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Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)
Dr. Adam Rosen is an orthopedic surgeon who specializes in total joint replacement. He created this podcast which is aimed at interns, residents, fellows, and general orthopedists who are looking to dive into the details of total knee replacements, hip replacement, and classic articles.
Be sure to check out my YouTube page: https://www.youtube.com/playlist?list=PL226EPMMG9vZmOiuDpmmh36nNzyPrYcRS
(Disclaimer: This is my opinion. Any information gathered is not medical education. Practitioners need to use their education and experience to determine how to treat their own patients.)
Episodes
102 episodes
Balancing Algorithm in TKA
Most gunners, interns and residents have memorized "the chart." That chart with what to do in a TKA when flexion is loose or the extension gap is tight or vice versa. Here I want to review that and more and discuss the things that I...
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Using a Star System for Difficult Cases
In my first year of practice I remember a day where I only had three joints but it took all day and I was exhausted. Although they were all primaries they each had a component that made them hard - size, bone loss, stiffness.I cre...
The Outerbridge Classification
This is the first in a series of episodes where I review some classic articles and classifications.The Outerbridge classification was first presented in JBJS-B in 1961The classification is as follows:1 - Softening and swelli...
Patella Clunk
Although rarely seen with newer TKA designs this was a diagnosis seen in patients with TKAs and could be extremely symptomatic.Patellar clunk was first described by Hozack et al in 1989.Patellar clunk occurred when a fibrous nod...
HO - Brooker Classification
Brooker et al JBJS Vol 55-A 1973Class I - Islands of bone within the soft tissue around the hipClass II - Bone spurs from the pelvis or proximal femur , leaving at least 1 cm betweenClass III - Bone spurs from the pelvis or prox...
Fairbank
Knee Joint Changes after Meniscectomy by T.J. Fairbankpublished JBJS - Br 1948The following radiological changes were seen after meniscectomy1. Ridge formation2. Narrowing of the joint space3. Flattening of the femoral c...
Osteonecrosis Staging Systems
Here I review the two common classifications for ON of the hip, Ficat and Steinberg.The modified Ficat, Idiopathic bone necrosis of the femoral head, was published in 1985 JBJS-Br0 - Preclinical and pre-radiographicI -...
Vancouver Classification
Vancouver Classification by Duncan and Masri ICL 1995Treatment options added in CORR 2004Type AAL - lesser trochanter - non-op unless larger medial pieceAG - greater trochanter - non-op unless >2.5 cm displacement...
Cement Grading
Barrack & Harris JBJS-Br 1992"Improved Cementing Techniques and Femoral Component Loosening in Young Patients with Hip Arthroplasty. A 12 Year Radiographic Review."A - Complete fill, the classic "White Out"B - slight...
Dorr Classification
Dorr Classification; Bone 1993"Structural and Cellular Assessment of Bone Quality of Proximal Femur"A - Thick cortex - champagne flute canalB - Thin cortex with residual funnel shapeC - Thin cortex - "stove pipe ...
AORI
AORI ClassificationType 1 - Minimal bone defect, intact metaphysis - Treat with cement or impaction graftingType 2A - Metaphyseal bone damage of 1 femoral condyle (F2A) or 1 half of the tibial plateau (T2A...
Garden and Pauwels
Low-Angle Fixation in Fractures of the Femoral NeckGarden JBJS-B 1961Stage I - Incomplete and abducted or valgus impactedStage II - Complete and non-displacedStage III - Complete partially displacedStage IV - Complete fu...
The Future of TKA's with AI
I just wanted to share my thoughts and give you my two cents on where we may be in ten years. We still have 20% of patients that are dissatisfied after TKA. WHY?We get answers from industry - nav and robots?But, what is the question?
Gruen and Modes of Failure
"Modes of Failure" of Cemented Stem-type Femoral ComponentsGruen, McNeice and AmstutzCORR 1979Seven Gruen zones1 - proximal lateral 1/32 - central lateral 1/33 - distal lateral 1/34 - tip5 - distal medial...
Paprosky Classification of femoral bone loss
Paprosky Classification of Femoral Bone LossType I - minimal metaphyseal bone lossType II - extensive metaphyseal bone loss, minimal diaphyseal bone lossType IIIA - extensive metaphyseal and diaphyseal bone loss with greater or ...
Kellgren-Lawrence Classification
Kellgren, Lawrence. Radiological Assessment of Osteoarthritis. Ann Rheum Dis. 1957;16:494-502Grade 0 - No presence of OAGrade 1 - Doubtful narrowing, possible osteophytesGrade 2 - Possible narrowing, definite osteophytesGrad...
ICM 2018 Criteria for PJI
The International Consensus Meeting on MSK Infection presented their new criteria in 2018Major Criteria1. Two positive periprosthetic cultures w/ phenotypically identical organisms2. A sinus tract communicating with the j...
Crowe Classification
Total Hip Replacement in Congenital Dislocation and Dysplasia of the HipJohn Crowe, John Mani, Chitranjan RanawatJBJS 1979I - < 50% subluxationII - 50% - 75% subluxationIII - 75% - 100% subluxationIV - >100% su...
Singh Index and Ward's Triangle
Changes in Trabecular Pattern of the Upper End of the Femur as an Index of OsteoporosisManmohan Singh et alJBJS 1970Grade 6 - All normal trabeculae are visibleGrade 5 - accentuation of the principal compressive and principal...
DeLee and Charnley
Radiological Demarcation of Cemented Sockets in Total Hip ReplacementJesse DeLee and John CharnleyCORR 19763 Types/ZonesZone 1 - Superior lateralZone 2 - Central or MedialZone 3 - Inferior medial
ORDERS - ADCVAANDIMLS
Hopefully your system does not go down but when it does here is your cheat sheet.1. ALWAYS DATE AND TIME2. SIGN and print your name and/or doctor number, pager number, etc3. Make sure the patients name and medical record number ...
Hip Stability - Dorr
Current Concepts ReviewImpingement with Total Hip ReplacementJBJB 2007Aamer Malik, MD, Aditya Maheshwari, MD, and Lawrence Dorr, MDFor hip stability:Evaluate the x-rays and templateBe wary of hypermobile patients and...
Rosenberg View
The Forty-five-Degree Posteroanterior Flexion Weight-Bearing Radiograph of the KneeThomas Rosenberg, Lonnie Paulos, Richard Parker, David Coward, Steven ScottJBJS 1988PA x-ray with the knee in 45 degrees of flexion and t...