Latest Total knee replacement Podcast Episodes
Singh Index and Ward's Triangle
Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast) - April 09, 2021 07:00 - 9 minutes ★★★★★ - 4 ratingsChanges in Trabecular Pattern of the Upper End of the Femur as an Index of Osteoporosis Manmohan Singh et al JBJS 1970 Grade 6 - All normal trabeculae are visible Grade 5 - accentuation of the principal compressive and principal tensile trabeculae - Ward's triangle looks empty Grade 4...
Crowe Classification
Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast) - April 02, 2021 07:00 - 10 minutes ★★★★★ - 4 ratingsTotal Hip Replacement in Congenital Dislocation and Dysplasia of the Hip John Crowe, John Mani, Chitranjan Ranawat JBJS 1979 I - < 50% subluxation II - 50% - 75% subluxation III - 75% - 100% subluxation IV - >100% subluxation Support the Show.
ICM 2018 Criteria for PJI
Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast) - March 26, 2021 07:00 - 8 minutes ★★★★★ - 4 ratingsThe International Consensus Meeting on MSK Infection presented their new criteria in 2018 Major Criteria 1. Two positive periprosthetic cultures w/ phenotypically identical organisms 2. A sinus tract communicating with the joint ____________________ Minor Criteria > or equal to 6 = infected 4-5...
Kellgren-Lawrence Classification
Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast) - March 19, 2021 07:00 - 10 minutes ★★★★★ - 4 ratingsKellgren, Lawrence. Radiological Assessment of Osteoarthritis. Ann Rheum Dis. 1957;16:494-502 Grade 0 - No presence of OA Grade 1 - Doubtful narrowing, possible osteophytes Grade 2 - Possible narrowing, definite osteophytes Grade 3 - Definite narrowing, moderate osteophytes, some sclerosis and ...
Paprosky Classification of femoral bone loss
Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast) - March 12, 2021 08:00 - 7 minutes ★★★★★ - 4 ratingsPaprosky Classification of Femoral Bone Loss Type I - minimal metaphyseal bone loss Type II - extensive metaphyseal bone loss, minimal diaphyseal bone loss Type IIIA - extensive metaphyseal and diaphyseal bone loss with greater or equal to 4 cm intact diaphysis for "scratch fit" Type IIIB - ext...
Gruen and Modes of Failure
Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast) - March 05, 2021 08:00 - 9 minutes ★★★★★ - 4 ratings"Modes of Failure" of Cemented Stem-type Femoral Components Gruen, McNeice and Amstutz CORR 1979 Seven Gruen zones 1 - proximal lateral 1/3 2 - central lateral 1/3 3 - distal lateral 1/3 4 - tip 5 - distal medial 1/3 6 - central medial 1/3 7 - proximal medial 1/3 Modes of Failure I. Pistonin...
The Future of TKA's with AI
Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast) - March 05, 2021 00:00 - 15 minutes ★★★★★ - 4 ratingsI just wanted to share my thoughts and give you my two cents on where we may be in ten years. We still have 20% of patients that are dissatisfied after TKA. WHY? We get answers from industry - nav and robots? But, what is the question? Listen in to hear my thoughts on AR and AI and how a heads u...
Garden and Pauwels
Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast) - February 26, 2021 08:00 - 16 minutes ★★★★★ - 4 ratingsLow-Angle Fixation in Fractures of the Femoral Neck Garden JBJS-B 1961 Stage I - Incomplete and abducted or valgus impacted Stage II - Complete and non-displaced Stage III - Complete partially displaced Stage IV - Complete fully displaced Pauwels Classification 1935 I - up to 30 degrees II - ...
AORI
Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast) - February 19, 2021 08:00 - 11 minutes ★★★★★ - 4 ratingsAORI Classification Type 1 - Minimal bone defect, intact metaphysis - Treat with cement or impaction grafting Type 2A - Metaphyseal bone damage of 1 femoral condyle (F2A) or 1 half of the tibial plateau (T2A); posterior condyles are reduced - Treat with cement, augments, bone graft, ...
