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Miller > joints > Flashcards

joints Flashcards

1
Q

optimal pore size for bone ingrowth

A

50-150 um

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2
Q

safe zone for acetabular screw placement

A

posterior-superior

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3
Q

what structures are at risk in the anterior-superior quadrant of the acetabulum?

A

external iliac artery and vein

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4
Q

what structures are at risk in the posterior-inferior quadrant of the acetabulum?

A

sciatic nerve, inferior gluteal nerve and vessels, internal pudendal nerve and vessels

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5
Q

what structures are at risk in the anterior-inferior quadrant of the acetabulum?

A

obturator nerve, artery, vein

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6
Q

what vessel is between the TFL and sartorius in the anterior approach to the hip?

A

ascending branch of the lateral femoral circumflex

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7
Q

radiation dosing for HO ppx in THA

A

700-800 Gy within 24 hours before or 72 hours after surgery

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8
Q

ideal cup version

A

15-25 anteversion

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9
Q

goal combined anteversion

A

25-45

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10
Q

goal cup inclination

A

30-50 abduction

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11
Q

particle number and size in metal on poly and metal on metal

A

smaller particles in metal on metal but higher number

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12
Q

cell type in metal on metal wear debris

A

T-cell lymphocyte

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13
Q

what property causes fracture of ceramic heads

A

low toughness of material

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14
Q

properties of highly cross linked PE vs non-highly cross linked PE

A

highly cross linked generates smaller particles, is more resistant to wear, has reduced mechanical properties

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15
Q

order of release of medial structures in TKA

A

osteophytes, deep MCL (includes capsule), posterior medial corner (capsule, semimembranosus), superficial MCL

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16
Q

what part of the MCL is tight in flexion?

A

anterior superficial MCL

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17
Q

what part of the MCL is tight in extension?

A

posterior oblique superficial MCL

18
Q

what can be damaged when you place a retractor inferior to the TAL?

A

obturator nerve and artery

19
Q

structure at risk during lateral retinacular release in TKA

A

lateral superior geniculate artery

20
Q

where is the MFCA at risk in a THA?

A

underneath the quadratus femoris muscle or glut max tendon

21
Q

vessel at risk with placing retractor over ASIS in posterolateral approach for THA

A

branch of femoral artery

22
Q

position of fusion for hip

A

20-25 flexion, neutral abduction, 0-30 external rotation

23
Q

most common reason to convert hip fusion to THA

A

low back pain

24
Q

best indication for constrained liner

A

abductor deficiency

25
Q

gap size required for ingrowth

A

<50 um

26
Q

what is the max amount of micromotion that allows ingrowth/ongrowth

A

<150 um

27
Q

what nerve is most at risk with lengthening during THA

A

peroneal division of sciatic

28
Q

why do ceramic bearings have high fracture risk

A

low toughness of material

29
Q

cytokines a/w ALTR in MOM hips

A

IL-2/6, IFNy, RANKL

30
Q

order of release for valgus knee

A

osteophytes, lateral capsule, IT band (tight in extension), popliteus (tight in flexion), LCL

31
Q

common femoral deformity in valgus knee

A

lateral femoral condyle hypoplasia

32
Q

how does lateral femoral condyle hypoplasia affect component position in TKA

A

internal rotation of femoral component/external rotation of tibial component

33
Q

what kerboul angle is at high risk for collapse in AVN?

A

> 240, <190 is low risk

34
Q

most important type of wear in osteolysis process

A

adhesive wear

35
Q

cytokines release by macrophage in osteolysis

A

TNFa, IL-1B, TGFB, IL-6, PDGF, RANKL

36
Q

main determinant of number of PE particles generated

A

volumetric wear (related to square of radius of the head)

37
Q

how does head size affect linear and volumetric wear?

A

smaller head size -> increased linear wear, bigger head size -> increased volumetric wear

38
Q

where is the ascending branch of the LFCA at risk in THA?

A

anterior approach. passes up between TFL and sartorius

39
Q

what type of PE manufacturing has the best wear?

A

direct compression molding

40
Q

what causes stripe wear?

A

repetitive subclinical subluxation

Miller (12 decks)

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