Patient-Specific Instrumentation in Arthroplasty
PSI uses preop MRI/CT to fabricate custom cutting jigs. Goal: improve accuracy, reduce OR time/inventory; evidence shows marginal accuracy gains without clear functional...
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Proper X-ray positioning is essential because rotation, poor centring, inadequate exposure or incomplete anatomical coverage can significantly alter the apparent alignment and pathology on musculoskeletal radiographs. Orthopaedic interpreta...
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PSI uses preop MRI/CT to fabricate custom cutting jigs. Goal: improve accuracy, reduce OR time/inventory; evidence shows marginal accuracy gains without clear functional...
THA: cementless acetabular components standard; femoral fixation cemented (elderly) vs cementless (younger). TKA: tibial components commonly cemented; cementless options...
UKA: isolated compartment OA, intact ACL/collaterals, correctible deformity; faster recovery, more natural kinematics. TKA: multicompartment disease, inflammatory arthrit...
Controversial: to resurface or not during TKA. Resurfacing: reduces anterior knee pain, avoids secondary resurfacing procedures. Non-resurfacing: avoids patellar complica...
Common indications: aseptic loosening, PJI, instability, stiffness, polyethylene wear, periprosthetic fracture, malalignment. Workup: exclude infection (ESR/CRP ± aspirat...
Primary driver of late osteolysis and aseptic loosening in TKA. Wear modes: adhesive/abrasive; delamination & pitting with high contact stress/oxidation in older PE. Risk...
Periprosthetic osteolysis = bone loss from wear particle-induced inflammation. Detected on radiographs as radiolucencies, cystic defects; CT useful for mapping, MRI (MARS...
Incidence rising with aging population and expanding TKA volumes. Common sites: distal femur (supracondylar), tibia (around keel/stem), patella (resurfaced patella). Clas...
Trunnionosis = corrosion/wear at head–neck modular junction of THA. Mechanism: fretting + crevice corrosion, leading to metal ion release. Clinical: unexplained pain, swe...
Main bearing couples: Metal-on-Polyethylene (MoP), Metal-on-Metal (MoM), Ceramic-on-Ceramic (CoC), Ceramic-on-Polyethylene (CoP). MoP: gold standard; risk of wear/osteoly...
Commonest source of dissatisfaction after TKA. Includes anterior knee pain, maltracking, subluxation/dislocation, fracture, loosening of patellar component. Risk factors:...
Accounts for ~20% of TKA revisions. Types: extension instability, flexion instability, mid-flexion instability, recurvatum. Causes: ligament imbalance, component malposit...