Dorr Classification
Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast) - February 12, 2021 08:00 - 5 minutes ★★★★★ - 4 ratingsDorr Classification; Bone 1993 "Structural and Cellular Assessment of Bone Quality of Proximal Femur" A - Thick cortex - champagne flute canal B - Thin cortex with residual funnel shape C - Thin cortex - "stove pipe canal" Canal/Canal Ratio A - <0.5 B - 0.5 - 0.75 C - >0.75 Support the Sh...
Cement Grading
Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast) - February 05, 2021 08:00 - 8 minutes ★★★★★ - 4 ratingsBarrack & Harris JBJS-Br 1992 "Improved Cementing Techniques and Femoral Component Loosening in Young Patients with Hip Arthroplasty. A 12 Year Radiographic Review." A - Complete fill, the classic "White Out" B - slight radiolucency C - radiolucencies 50% - 99% D - complete radiolucent line...
Vancouver Classification
Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast) - January 29, 2021 08:00 - 6 minutes ★★★★★ - 4 ratingsVancouver Classification by Duncan and Masri ICL 1995 Treatment options added in CORR 2004 Type A AL - lesser trochanter - non-op unless larger medial piece AG - greater trochanter - non-op unless >2.5 cm displacement Type B B1 - well fixed stem - ORIF B2 - loose stem, adequate bone stock - ...
Osteonecrosis Staging Systems
Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast) - January 23, 2021 08:00 - 9 minutes ★★★★★ - 4 ratingsHere I review the two common classifications for ON of the hip, Ficat and Steinberg. The modified Ficat, Idiopathic bone necrosis of the femoral head, was published in 1985 JBJS-Br 0 - Preclinical and pre-radiographic I - Xray is normal but hip is symptomatic II - sclerosis and cysts on xray ...
Fairbank
Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast) - January 16, 2021 08:00 - 5 minutes ★★★★★ - 4 ratingsKnee Joint Changes after Meniscectomy by T.J. Fairbank published JBJS - Br 1948 The following radiological changes were seen after meniscectomy 1. Ridge formation 2. Narrowing of the joint space 3. Flattening of the femoral condyle Support the Show.
HO - Brooker Classification
Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast) - January 10, 2021 20:00 - 4 minutes ★★★★★ - 4 ratingsBrooker et al JBJS Vol 55-A 1973 Class I - Islands of bone within the soft tissue around the hip Class II - Bone spurs from the pelvis or proximal femur , leaving at least 1 cm between Class III - Bone spurs from the pelvis or proximal femur, reducing the space between to less than 1 cm Class I...
Patella Clunk
Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast) - December 26, 2020 08:00 - 6 minutes ★★★★★ - 4 ratingsAlthough rarely seen with newer TKA designs this was a diagnosis seen in patients with TKAs and could be extremely symptomatic. Patellar clunk was first described by Hozack et al in 1989. Patellar clunk occurred when a fibrous nodule forms above the patella. This nodule would get caught in th...
The Outerbridge Classification
Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast) - December 20, 2020 19:00 - 7 minutes ★★★★★ - 4 ratingsThis is the first in a series of episodes where I review some classic articles and classifications. The Outerbridge classification was first presented in JBJS-B in 1961 The classification is as follows: 1 - Softening and swelling 2 - Fragmentation and fissuring less than 1/2 inch diameter 3 - ...
Using a Star System for Difficult Cases
Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast) - December 04, 2020 23:00 - 6 minutes ★★★★★ - 4 ratingsIn my first year of practice I remember a day where I only had three joints but it took all day and I was exhausted. Although they were all primaries they each had a component that made them hard - size, bone loss, stiffness. I created a system that allowed me to communicate with my scheduler ...
Balancing Algorithm in TKA
Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast) - November 21, 2020 08:00 - 27 minutes ★★★★★ - 4 ratingsMost gunners, interns and residents have memorized "the chart." That chart with what to do in a TKA when flexion is loose or the extension gap is tight or vice versa. Here I want to review that and more and discuss the things that I look for during balancing. Support the Show.
