Reconstruction Flashcards
1
Q
Disc Replacement
A
- To treat pain from IVD degeneration, used as an alt to spinal fusion
- Result aims to relieve pain, reproduce biomechanics of normal disc, reduce mechanical forces to adjacent segments, to be as cost effective and efficacious as fusion.
- 4 categories (composite, elastic, mechanical, nucleus) or (constrained, semi-constrained - CoCr endplates with fixation keels implant intentionally restricts ROM, unconstrained - UHMWPE sphere increases with CoCr endplates, increases flexion-extension and axial rotation compared to intact, deformable)
- Possible complication
(heterotopic ossification, migration or loosening, implant or vertebral body fracture, wear, adjacent segment degeneration, osteolysis)
2
Q
ACL Repair
A
- Aim to create rotation and A-P knee stability
- ACL resists excessive tibial translation and rotational loads. (2 bundles AMB and PLB - sporadic bundles of collagen fibres,, with non-uniform diameter and varied orientation)
- Ruptures due to pivoting injury (knee valgus moments)
- Repair = allograft (costly), Autograft (donor site instability - from hamstring tendon commonly, but can be quadriceps or patella tendon), synthetic grafts (high ultimate tensile strength)
- Future trends (LARS artificial ligaments - a scaffold capable of resisting loads)
3
Q
Osteotomy
A
- To modify load transmission by changing the alignment of the bone
- Reasons include: OA and perthes disease (disrupted blood supply to femoral head - necrosis, collapse, repair and remodelling)
- Most recover from perthes using physiotherapy
- Surgical interventions for perthes include: Femoral osteotomy, pelvic osteotomy
- Treatment for unicompartmental knee OA: Open wedge osteotomy,, aiming to straighten the mechanical axis
