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Total Hip Arthroplasty: Using clinical performance to guide implant selection Total Hip Arthroplasty: Using clinical performance to guide implant selection
This supplement features studies and registry data related to Corail and Pinnacle THA components.
Robotic Arm Guidance to Improve Lateral UKA Accuracy Robotic Arm Guidance to Improve Lateral UKA Accuracy
MAKOplasty® provides the amazing precision of the RIO® Robotic Arm Interactive Orthopedic System and the innovative and enabling designs of the RESTORIS® MCK MultiCompartmental Knee System. Together focused purely on restoring the natural knee, freed from the confines of conventional instrumentation.
Infected Tumor Prostheses CME
Author(s)/Faculty: Luis Coll-Mesa, MD; Giovanni Guerra, MD; Andreas F. Mavrogenis, MD
Source: Orthopedics 34:12 Type: Journal Articles/Items: 1
Release Date: 12/1/2011 Expiration Date: 12/31/2012 Cost: $15 / $0
Credit Type: CME/Participation Number of Credit(s): 1/1 Provider:
Infection of tumor prostheses has been a major concern because of the extensive soft tissue dissection, long operating times, and patients’ immunosuppression by cancer and adjuvant treatments. Infections most often present within 2 years postoperatively, with approximately 70% of postoperative deep infections presenting within 12 months after surgery. They are typically low organism burden infections, the pathogenesis of which is related to bacteria growing in biofilms. Staphylococci are the most common pathogens involved in prosthetic joint infections, accounting for approximately 50% of infections overall, followed by streptococci, enterococci, Enterobacteriaceae species, Pseudomonas aeruginosa, and anaerobe species. Multiple pathogens may be isolated in approximately 25% of cases, with the most common combination being coagulase-negative Staphylococcus and group-D Streptococcus. Early diagnosis and appropriate treatment are necessary. However, diagnosis may be challenging because clinical symptoms are highly variable and numerous preoperative and intraoperative diagnostic laboratory tests are nonspecific. In most cases, a 1- or 2-stage revision surgery is necessary for eradicating the megaprosthetic infection. Prevention of infection is important. The future will see technical advances for infections of tumor prostheses in areas such as microbiological diagnostics and biofilm-resistant prostheses.
Intrasubstance Ruptures of the Biceps Brachii: Diagnosis and Management CME
Author(s)/Faculty: Edward D. Arrington, MD; Stephen A. Parada, MD; John M. Slevin, PA-C
Source: Orthopedics 34:11 Type: Journal Articles/Items: 1
Release Date: 11/1/2011 Expiration Date: 11/30/2012 Cost: $15 / $0
Credit Type: CME/Participation Number of Credit(s): 1/1 Provider:
Traumatic intrasubstance ruptures of the biceps brachii are rare and historically specific to military static line parachute jumps; however, these injuries have recently been reported in the civilian literature. Diagnosis is made by history, clinical weakness in supination and elbow flexion, extensive ecchymosis and edema, and a palpable defect. Ultrasound and magnetic resonance imaging are useful to confirm the diagnosis and injury severity. Nonoperative treatment involves splinting in acute flexion. Early surgical intervention with primary repair has been shown to be more successful than late reconstruction.
Chronic OA Management; Volume 1, Issue 1 CME
Author(s)/Faculty: Martin Englund, MD, PhD; William F. Harvey, MD, MSc, FACR
Source: OrthoSuperSite Type: Publication Articles/Items: 1
Release Date: 10/15/2011 Expiration Date: 10/14/2012 Cost: $0.00 / $
Credit Type: CME/Participation Number of Credit(s): 1.0/1.0 Provider:
Osteoarthritis (OA) is a chronic, progressive and multifactorial disease characterized by degenerative and inflammatory processes affecting joints and surrounding tissues, resulting in pain and functional disability. Despite the availability of practice guidelines for the management of OA, inadequacies in practices of clinicians and patients have been found, leading to suboptimal outcomes. This publication series explores a structured, multidisciplinary approach to care to optimize long-term outcomes for patients with this chronic disease.
