Colegio Mexicano de Ortopedia y Traumatología

Colegio Mexicano de Ortopedia y Traumatología
CMO en linea....

jueves, 29 de agosto de 2013

BL Reverse hybrid THR Done / Discusion entre pares

BL Reverse hybrid THR Done



  • Ashraf Atef What is the meaning of reverse
    Hace 19 horas a través de móvil 
  • Himanshu Rohela Left side acetabular component should be little more vertically oriented both the femoral component are not centralised in canal may cause persistent thigh pain
    Hace 18 horas a través de móvil 
  • Himanshu Rohela Reverse hybrid is cementing on acetabular side i guess
    Hace 18 horas a través de móvil
  • Himanshu Rohela Bone quality not good on femur side cementing should have been done femoral component lossening and sinking must be kept in mind
    Hace 18 horas a través de móvil 
  • Shyamlal Mukhi Excellent job pre op xrays age both stems are in mild varus ?
    Hace 18 horas a través de móvil ·
  • Hanume Gowda S N Why was this done. ..whats the age of the patient. ..
    Both stems in varus.left more so..
    Left also appears loose???..
    Acetabulum done very well. .
    why this combination. ..any specific indication. ...
    Hace 18 horas a través de móvil 
  • Shyamlal Mukhi @hanume acetabulum is not loose it appears like this on digital xrays
    Hace 17 horas a través de móvil 
  • Shyamlal Mukhi @hanume this was sickle cell with avn un cemented coc is my choice or e poly on ceramic uncemented
    Hace 17 horas a través de móvil 
  • Hanume Gowda S N Sir I spoke abt the left stem not acetabulum..both side acetabulum. .good..
    Hace 16 horas a través de móvil 
  • Hanume Gowda S N The idea of uncemented being superior over cemented is unfounded.....
    Evidence does not shiw any advantage. .on the contrary revision rates are higher with uncemented than cemented. ....across age groups and across continents. ..
    Hace 16 horas a través de móvil 
  • Hanume Gowda S N Uncemented being more expensive...adds to burden ....
    Hace 16 horas a través de móvil 
  • Drgirish Gupta Reverse hybrid means cemented acetabulam & noncemented stem
    Hace 16 horas a través de móvil 
  • Drgirish Gupta Pt age 45yr male with sickle cell anaemia poor pt
    Hace 16 horas a través de móvil 
  • Hanume Gowda S N Dr Girish can you give an idea as to why this combination ws done...the logic...
    I am only trying to understand. .and not being pesky or persistent....
    Whats the advantage. ...
    Hace 15 horas a través de móvil 
  • Niraj Vora Hanume, as you have pointed out, uncemented is not evidentially superior to cemented.

    The rationale of the reverse hybrid is that it brings down the cost significantly, as the main cost in any uncemented system is the acetabular side. The femoral side comes to almost the same, when you factor in the cost of the cement, stem, restrictor, cement gun etc etc.

    There is some evidence to support this technique in the Scandinavian Registry, though I cannot recall if it was in a slightly older cohort of patients.
  • Hanume Gowda S N Thanks dr Niraj....but revision rates are definitely higher with uncemented. ..isn't it???
    Hace 15 horas a través de móvil 
  • Niraj Vora Are they?? Uncemented what? Femur, socket? Both?
  • Hanume Gowda S N Both is what I understand after reading the lit... Anyways I would not argue with you on this. ..I am a gen. ortopod and you are an Arthroplasty surgeon. ..you must have read more on this.....
    Hace 15 horas a través de móvil 
  • Niraj Vora No no Hanume, nothing like that boss, you are as qualified to discuss this as I am, or anyone else for that matter.

    Vis-a-vis the loosening, while literature may pronounce its verdict one way or the other, the final factor is the technique, alignment and quality of implants chosen.

    The Corail stem has now shown us excellent results at 20 years, and that comes from the Annecy group. These are good outcomes, I would think.
  • Hanume Gowda S N Thanks. ..I do read a lot on this and get a little confused...
    Hace 15 horas a través de móvil 
  • Hanume Gowda S N When initially I started doing hips.. I did uncemented but cost was the concern...I used indus stem and S&N cup..did 8 of them so for... 9yrs down the line they are all doing well..

    then started reading more and got more confused. ..Now mostly cemented....
    Need to rethnk..
    Hace 15 horas a través de móvil 
  • Manoj Patel Stem in varas not good
    Hace 14 horas a través de móvil 
  • Amit K Srivastava I must say you have nice cementing technique and fantastic acetabular implantation
    Good job doc🍻
    Hace 10 horas a través de móvil
  • Hace 9 horas a través de móvil · Me gusta
  • Anuj Agrawal Carrying on the discussion of cemented vs uncemented, many cemented stems have shown excellent survival over 20-25 years, and hybrid THR is an acceptable alternate to uncemented THR, esp where cost is a concern. But, this cannot be generalised to all c...Ver más
    Hace 7 horas a través de móvil
  • Sanjay Kumar Tiwari the entry of femoral canal could fave been a little more lateral...pt may have erosion of poster lateral cortex and pain in five years time since stem tip is not centralised....acetabulum is good.
  • Drgirish Gupta In case of sickle cell anaemia reverse hybrid is better than the other bc cementless acetabulam cup having more chances of protrude &cementless stem prefer bc cementing in stem may cause sickle cell crisis 
    Refer text
  • Ismail Fathalla The literature confirms that cemented components have a longer survival than uncemented ones. The only thing is that I would have cemented the femoral component as well. The only good thing about uncemented cups is the bearing technology and the possibility of using a bigger head. Well done. Is the acetabulum medialized intentionally?
  • Drgirish Gupta Thanks
    Acetabulum diseased so that remove bone from that side
    Hace 52 minutos a través de móvil