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Weekly News, Analysis, and Commentary

Large Joints Features & News

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Parvizi, Scott Debate Simultaneous Bilateral TKA

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

“There are higher complications and mortality with simultaneous bilateral total knee surgery (SBTKA),” argues Jay Parvizi, “it is for a select group of patients.” Richard Scott counters, “SBTKA is indicated in 10-15% of patients, patient and family satisfaction is high, and recent reports indicate a cost savings and the overall morbidity is less compared to staged procedures.”

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Minas, Lachiewicz Debate Patient Specific TKA

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

“Patient specific TKA—especially in large patients or very small patients—gives a precise fit. It’s easy for the OR staff, the jigs are accurate, and you get excellent intraoperative stability,” argues Tom Minas. Paul Lachiewicz counters, “Ask yourself three questions: Does it provide better outcomes and decreased revisions for patients? Is it less expensive? Is it easier for the surgeon? For patient specific instrumentation the answer is ‘NO’ to all three.”

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Lewallen, Thornhill Debate All Poly Tibias

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

“Modular platforms are more expensive, unproven, and you have a rigid implant along with bone stress shielding,” argues David Lewallen. But Tom Thornhill counters, “You have fewer options with an all poly tibia, including the fact that you can’t go without cement. And if you cemented an all poly tibia you can sometimes miss the fact that there is cement left towards the back.”

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Orthopedic Logistics Is Outdated

Inventory Management / Source: Wikimedia Commons and Chirantan Ghosh
Inventory Management / Source: Wikimedia Commons and Chirantan Ghosh

Are the logistics of orthopedics not only outdated but ripe for disruption? Smith & Nephew’s new Syncera venture claims to be just such a force for logistics disruption. Syncera says it is not about generic implants. Nor is it about rep-less operations. Instead it is about new tools and strategies to deliver the seven rights of logistics.

Gehrke, Cameron Debate Use of Cement in Small Canals

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

When it comes to small canals, with cemented stems you get better outcome and survival, fewer dislocations, fewer periprosthetic fractures, and fewer revisions!” argues Thorsten Gehrke. Hugh Cameron says, “Small stems are short and lucency will develop. And with cement in small canals you are reaming heavily and most of the cancellous bone is removed, thus the bone-cement interlock is poor.”

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