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Weekly News, Analysis, and Commentary

Orthopaedic Crossfire® Features & News

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Berend v. Meneghini: Liposomal Bupivacaine Injectables: Game Changers in Pain Management

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The #1 game changer in large joint arthroplasty has been the shift from inpatient surgery to better pain control and outpatient surgery. Liposomal bupivacaine is the poster child of this shift, but is it worth the extra $300? Michael Berend and Michael Meneghini debate this question in an absolutely stellar review of the latest data.

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Trousdale v. MacDonald: The Cemented All Poly Tibia in the Active <60 Patient

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Would you use an all poly tibia in the active patient under 60 years old? Of course you should, says Robert Trousdale from the Mayo Clinic. No way! Says Steven MacDonald from the University of Western Ontario. Younger patients have higher revision rates with an all poly tibia. Who wins this great debate? You be the judge.

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Lewallen v. Hofmann: The Cemented All-Poly Tibia: An Affordable Care Act Solution

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All-poly tibia is a very cost effective alternative and, says David Lewallen, M.D., should be part of every knee surgeon’s armamentarium. BUT, newer modular designs and metal backed trays give today’s surgeon more versatility, counters Aaron Hofmann, M.D. This is an essential debate and a must read for every orthopod.

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The Use of Stems in Complex Primary TKA: Necessary & Sufficient

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To stem or not to stem, that is the question when faced with a specifically complex primary or revision knee arthroplasty because of deformity or instability. New Zealander Kelly Vince gives the pro-stem case while HSS’ Thomas Sculco shows himself to be a stem-less kind of guy. Who wins? The reader. Another truly excellent and informative debate from CCJR.

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Gehrke v. Haidukewych: Mega Prosthesis for Distal Femoral Peri-Prosthetic Fx’s

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OK, it’s a distal femoral peri-prosthetic fracture. Do you reach for the locking plates, the screws or the intramedullary nails? Or do you opt for a mega prosthesis? This week’s Orthopaedic Crossfire® debate tackles this excellent subject with ENDO-Klinik’s Gehrke choosing the big implant and Orlando Health’s Haidukewych going ORIF. Who wins? You judge.

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Berend v. Dunbar: Outpatient TJA: “Drive-Thru” Surgery

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Same day total knee arthroplasty is the siren song of large joint reconstruction. Michael Berend has performed over 2, 000 knee arthroplasties with 98% of these folks going home the same day and recommends it strongly. Michael Dunbar points out that these are select patients in a tightly controlled environment. Hard to duplicate especially with heavier, more diabetic and older patients. Read this very interesting debate here.

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Gonzalez Della Valle v. Gross: Extensive Acetabular Bone Loss: Impaction Grafting, a Preferred Solution

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Acetabular bone loss and impaction grafting, for which patients is it good strategy, which patients is it a ‘no-way’ strategy and is it overly technique dependent? Alejandro Gonzalez Della Valle and Allan Gross, with Daniel Berry moderating, tackle this important and impactful (pun intended) subject.

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Murphy v Maloney: Ceramic on Ceramic THA in Patients <60: A New Standard

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Does a patient’s age determine whether to use ceramic-on-ceramic THA? As we saw with the excellent 2013 CCJR debate regarding ceramic-on-ceramic, this is a popular topic. This year Stephen Murphy reminds us that “ceramic-on-ceramic bearings have excellent results” while William Maloney points out that they are not a standard of care and can squeak. Lieberman moderates yet another terrific CCJR debate.

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