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Weekly News, Analysis, and Commentary

Large Joints Features & News

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Lee v. Lombardi Over Patient Specific Instrumentation

Image created by RRY Publications, LLC
Image created by RRY Publications, LLC

“The data does not support the use of patient specific instrumentation (PSI),” says Gwo-Chin Lee. “Claims of decreased operative time and improved alignment are unfounded.” Adolph Lombardi states, “The majority of studies DO show decreased processing and sterilization time, turnover time, etc. And hey, these things could soon be delivered to your OR by drone.”

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Jones v. MacDonald Over Tourniquetless TKA

Image created by RRY Publications, LLC
Image created by RRY Publications, LLC

“OK, so you have a bloodless field using a tourniquet in TKA,” says Dickey Jones. “But there are many downsides, such as nerve damage and a delay in the recovery of muscle function.” Hold on says Steve MacDonald, “There is no clinical evidence of nerve damage or delays in muscle function recovery when employing a tourniquet.”

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Gustke Debates Callaghan: Ultracongruent Liners or Posterior Stabilization

Image created by RRY Publications, LLC
Image created by RRY Publications, LLC

“An ultracongruent liner provides the same function and similar results to a PS liner,” says Ken Gustke. And it avoids the risk of clicking, post wear, etc. John Callaghan disagrees, “It’s all about motion. After 90-110 degrees of motion you need rollback…and a post provides that. An ultracongruent liner couldn’t possibly do that.”

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Gehrke Debates Haidukewych: Mega Prostheses

Image created by RRY Publications, LLC
Image created by RRY Publications, LLC

“Mega prostheses can work in elderly patients and osteopenic patients with poor bone stock who need a quick procedure,” says Thorsten Gehrke. George Haidukewych isn’t quite so sanguine. “I do a mega prosthesis as a last resort, with a very distal fracture, with severe osteolysis, etc.” and “ORIF remains the gold standard for periprosthetic fractures.”

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