Category: Blog

Ultrasound and Cementless Prosthesis Revision

Total joint replacement surgeries are one of the most common procedures practiced in orthopedics with hip and knee replacements being the most common procedures performed, followed by shoulder and elbow replacements. Over time, a total joint replacement begins to wear and tear, and a revision procedure may be necessary to replace worn-out joint components with a new or improved prosthesis.

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Ultrasound and the Removal of Bone Cement in Revision Arthroplasty Surgery

Revision arthroplasty is a procedure performed when a worn-out hip, knee, shoulder, or elbow joint replacement component requires replacement with a new prosthesis. Hip and knee arthroplasties are some of the most common procedures undertaken today. It is estimated that in 10 years, the number of primary total hip arthroplasty interventions will grow by 71% to 635,000 procedures, and primary total knee arthroplasties will undergo an 85% increase, totaling 1.26 million procedures in the United States. Consequently, total hip and total knee revisions are projected to grow by 137% and 601%, respectively, between 2005 and 2030.[1] Shoulder arthroplasty is also a prevalent joint replacement surgery, being the third most common after hip and knee replacement. In terms of complications, total elbow arthroplasty has complication rates higher than that of total joint arthroplasty of all other joints.

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Principles of Multiplanar Deformity Analysis and Correction in Long Bone

A multiplanar deformity analysis can be both simple and complex: a correct determination of angular and metric deformity apex and plane is a fundamental task. This is true in both the preoperative surgery planning and the postoperative management phases, in order to obtain the most accurate correction and promote the quickest recovery for the patient’s well-being.

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Calculation of the True Plane of the Deformity

The initial assessment of any lower extremity deformity is fundamental to plan a successful surgical program of correction, as well as an effective post-operative management of the healing process. The assessment should include the X-rays of full length weight bearing of both legs, with a complete axis evaluation to fix the position of the deformities, which is “the true plane of the deformity”.

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Tips for Timely Diagnosis of Charcot Foot and Ankle

It is known that around 9 per cent of patients with diabetic neuropathy and foot ulcers develop a Charcot foot and ankle. This pathology often goes unrecognized, particularly during the acute phase, until severe complications occur, such as an abnormal pressure distribution on the plantar fascia with bones weakened enough to fracture, followed by a marked foot and ankle deformation and, in the worst cases, by amputation. Thus, today, one of the most crucial questions is how to timely diagnose this condition.

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Acute or Gradual Correction of a Deformity?

Although several studies have reported good results of the treatment of the lower extremity deformity combined with shortening – a condition that often means disabling impairment in the daily life activities – to date there are still very few studies that review the evidence by comparing the outcomes of acute versus gradual correction.

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Magnetic Resonance for Charcot Foot and Ankle Diagnosis

Charcot Foot and Ankle is a significant problem caused by peripheral neuropathy, with an estimated incidence of 0.3 to 7.5% in the diabetic population. This condition, which is also known as Charcot arthropathy, Charcot joint, or neuropathic arthropathy, affects the soft tissues, joints, and bones in the foot and ankle. If left untreated, it may lead to progressive foot deformity, ulceration, or osteomyelitis. In the most advanced stages, it may be necessary to resort to limb amputation.

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Tips for the Prevention of Charcot Foot and Ankle

Charcot Foot and Ankle is a severe condition that, if left untreated, may lead to deformity, permanent disability, amputation or ultimately to the patient’s death. People with diabetic neuropathy are at high risk of developing Charcot Foot and Ankle, because of the decreased sensation and diminished ability to feel temperature, pain or trauma.

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CORA (Center Of Rotation of Angulation)

The term CORA (Center of Rotation of Angulation) means a method of mechanical and anatomical axis planning based on joint orientation, which has gained international recognition and acceptance. Many surgeons from all over the world apply this method to limb lengthening and deformity correction, and the CORA principles and concepts have clearly shaped both design and functionality of the last generation of external devices.

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