Weightbearing CT to Diagnose Syndesmotic Instability in Weber B Lateral Malleolar Fractures
Early diagnosis of syndesmotic instability is critical for optimizing clinical outcomes, but more subtle instability can be difficult to identify. WBCT affords a unique opportunity to evaluate such injuries in 3D compared to more traditional 2D syndesmosis measurement. WBCT can be used for assessment of the wide range of syndesmotic injuries and their 3D character.
Rotating platform: High conformity, low wear
Early failures were often due to aseptic loosening, malalignment, instability, 7 severe prosthetic restraint. New problems like increased contact stresses, abnormal kinematics, & increased polyethylene shear stresses were observed due to improve surgical technique. Current TKA Design include protecting the fixation interface by limiting prosthetic loosening and reducing polyethylene wear
Medial Pivot: More Predictable, Physiologic Kinematics
Total knee arthroplasty is a reliable treatment for end stage arthritis with ten-year survivorship. However, patient dissatisfaction can be 15-20% despite of good long-term survivorship. Medical pivot designs do not lead to loosening but they promote normal knee kinematics & enhance AP stability. They might lead to better patient satisfaction and better patient activity.
Why would you leave Cement - You can’t beat it
Cement fixation has been the gold standard when performing a total knee arthroplasty (TKA). However, cemented TKAs were associated with less predictable outcomes survivorship with those early generation implants. In today’s time, cemented TKA’s are enjoying the phase of resurgence. Cement less implants have higher costs but 10 times quicker in operative time than cemented.
Should We Use Vancomycin Powder Topically?
Surgical site infection is an vital issue. In spine surgery, the use of vancomycin has become routine to inhibit surgical site infections. Vancomycin powder reduces rate of hip and knee prosthetic joint infection without local and systemic adverse reactions. It should also be contemplated in primary & revision joint arthroplasty.
