Osteolysis In a Well Fixed Acetabular Cup, Retain or Revise?

Wear and Osteolysis are the commonest cause of aseptic loosening in Total Hip Arthroplasty (THA), requiring revision. A less invasive approach could be undertaken in terms of an earlier intervention by isolated the liner change only. Indications and contraindications of each approach are reviewed with some technical tips. Outcome results have shown that isolated liner exchange alone does have a higher risk of instability

Total Hip Arthroplasty in Sickle Cell Disease

Sickle cell disease (SCD) is a hemoglobinopathy characterized by abnormal morphology of blood cells causing transient interruption of blood supply to various body parts. Femoral Head avascular necrosis is one of the commonest skeletal sequeale of SCD. Total Hip arthroplasty (THA) in SCD has evolved through different stages with a spectrum of results and technical challenges. This article reviews the pathologic basis of sickle cell disease , the various challenges perioperatively associated with THA in SCD

Effect of opening-wedge high tibial osteotomy on three-dimensional knee kinematics

While it is clear that opening-wedge high tibial osteotomy (HTO) changes alignment in the coronal plane, which is its objective, it is not clear how this procedure affects knee kinematics through the range of joint motion and in other planes. Our research question was: how does opening-wedge HTO change three-dimensional tibiofemoral and patellofemoral kinematics in loaded flexion in patients with varus deformity? Three-dimensional kinematics were assessed over 0-60° of loaded flexion using a MR method before and after opening-wedge HTO in a cohort of 14 knees of 13 male subjects. At 6 and 12 months post-op, opening-wedge HTO caused increased tibial anterior translation (mean 2.6 mm, p < 0.001), decreased patellar proximal translation (mean -2.2 mm, p < 0.001), decreased patellar spin (mean -1.4°, p < 0.05), increased patellar tilt (mean 2.2°, p < 0.05), and changed three other parameters. Mean WOMAC score decreased significantly (p < 0.001) from 49.6 (SD 16.4) preoperatively to 28.2 (SD 16.6) at 6 months and 22.5 (SD 14.4) at 12 months. The three-dimensional kinematic changes found may be important in explaining inconsistency in clinical outcomes, and suggest that measures in addition to coronal plane alignment should be considered.Applied Science, Faculty ofMedicine, Faculty ofNon UBCMechanical Engineering, Department ofOrthopaedic Surgery, Department ofReviewedFacultyOthe

Cartilage health in high tibial osteotomy using dGEMRIC : relationships with joint kinematics

Applied Science, Faculty ofMedicine, Faculty ofNon UBCMechanical Engineering, Department ofOrthopaedic Surgery, Department ofReviewedFacultyOthe