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Osteotendinous Suturing for Anchorage of Medial Arthrotomy in Total Knee Arthroplasty

Open Journal of Orthopedics 2016年第12期6卷 357-362页

作者： Sanjay Agarwala Lokesh Sharoff sameer chaudhari Department of Orthoapedic Surgery P.D. Hinduja National Hospital & Medical Research Centre Mumbai India

Aim: To develop a method for closure of the arthrotomy wound and approximation of the medial periosteum at the level of tibial tuberosity after total knee arthroplasty in severe varus deformity. Method: We describe a technique of osteotendinous suturing through the tibial tuberosity for suturing of the medially elevated periosteum. Result: This is an easily reproducible technique which results in very early mobilisation and no additional complications and has several advantages over other methods of closure. Conclusion: The osteotendinous technique can be used for medial arthrotomy closure after correction of severe varus deformities and also after partial patellar tendon avulsions in total knee arthroplasty surgeries.

关键词： Total Knee Replacement Anchor Patellar Tendon Avulsion Bone Tunnel Patellar Tendon Suturing Transosseous

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Restoring Natural Hip Movements with Large Head (Ceramic on Ceramic) Total Hip Replacement: Experience of Our 150 Patients over 6 Years

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Open Journal of Orthopedics 2017年第12期7卷 414-427页

作者： Sanjay Agarwala Mayank Vijayvargiya sameer chaudhari Department of Orthopedics P.D. Hinduja National Hospital Mumbai India

Background: Asian cultures require floor-seated positions demanding a high range of motion (ROM). Ceramic-On-Ceramic (COC) interface allowed the use of larger head with reduced wear debris generation and adverse tissue reactions. This study was conducted to analyze 6-year clinical-radiological outcome with large head fourth generation DeltaMotion®ceramic-on-ceramic (COC) hip articulation, with special emphasis on postoperative ROM, ability to sit cross-legged, stability, hip noise and revision surgery. Material and Methods: 150 consecutive hips were operated for primary cementless Total Hip Replacement (THR) using DeltaMotion®at a tertiary care center in Mumbai, India, between January 2010 and January 2015. Clinico-radiological outcome was assessed using the Harris Hip Score (HHS) and radiographs at 6 weeks, 6 months, and annually thereafter. Results: 108 (74.5%) patients were males and 37 (25.5%) were females with an average age of 50.87 years. Mean follow-up was 54 months (range: 37 - 86 months). The mean ROM was 120° in flexion, 10° in extension, 30° in adduction, 45° in abduction, 25° in internal rotation and 25° in external rotation. The mean HHS showed a statistically significant improvement of 64.5% (from 54.66 ± 6.42 pre-operatively to 89.95 ± 4.32 post operatively) (p-value: 0.001). 92% of patients were able to sit in squatting position and 92% were able to sit cross-legged on the floor at last follow-up. 0.7% joints (1 hip) had squeaking. Considering no revision surgery as the end point, 6-year prosthesis survivorship was 100%. Complications (superficial infection) occurred in three hips (2%). All patients reported to be satisfied with their outcome after surgery. Conclusion: We infer that DeltaMotion large head COC bearing allows scope for using larger head size in relatively smaller Indian hips due to factory fitted ceramic lining. At 6-year follow-up, high activity level was observed with excellent clinical-radiological outcomes and component lo

关键词： Ceramic-on-Ceramic Total Hip Arthroplasty Squeaking Prosthesis Survivorship Harris Hip Score

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