Instructional course lectures
-
A significant proportion of patients will experience moderate to severe pain after hip or knee replacement surgery. Multimodal pain control regimens have been developed to address this issue. ⋯ Cyclooxygenase-2 inhibitors, a class of NSAIDs, are not believed to increase the risk of bleeding and may be useful in this population of patients. However, recent research shows increased cardiovascular and renal risks with cyclooxygenase-2 inhibitors and has limited their use for postoperative pain control in joint arthroplasty patients.
-
Review
Radiculopathy and the herniated lumbar disk: controversies regarding pathophysiology and management.
Lumbar disk herniation is one of the most common problems encountered in orthopaedic practice. Despite the frequency of its occurrence, however, much about lumbar disk herniation is poorly understood. It is important to review the basic and clinical science underlying the pathophysiology and treatment, surgical and nonsurgical, of this disorder.
-
Plate fixation of fractures began before the start of the 20th century. Initially, plates and screws were used to decrease deformity. There was minimal interest in the biology of fracture union. As knowledge increased in regard to the science of bone healing, fixation techniques and implants also evolved, from the development of rudimentary rigid constructs to stable locked plating.
-
The evaluation of injury of the cervical spine in children is complicated by biomechanics of the pediatric cervical spine that differ from those in the adult, by incomplete maturation and ossification of the vertebral segments, and by difficulties the physician may have in communicating with the child. Because the upper cervical region, from occiput to C2, is most susceptible to injury in children, it is important to have an understanding of mechanisms of injury, diagnostic imaging modalities, and therapeutic interventions. A clear understanding of adult and pediatric cervical spine differences will facilitate early diagnosis and appropriate treatment of cervical spine injuries in young children.
-
The Smith-Petersen osteotomy has been a mainstay in the treatment of sagittal deformity since it was first described in 1945. The primary indication for an osteotomy is fixed sagittal deformity. When an osteotomy is performed in a patient with ankylosing spondylitis, it can be combined with an anterior column osteoclasis to achieve a correction of up to 40 degrees to 50 degrees. When performed for other indications, the osteotomy can result in approximately 10 degrees of correction per level treated.