Novel Oral Anticoagulants for VTE Prevention in Orthopedic Surgery: Overview of Phase 3 Trials CME
Author(s)/Faculty: Richard J. Friedman, MD, FRCSC
Source: Orthopedics 34:10 Type: Journal Articles/Items: 1
Release Date: 10/1/2011 Expiration Date: 10/31/2012 Cost: $15 / $0
Credit Type: CME/Participation Number of Credit(s): 1/1 Provider:
Outpatient use of anticoagulants to prevent venous thromboembolism after total hip or knee arthroplasty may be hampered either by requirements for parenteral administration or high variability and frequent monitoring of anticoagulant activity. Trials of the new oral direct factor Xa inhibitors rivaroxaban and apixaban and the direct thrombin inhibitor dabigatran indicate that they can be administered in fixed doses without monitoring and that they generally have efficacy at least equivalent to enoxaparin, although with potential minor differences in the balance of efficacy vs risk for bleeding. This article reviews the results and pharmacokinetic properties that may influence their use in clinical practice.
The Role of Prophylactic Antibiotics in Open Fractures in an Era of Community-acquired Methicillin-resistant Staphylococcus aureus CME
Author(s)/Faculty: Robert W. Belknap, MD; Steven J. Morgan, MD; Connie S. Price, MD
Source: Orthopedics 34:08 Type: Journal Articles/Items: 1
Release Date: 8/1/2011 Expiration Date: 8/31/2012 Cost: $15 / $0
Credit Type: CME/Participation Number of Credit(s): 1/1 Provider:
Infection is a feared complication and a common cause of loss of function following open fractures. Despite the evidence supporting the administration of prophylactic antibiotics after open fractures, data demonstrating the optimal regimen is lacking. We reviewed the data supporting the current prophylaxis recommendations and the changing epidemiology of Staphylococcus aureus, the most common cause of surgical site infection in patients with open fractures. Until well-designed randomized trials are conducted, we recommend that providers consider selecting antibiotics active against MRSA for open fracture prophylaxis based on the local prevalence of MRSA carriage and individualized risk factors.
Recurrent Anterior Shoulder Instability Associated With Bony Defects CME
Author(s)/Faculty: Joseph A. Abboud, MD; Oke A. Anakwenze, MD; Jason E. Hsu, MD
Source: Orthopedics 34:07 Type: Journal Articles/Items: 1
Release Date: 7/1/2011 Expiration Date: 7/31/2012 Cost: $15 / $0
Credit Type: CME/Participation Number of Credit(s): 1/1 Provider:
Mobility of the glenohumeral joint is facilitated through the complex interplay of soft tissue and osseous anatomy. Arthroscopic shoulder stabilization is commonly used in the surgical management of shoulder instability. However, the management of the unstable shoulder associated with bony defects (glenoid, humeral, or combined) can be challenging. Adequate recognition of bony defects is paramount to successful treatment and entails a careful history, clinical examination, and advanced radiographic imaging. Nonoperative methods of treatment are often insufficient for treating patients with large bony defects. Bony procedures, as opposed to soft procedures, may yield better outcomes in this patient population. However, respective surgical techniques used to address these defects are technically challenging with a significant learning curve and may lead to significant morbidity. This represents a paradigm shift in treatment and replaces the old paradigm of “open vs arthroscopic” instability surgery.
COX-2 Inhibitors for the Prevention of Heterotopic Ossification After THA CME
Author(s)/Faculty: George C. Babis, MD, DSc; Andreas F. Mavrogenis, MD
Source: Orthopedics 34:06 Type: Journal Articles/Items: 1
Release Date: 6/1/2011 Expiration Date: 6/30/2012 Cost: $15 / $0
Credit Type: CME/Participation Number of Credit(s): 1/1 Provider:
  1. Recognize the increased possibility of heterotopic ossification after total hip arthroplasty (THA).
  2. Outline the increased percentage of serious complications with the use of conventional nonsteroidal anti-inflammatory drugs (NSAIDs).
  3. Identify a safer drug for prophylaxis of heterotopic ossification after THA.
  4. Recognize that the risk of side effects with COX-2 inhibitors is lower compared to conventional NSAIDs and directly related to the time of administration.
AAOS 2011 Focus: Redefining Success in Revision TKA Surgery
This monograph is based on several AAOS 2011 presentations, including clinical outcomes of traditional and emerging techniques in bone loss and infection management, with a focus on metaphyseal fixation.