ABSTRACT
We describe a surgical technique that has been used successfully during arthroscopic anterior cruciate ligament reconstruction to enhance the visual clarity of the operating field specifically during tunnel placement. The precise siting of both tibial and femoral tunnels is critical to both the short- and long-term success of this procedure. Gentle insufflation of the knee joint with air prior to tunnel siting allows for an excellent view of the intercondylar notch. This visual clarity helps in the precise placement and measurement of the femoral tunnel.
Subject(s)
Anterior Cruciate Ligament/surgery , Arthroscopy/methods , Insufflation/methods , Air , Anterior Cruciate Ligament Injuries , Femur/surgery , Humans , Osteotomy/methods , Sodium Chloride , Therapeutic Irrigation , Tibia/surgeryABSTRACT
When revision hip surgery is undertaken to remove a cemented cup from the pelvis the preservation of bone stock and structural integrity of the acetabulum is a major concern. We describe a safe technique for cup removal, which helps avoid a rim fracture occurring during this procedure. This should ensure the defect remains a cavitatory defect and does not become a segmental one with a more uncertain prognosis.
Subject(s)
Acetabulum/surgery , Arthroplasty, Replacement, Hip/methods , Debridement/methods , Humans , ReoperationABSTRACT
Long-term follow-up of total hip replacements (THR) is essential for accurate recording of complications associated with this procedure, in particular the occurrence of wear and aseptic loosening which may warrant revision surgery. A significant proportion of patients with aseptic loosening are asymptomatic and radiological signs may be subtle and easily missed. Occasionally a synovial cyst can develop as a result of polyethylene wear debris and aseptic loosening. These cysts are usually small but can expand and become symptomatic. We describe a case where a large cyst caused sufficient extrinsic compression of the femoral vein as to occlude it. This was a potentially life-threatening complication. We emphasize the importance of clinical examination for leg swelling and groin mass in routine surveillance of total hip replacement. (Hip International 2002; 4: 394-6).
ABSTRACT
We studied the position of the popliteal artery in 32 patients with primary osteoarthritis of the knee. A total of 45 knees were studied using a noninvasive technique with color-flow duplex scanning. The distance between the popliteal artery and the posterior tibial cortex was measured in various positions of flexion. The distance separating them was found to be maximal between 60 degrees and 90 degrees. The study was repeated in a smaller series of 17 patients (20 knees) after knee replacement but with less conclusive results. We believe the safest position on which to operate in primary arthroplasty is with the knee in flexion, but the safety margins are not the same in revision surgery.
