Pub Date : 2023-07-05DOI: 10.1097/bto.0000000000000641
S. Deshpande
Gap balancing and measured resection techniques form the basic guidance on soft tissue balancing in total knee arthroplasty teachings. The concepts around knee arthroplasty constantly evolving keeping the basics right. Surgeons across the globe are blending established known techniques with newer modifications. The anatomic, functional, and kinematic alignments of the prosthetic knee are frequently debated at conferences. Irrespective of the alignment principle one is following the aim is to achieve a balanced knee for better function. While balancing the knee arthroplasty the basic theme accepted worldwide is the combination of gap balancing and measured resection philosophy. The additional procedures that aid in are these soft tissue releases, lateralization of the prosthesis, reduction osteotomy, and downsizing of the implant which results into a modern current way of approaching the idea of balancing. The surgical workflow I have discussed here is actually the amalgamation of standard teachings and newer trends resulting into the Hybrid integrated technique (H) of balancing a prosthetic a total knee arthroplasty. From the orthopedic trainee point of view it is confusing to see the operating room execution is different than conventional books information. Hence, there is a need to create a beginner’s guide of the current workflow. The modern algorithm helps in balancing the soft tissue releases and bony releases to complement each other. The below-mentioned surgical workflow is not a novel approach but scientifically documenting the current practice implemented by many surgeons at various arthroplasty centers. Hence, it is not a presentation of a personal clinical case study series but an adaptation of various surgical steps to form a workflow.
{"title":"Hybrid Integrated Approach: Beginner’s Guide to the Balancing in Knee Arthroplasty","authors":"S. Deshpande","doi":"10.1097/bto.0000000000000641","DOIUrl":"https://doi.org/10.1097/bto.0000000000000641","url":null,"abstract":"Gap balancing and measured resection techniques form the basic guidance on soft tissue balancing in total knee arthroplasty teachings. The concepts around knee arthroplasty constantly evolving keeping the basics right. Surgeons across the globe are blending established known techniques with newer modifications. The anatomic, functional, and kinematic alignments of the prosthetic knee are frequently debated at conferences. Irrespective of the alignment principle one is following the aim is to achieve a balanced knee for better function. While balancing the knee arthroplasty the basic theme accepted worldwide is the combination of gap balancing and measured resection philosophy. The additional procedures that aid in are these soft tissue releases, lateralization of the prosthesis, reduction osteotomy, and downsizing of the implant which results into a modern current way of approaching the idea of balancing. The surgical workflow I have discussed here is actually the amalgamation of standard teachings and newer trends resulting into the Hybrid integrated technique (H) of balancing a prosthetic a total knee arthroplasty. From the orthopedic trainee point of view it is confusing to see the operating room execution is different than conventional books information. Hence, there is a need to create a beginner’s guide of the current workflow. The modern algorithm helps in balancing the soft tissue releases and bony releases to complement each other. The below-mentioned surgical workflow is not a novel approach but scientifically documenting the current practice implemented by many surgeons at various arthroplasty centers. Hence, it is not a presentation of a personal clinical case study series but an adaptation of various surgical steps to form a workflow.","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"46 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80789915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-26DOI: 10.1097/bto.0000000000000638
N. Bor, E. Dujovny, N. Rozen, G. Rubin
{"title":"Role of External Fixator Assistance in Tibial Rotation Osteotomy—Technique and Results","authors":"N. Bor, E. Dujovny, N. Rozen, G. Rubin","doi":"10.1097/bto.0000000000000638","DOIUrl":"https://doi.org/10.1097/bto.0000000000000638","url":null,"abstract":"","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"277 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87086726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-26DOI: 10.1097/bto.0000000000000636
Arunlal Nadar, Shikha Sachdeva, C. M. Granade, D. Seligson
{"title":"Application of the Alvarado Knee Holder in Infrapatellar Tibial Nail Removal: A Technical Trick","authors":"Arunlal Nadar, Shikha Sachdeva, C. M. Granade, D. Seligson","doi":"10.1097/bto.0000000000000636","DOIUrl":"https://doi.org/10.1097/bto.0000000000000636","url":null,"abstract":"","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"8 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76091705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Two-pin Posterior Tuberosity to Medial Wall Reduction Technique in Calcaneal Fracture Using Sinus Tarsi Approach","authors":"Navindravadhanam Sockalingam, Voon Chin Leow, T. Balakrishnan, Chun-Keat Eo, Tharumaraja Thiruselvam","doi":"10.1097/bto.0000000000000637","DOIUrl":"https://doi.org/10.1097/bto.0000000000000637","url":null,"abstract":"","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"20 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83294518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-15DOI: 10.1097/bto.0000000000000634