Consults for the Non-Orthopedic Specialists
Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast) - November 15, 2020 21:00 - 26 minutes ★★★★★ - 4 ratingsOrtho is consulted for many things. Here I would like to go over a few topics. First, for most ortho consults we need an x-ray. For a fracture or dislocation it is imperative. Even without trauma a bone can break if it had an un-diagnosed tumor. Even when the xray is normal, the information...
Hip Fractures for the Hospitalist
Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast) - November 07, 2020 08:00 - 25 minutes ★★★★★ - 4 ratingsHip fractures are a frequent admission at hospitals. Here I will go over things that are helpful in getting patients to the OR safely and timely. It is not important for the medical team to attempt to classify the type of fracture, leave that up to the orthopedic team. Simply refer to it as a...
Pre-op Surgical Evaluation for the PCP
Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast) - October 31, 2020 20:00 - 29 minutes ★★★★★ - 4 ratingsI hate the word clearance, but prefer a pre-op eval or stratification. Here I will go into detail of the things I look for when a patient is referred to their PCP prior to elective orthopedic surgery. I will go over not only what, by why each item is important. For each test I will explain wh...
Pre-op Surgical Evaluation for the PCP
Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast) - October 31, 2020 20:00 - 29 minutes ★★★★★ - 4 ratingsI hate the word clearance, but prefer a pre-op eval or stratification. Here I will go into detail of the things I look for when a patient is referred to their PCP prior to elective orthopedic surgery. I will go over not only what, by why each item is important. For each test I will explain wh...
Hip Pain for the PCP
Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast) - October 24, 2020 07:00 - 22 minutes ★★★★★ - 4 ratingsHere I am going to try to go through hip pain in the office setting in patients over 50. Think about location, is it in the groin, laterally or in the buttock. Take a good history and physical exam. Xray are beneficial but need to be WEIGHT BEARING to adequately assess for arthritis. Altho...
Achilles Injuries for the Primary Care Provider
Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast) - October 17, 2020 07:00 - 22 minutes ★★★★★ - 4 ratingsHere I will review the 3 common achilles problems - achilles tendinitis, achilles tendinosis and achilles tendon rupture. I will discuss the plantaris tendon rupture which can be mistaken for an achilles injury. I will briefly describe the symptoms, exam and workup for these diagnoses. I will...
Knee Pain for the Primary Care Provider
Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast) - October 10, 2020 22:00 - 36 minutes ★★★★★ - 4 ratingsIn season 3 I am going to try to pass on some orthopedic knowledge to non-orthopedic health care providers. It has been shown that the MSK knowledge coming out of medical school is poor, yet a high number of visits in the office and ER are for orthopedic problems. Here I am starting with non-t...
Choosing a Fellowship
Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast) - October 05, 2020 07:00 - 23 minutes ★★★★★ - 4 ratingsIt looks like things will be virtual for now. I am going to offer my thoughts on what I was looking for when I applied for a fellowship. I'll review things I think are important such as number and type of cases, office hours and education. Briefly, I touch on things I discuss as an overview o...
Choosing a Practice
Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast) - October 04, 2020 07:00 - 14 minutes ★★★★★ - 4 ratingsAfter medical school, residency and probably fellowship it is time to find a practice. Here I will try to offer my two cents on what to think about and what to look for when you start looking for that first job out of training. Support the Show.
Anterior vs Posterior Referencing
Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast) - October 04, 2020 00:00 - 19 minutes ★★★★★ - 4 ratingsTKA's are complicated and the femoral preparation is complicated. We are concerned about bone resection, rotation, sizing and more. If the implant is wide or gaps tight you may need to downsize. The initial referencing can be anterior or posterior. Each has its pro's and con's. Here I will ...
Coding
Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast) - September 26, 2020 07:00 - 22 minutes ★★★★★ - 4 ratingsI am not a coding expert. I know that through med school, residency and fellowship I received little to no education on coding. Here I want to offer my simple overview of new versus established, level 3 vs level 4 and how to code based on time. I hope this offers an introduction and helps you...
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