Key concept Irrigation and debridement with polyethylene insert exchange (IDPE) or Open debridement and polyethylene insert exchange (ODPE) is a form of DAIR (Debridement, Antibiotics and Implant Retention) used for selected acute periprosthetic joint infections (PJI) after TKA. When to consider and when not to consider IDPE or ODPE? Favorable…
Tag: Arthroplasty
Fellowship Blog
Total Knee Arthroplasty (TKA) in Obese Patients
Nearly 50–60% of patients undergoing total knee arthroplasty (TKA) are obese, making obesity one of the most important factors influencing perioperative planning and outcomes. These obese patients often require TKA at a younger age. It is a major risk factor for knee osteoarthritis due to: High BMI can be classified…
Fellowship Blog
Simultaneous Bilateral Total Knee Arthroplasty (SBTKA): A Practical Perspective
Recently, we operated on a 58-year-old female patient with advanced bilateral knee osteoarthritis (OA). She underwent simultaneous bilateral total knee arthroplasty (TKA) using a medial parapatellar approach. Both femoral components were size 3, tibial components size 3, and a 10mm polyethylene insert was used on each side. Some practical considerations…
Fellowship Blog
Mathematical Principles in Mechanically Aligned Total Knee Arthroplasty
Mechanical Axis Concept Natural Knee Target alignment in MA-TKA Tibial cut Distal femoral cut Posterior femoral cut The 3° Compensation Rule Distal femoral and Tibial resection thickness = Implant thickness 2 mm rule in TKA References:
Fellowship Blog
The 0-3-6-9 rule in Mechanical Alignment Total Knee Arthroplasty (MA-TKA)
The goal of MA-TKA is to restore the normal mechanical axis. In contrast to kinematic axis alignment, which attempts to recreate native knee joint line (3° tibial varus and 3° femoral valgus), in MA-TKA, the distal femur and the tibia are cut to be perpendicular (0°) to the mechanical axis….
Fellowship Blog
A THR After Acetabular ORIF and the 9 Intraoperative Tests That Matter
Today was one of those surgeries that stays with you not just for the technical challenge, but for what it teaches you as a growing orthopedic surgeon. Our patient was a 30-year-old male with painful AVN of the femoral head, years after an acetabular fracture that had been treated with…
Fellowship Blog
A New Chapter: Beginning My Fellowship Journey at B&B Hospital
I will be sharing my fellowship journey from my journal here. The posts will be backdated and hopefully I will catchup eventually. Dated: July 15, 2025 As I begin this fellowship training in Hip, Pelvi-Acetabulum, and Arthroplasty at B&B Hospital for one year, I felt like taking a step back…