis Heterotopic bone prophylaxis Post-operative pain management Post-operative rehabilitation protocol: weight bearing, role of physical therapy Post-operative activity restrictions Post-operative antibiotic prophylaxis for procedures
While total hip arthroplasty is considered to be one of the most cost-effective medical interventions, the total cost of care for a population patients treated by THR can present a significant burden on the payer, whether it be an employer, private insurer or government. Data on the true cost of care has rarely been made available to the treating physician. Such lack of information makes comprehensive management difficult. Bundled payment models of care require knowledge of all costs associated with the care of our patients and opens new opportunity for analysis to improve management and outcomes. The current study assess the influence of surgical technique on total cost of care for total hip arthroplasty. Payment data for 341 patients who underwent total hip arthroplasty at a single institution from June 1st, 2011 to October 31st, 2014 were analyzed. Each procedure was performed using either the superior, anterior, or posterior exposure. The superior exposure was performed with femoral head excision and without dislocation of the hip. The data were analyzed for total cost, inpatient cost, inpatient physician cost, readmission cost, skilled nursing facility cost, and home healthcare agency cost among the different approaches.Introduction
Methods
We reviewed one hundred and twenty patients who had primary total hip replacement using Corail/Pinnacle Metal on metal bearing surfaces between 2006 and 2009. We were interested in the metal ion levels of the whole cohort, the incidence of unexplained pain, pseudo tumour lesions (ALVAL) and early loosening and failure. We were particularly interested in the relationship of the acetabular cup position in relation to the pelvis and lumbar spine. We reviewed 120 charts and 104 patients in total. All patients had metal ion assays (cobalt and chromium) All patients had standardised radiographic evaluation using a special technique to assess acetabular cup position and the relationship to the pelvis and lumbar spine.Purpose of the study
Material and methods
Aim. The aim of the present work was (i) to survey the situation of healthcare regarding the use of antibiotics in orthopaedics and trauma surgery in Germany, (ii) to determine which empiric antibiotic regimens are preferred in the treatment of periprosthethic joint infections (PJI) and (iii) to evaluate the hypothetical antibiotic adequacy of the applied empirical antibiotic therapy regimens based on a patient collective of a German university hospital. Method. A survey on empirical and prophylactic antibiotic therapy was conducted at German university and occupational health clinics (BG clinics), each in the specialties of orthopedics and trauma surgery. A total of 71 clinics were contacted by email. The questionnaire sent included open-ended questions on systemic antibiotic prophylaxis in
Aims. As the peak of the COVID-19 pandemic passes, the challenge shifts to safe resumption of routine medical services, including elective orthopaedic surgery. Protocols including pre-operative self-isolation, COVID-19 testing, and surgery at a non-COVID-19 site have been developed to minimize risk of transmission. Despite this, it is likely that many patients will want to delay surgery for fear of contracting COVID-19. The aim of this study is to identify the number of patients who still want to proceed with planned elective orthopaedic surgery in this current environment. Methods. This is a prospective, single surgeon study of 102 patients who were on the waiting list for an elective hip or knee procedure during the COVID-19 pandemic. Baseline characteristics including age, ASA grade, COVID-19 risk, procedure type, surgical priority, and admission type were recorded. The primary outcome was patient consent to continue with planned surgical care after resumption of elective orthopaedic services. Subgroup analysis was also performed to determine if any specific patient factors influenced the decision to proceed with surgery. Results. Overall, 58 patients (56.8%) wanted to continue with planned surgical care at the earliest possibility. Patients classified as ASA I and ASA II were more likely to agree to surgery (60.5% and 60.0%, respectively) compared to ASA III and ASA IV patients (44.4% and 0.0%, respectively) (p = 0.01). In addition, patients undergoing soft tissue knee surgery were more likely to consent to surgery (90.0%) compared to patients undergoing
The selection of an acetabular component for