Скачать или смотреть Bone Shaving Mess in Hip Replacement Surgery

Acetabular (hip socket) preparation in #TotalHipArthroplasty requires the acetabular cavity to be reamed in preparation for the insertion of an acetabular implant (metal cup). An accurate press fit maximizes initial acetabular cup mechanical stability, bone contact and ingrowth, thus improving chances of long-term success.
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Successful #HipReplacement press-fit implantation relies on an accurately reamed bone cavity. Under-reaming can lead to intra-operative pelvic fractures, acetabular cup deformation and implant loosening over time, while over-reaming can cause loosening through excessive micro-motion with subsequent failure to achieve bony ingrowth. Inaccurate reaming also makes surgeons likelier to unknowingly undersize or oversize implants.
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Factors affecting the accuracy of the reamed acetabulum can include reaming technique, quality of bone, reamer type, and regular sharpening of reamers. Poor technique can lead to reaming errors resulting in variations in cavity size and shape. Current literature suggests that a straight reaming technique may avoid eccentric reaming and enlargement of the diameter of the acetabular bed. Recommendations on the optimal reaming technique, from manufacturers themselves, vary, with one reaming system, suggesting that the reamer handle should be angled at the same orientation as the component to be implanted, throughout, while other manufacturer’s guidance encourages surgeons to ‘gently rock the reamer handle back and forth approximately 5 degrees to ensure the reamed acetabular cavity is accurate for the desired press fit’. This reaming style involves rotating the reamer head within the cavity as it reams the acetabulum. This technique will henceforth be referred to as the ‘whirlwind’ reaming approach. The effects of this whirlwind technique have not been compared to the straight reaming technique, in terms of accuracy, to our knowledge. #hipreplacement #orthopedicsurgeon #bonecuts
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Total Hip Arthroplasty (THA); hip replacement surgery; acetabular cavity reaming; oversized acetabular implant; press fit; initial acetabular cup stability; bone contact and ingrowth; under-reaming; over-reaming; reaming accuracy; regular sharpening of reamers; single-use reamers;