Sandeep S. Bains, Daniel Hameed, Zhongming Chen, J. Herzenberg, Philip K. McClure
{"title":"Masquelet Technique: Visualization of Cement Spacer Utilizing Methylene Blue","authors":"Sandeep S. Bains, Daniel Hameed, Zhongming Chen, J. Herzenberg, Philip K. McClure","doi":"10.1097/bto.0000000000000634","DOIUrl":"https://doi.org/10.1097/bto.0000000000000634","url":null,"abstract":"","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"13 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86065786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-27DOI: 10.1097/bto.0000000000000631
G. Schwarzman, Reece I. Vesperman, Matthew C. Mai
{"title":"Anterior Total Hip Arthroplasty With Gluteus Medius Repair: A Novel Technique","authors":"G. Schwarzman, Reece I. Vesperman, Matthew C. Mai","doi":"10.1097/bto.0000000000000631","DOIUrl":"https://doi.org/10.1097/bto.0000000000000631","url":null,"abstract":"","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"25 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81503793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-27DOI: 10.1097/BTO.0000000000000630
K. Emara, R. Diab, A. Fathy, Mohamed N. Essa, M. Eisa, M. A. Elshobaky, Ahmed K. Emara, Kyrillos Rashid, Mostafa Gemeah
Purpose: Blount disease is due to an idiopathic defect in the posteromedial proximal tibial physis resulting in increasing bowing of the leg in addition to lateral knee thrust with lateral collateral ligament laxity. Our rationale is that Blount disease has a bony and ligamentous laxity element of the lateral collateral ligament that can be corrected simultaneously through hemiepiphysiodesis of the tibia and epiphysiodesis of proximal fibula physis by cannulated screws. Patients and Methods: This is a retrospective study conducted on 23 limbs with tibia vara treated between 2010 and 2017 followed up for 2 to 6 years. Ages ranged from 9 to 13 years with a late-onset type of Blount disease. We used a percutaneous transphyseal fully threaded screws traversing the proximal tibial lateral hemiepiphysis, and another screw inserted traversing the proximal fibular epiphysis. Results: There was a statistically significant improvement of the radiographic parameters, especially in the form of joint line congruence angle in both supine and standing positions. All patients were clinically and radiographically completely corrected without complications, except 1 patient with a surgical site superficial infection, treated medically. Conclusion: Fibular-guided growth surgery with lateral proximal tibia epiphysiodesis is a minimally invasive technique that improves the corrective power of hemiepyphysiodesis of the posterolateral compartment of the knee. Level of Evidence: Level IV, retrospective case series.
{"title":"Supplementary Fibular-guided Growth in Treatment of Late-onset Blount Disease","authors":"K. Emara, R. Diab, A. Fathy, Mohamed N. Essa, M. Eisa, M. A. Elshobaky, Ahmed K. Emara, Kyrillos Rashid, Mostafa Gemeah","doi":"10.1097/BTO.0000000000000630","DOIUrl":"https://doi.org/10.1097/BTO.0000000000000630","url":null,"abstract":"Purpose: Blount disease is due to an idiopathic defect in the posteromedial proximal tibial physis resulting in increasing bowing of the leg in addition to lateral knee thrust with lateral collateral ligament laxity. Our rationale is that Blount disease has a bony and ligamentous laxity element of the lateral collateral ligament that can be corrected simultaneously through hemiepiphysiodesis of the tibia and epiphysiodesis of proximal fibula physis by cannulated screws. Patients and Methods: This is a retrospective study conducted on 23 limbs with tibia vara treated between 2010 and 2017 followed up for 2 to 6 years. Ages ranged from 9 to 13 years with a late-onset type of Blount disease. We used a percutaneous transphyseal fully threaded screws traversing the proximal tibial lateral hemiepiphysis, and another screw inserted traversing the proximal fibular epiphysis. Results: There was a statistically significant improvement of the radiographic parameters, especially in the form of joint line congruence angle in both supine and standing positions. All patients were clinically and radiographically completely corrected without complications, except 1 patient with a surgical site superficial infection, treated medically. Conclusion: Fibular-guided growth surgery with lateral proximal tibia epiphysiodesis is a minimally invasive technique that improves the corrective power of hemiepyphysiodesis of the posterolateral compartment of the knee. Level of Evidence: Level IV, retrospective case series.","PeriodicalId":45336,"journal":{"name":"Techniques in Orthopaedics","volume":"15 1","pages":"111 - 114"},"PeriodicalIF":0.3,"publicationDate":"2023-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88546948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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