Chapters authored
The Modern Universal Total Knee Arthroplasty: Maximized Value, Streamlined Efficiency
A universal total knee arthroplasty system able to accurately resurface either left or right knees of all shapes and sizes is compelling as there is an increased need for improved efficiency and value. With a modern universal total knee system, a single instrument tray can be utilized for more than 90% of cases and doesn’t require any specific customization or disposable instruments. This streamlined workflow is accomplished with unique instrumentation that features a symmetrical femoral and tibial implant for all patients. Symmetrical tibial implants have been shown to have equivalent outcomes and low complications compared to asymmetric tibial trays. The universal symmetrical femoral implant, with its deepened trochlear groove, allows for optimal patellar tracking and recent studies have demonstrated this symmetrical femoral implant to have comparable femoral rollback and axial rotation to native knees. This efficient instrumentation reduces overall inventory, decreases turnover times, and exposes fewer instruments that may otherwise be susceptible to contamination. All without detriment to the patient outcome or surgeon workflow. Studies have shown clinical scores of the modern universal total knee arthroplasty system are a great value not only to the surgeon but also to the healthcare system as a whole—a necessity in modern healthcare.
Part of the book: Healthcare Access
Instability in Total Hip Arthroplasty
Total hip arthroplasty (THA) is becoming one of the most frequently sought-after surgeries in orthopedics. As the techniques and implants continue to evolve, the stability of the prosthesis is always at the forefront of the surgeon’s mind. Multiple factors contribute to implant stability and there are many intraoperative decisions that can be made by the surgeon to increase stability. Techniques including approaches, adjusting length, adjusting offset, as well as implant choices can dictate stability in THA. There are multiple options that exist including different liners and constraint. One non modifiable variable which surgeons often struggle with is the spinopelvic relationship which can also affect stability post operatively. These factors include lumbar arthritis, variable pelvic tilt, and others that can make a routine approach to a total hip unsuccessful and increase the risk of post-operative complications. Ultimately there are many things to consider when approaching THA in patients, especially in the setting of abnormal pathology.
Part of the book: Arthroplasty