Acetabular labral tears in the athlete

Contains fulltext : mmubn000001_183455452.pdf (publisher's version ) (Open Access)Promotores : R. Van de Walle, E. Kittel en D. Schotanus131 p

The New Demands by Patients in the Modern Era of Total Joint Arthroplasty: A Point of View

Historians have the opportunity of viewing events, people, and their epoch through an aperture in time. With retrospective clarity, change and the forces effecting change can be appropriately categorized, emphasized, and interpreted. Sociologists see change in a forward-focused manner. When we examine our patients today, it is clear our current patients having total joint arthroplasty are different from those in years past. The sociologic influences effecting this change are many and include the revolutionary explosion of, access to, and dissemination of information; increased wealth, life activity expectation, and life expectancy; and an aging workforce. Concurrent with these forces registering change in our patient population is an erosion in respect for professionalism and vertically oriented authoritarian structure throughout society. Our patients are citizens of our modern age. Our public has come to expect miracles in medicine as the norm, yet these miracles are not without inherent risk. The trap implicit in allowing an incompletely informed populace to drive the decisions we make may be bridged by a more complete understanding of who our patients are and what their needs include. This discussion attempts to offer some insight into the forces at play. It focuses on how the changes in society, population, and technology have affected patients’ knowledge and attitude toward medicine and what our response as physicians should be

Tapered modular fluted titanium stems for femoral fixation in revision total knee arthroplasty

Consensus regarding femoral stem fixation options in revision total knee arthroplasty remains controversial. Tapered, modular, fluted titanium (TMFT) stems have an excellent track record in total hip arthroplasty for their ability to provide axial and rotational stability in situations of compromised host bone. We present 3 successfully treated cases in which the Food & Drug Administration granted permission to use custom TMFT stems in situations of failed femoral fixation in multiple revised knees. These stems hold promise to achieve stable fixation in revision total knee arthroplasty where host metadiaphyseal bone is deficient. Implant manufactures should consider dedicating future resources to create adapters that can link existing successful TMFT stems currently used in hip arthroplasty to revision total knee components when host bone is severely compromised

Hip arthroscopy: surgical approach, positioning, and distraction

The hip is the most deeply recessed joint in the body making it difficult to access arthroscopically. However, for the patient with a symptomatic loose body or labral tear open techniques are less advantageous. It is for this reason that, however difficult, minimally-invasive approaches to the hip have been developed. Meticulous attention to proper positioning and portal placement is paramount for safe and successful arthroscopy of the hip. The current authors will review the seminal features of positioning and minimally-invasive surgical approaches to the hip