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Periprosthetic Fracture Management and Fixation

Periprosthetic Fractures Around Total Hip and Knee Replacements

Periprosthetic fractures are breaks in the bone that occur around or near a joint replacement implant. These fractures present a growing concern in orthopedics, with an increasing incidence attributed to factors such as the rising number of joint replacement surgeries performed each year and the aging population1. This article offers a comprehensive overview of periprosthetic fractures around total hip and knee replacements, encompassing their incidence, management, classification, surgical techniques, and implant options.

Incidence of Periprosthetic Fractures

The incidence of periprosthetic fractures can vary based on factors like the type of … Read more

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Post-Arthroplasty Rehabilitation: Protocols and Strategies

Total Joint Arthroplasty and the Importance of Structured Physical Therapy and Rehabilitation Programs

Total joint arthroplasty (TJA) is a surgical procedure in which parts of an arthritic or damaged joint are removed and replaced with a prosthesis. The most common types of TJA are total hip arthroplasty (THA) and total knee arthroplasty (TKA) 1. TJA is a highly effective procedure for relieving pain and restoring function in individuals with severe joint damage 2. However, despite the effectiveness of TJA in reducing pain and improving function, there is still uncertainty about the most effective rehabilitation interventions and components 3… Read more

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Robotic hip arthroplasty analysis

Robotic-Assisted Hip Arthroplasty: A Comprehensive Analysis of Outcomes, Cost-Effectiveness, and Learning Curves Compared to Traditional Techniques

Introduction

Total hip arthroplasty (THA) is a common surgical procedure for end-stage hip osteoarthritis. It reliably decreases pain and improves function and quality of life in patients with advanced hip disease at up to 25–30 years of follow-up 1. While traditional THA techniques have demonstrated satisfactory long-term outcomes, with almost 60% of hip replacements lasting for 25 years 2, ongoing efforts focus on optimizing surgical outcomes and minimizing complications such as intraoperative fracture, hip instability, and leg length discrepancy (LLD) 2. … Read more

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Chapter 10 Inflammatory Arthritis

This chapter delves into the complexities of inflammatory arthritis, focusing primarily on Rheumatoid Arthritis (RA) and its juvenile form, along with gout.

RA, a chronic autoimmune disease, is characterized by the immune system attacking the joint’s synovium, leading to inflammation, pain, and eventual joint destruction. The chapter explores the pathogenesis of RA, noting the involvement of T cells, cytokines, and other immune processes. It also discusses the epidemiology, revealing that RA affects roughly 1% of the US population, with a higher prevalence in women and those between 40 and 60. The clinical presentation, diagnostic imaging, and laboratory studies are also … Read more

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Chapter 9 Osteoarthritis

This chapter delves into the complexities of osteoarthritis, a degenerative joint disease impacting millions. It begins by distinguishing between primary and secondary osteoarthritis, emphasizing that while radiographic evidence is common, it doesn’t always correlate with pain. The chapter highlights the progressive loss of articular cartilage as the primary mechanism, noting the bone’s reactive changes and the eventual destruction of the joint.

Key risk factors like age, genetics, obesity, and joint deformities are discussed, along with the pathophysiology of cartilage breakdown and bone changes. The clinical presentation of osteoarthritis is detailed, including pain characteristics, physical examination findings, and the importance of … Read more

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Chapter 8 Anatomy

This chapter provides a detailed overview of the anatomy of the human body, focusing on the skeletal and muscular systems, as well as the nervous and circulatory systems.

Here’s a breakdown of the key areas covered:

Shoulder and Arm:

  • The shoulder is a complex joint made up of three bones (clavicle, scapula, and humerus) and three joints (glenohumeral, acromioclavicular, and scapulothoracic).
  • The rotator cuff muscles stabilize the shoulder joint.
  • The brachial plexus innervates the shoulder and arm.

Elbow and Forearm:

  • The elbow is a hinge joint that allows for flexion and extension, as well as pronation and supination of the

… Read more

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Chapter 7 Inflammation

Inflammation – A Delicate Balance

This chapter delves into the complex process of inflammation, a double-edged sword in the human body. While essential for healing and defense against foreign invaders, inflammation can also become a destructive force in chronic conditions like rheumatoid arthritis.

The chapter breaks down the intricate cellular and molecular events that drive inflammation. It explores the roles of various agents, including cytokines, chemokines, and arachidonic acid metabolites, in orchestrating the inflammatory response. It also highlights the differences between acute and chronic inflammation, emphasizing the potential for long-term damage in the latter.

Key concepts include:

  • The Inflammatory Process:

… Read more

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Chapter 6 Skeletal Muscle

Skeletal Muscle – A Symphony of Structure and Function

Dive into the intricate world of skeletal muscle, the body’s powerhouse, making up 40-45% of our dry weight! This chapter unveils the secrets behind movement and strength, exploring the fascinating architecture of muscles, from the slender sartorius to the fan-shaped pectoralis major.

Unveiling the Microscopic Marvels:

  • Myofibers: The fundamental building blocks, each a multinucleated cell spanning part or all of the muscle’s length.
  • Connective Tissue Framework: Endomysium, perimysium, and epimysium work in harmony to support and coordinate muscle movement.
  • Tendons: The crucial link between muscle and bone, enabling force transmission and

… Read more

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Chapter 5 Meniscus and Intervertebral Disks

This chapter delves into the crucial roles of the meniscus and intervertebral discs in the human body, highlighting their complex anatomy, biomechanical functions, and clinical significance.

Meniscus: The meniscus is a crescent-shaped fibrocartilage in the knee that acts as a shock absorber, load distributor, and joint stabilizer. It enhances contact between bones, reducing stress and preventing anterior displacement. Injuries to the meniscus are common and can lead to osteoarthritis. The chapter discusses the meniscus’s physiological functions (shock absorption, load transmission, stability, lubrication, proprioception), histology, anatomy (medial and lateral), vascular supply, development, and pathophysiology of tears. It also touches on new … Read more

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Chapter 4 Ligaments

Ligaments: The Unsung Heroes of Your Joints

Ever wonder what keeps your joints stable and allows you to move? The answer lies in ligaments, the strong, silent heroes of your musculoskeletal system. These tough, fibrous tissues connect bone to bone, acting like living ropes that resist tension and prevent excessive movement. But ligaments are more than just static connectors; they’re dynamic structures with fascinating properties.

A Delicate Balance of Strength and Flexibility

Ligaments possess a unique combination of strength and flexibility. They’re incredibly strong under tension, like a rope holding a heavy load. Yet, they also have a built-in “give” … Read more

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