Research & Publications
Revisiting the universal femoral component: Midterm outcomes of a modern design
Approximately 10 years ago a total knee arthroplasty system with a modern universal femoral component was introduced. It includes a symmetrical femoral and tibial component. The purpose of this study was to evaluate the 6-year clinical outcomes of this implant from a single surgeon.
Liposomal bupivacaine in posterior spine surgery: A piece of the puzzle for postoperative pain
Liposomal bupivacaine (LB) is a local analgesic that may be used at the time of surgery to limit postoperative pain around the surgical site. Its efficacy in decreasing pain, decreasing narcotic consumption, decreasing length of stay, and improving mobility is an area of intense research. The purpose of this study was to determine whether LB use was associated with improved patient-reported pain scores in the first 72 h following posterior spinal surgery, decreased postoperative narcotic need, and decreased length of stay.
Positive clinical outcomes at 10 Years with the universal femoral component in total knee arthroplasty
We evaluated a unique implant system that included a universal femoral component (UFC) design and instrumentation that would accommodate the UFC on both the left and right femur. There was a commitment to test two hypotheses: firstly, that the results of this 10-year follow-up study maintained patient outcomes compared to the initial 6-year follow-up assessment and secondly that this unique Q-angle design maintained patella tracking over the 10-year period. The results of the 10-year follow-up period determined that the two hypotheses were supported with the Knee Society Score (KSS) data and continued to support the use of this UFC.
Intraprosthetic Dislocation of a Modular Dual-Mobility Total Hip Arthroplasty With Posterior Migration of the Polyethylene Liner
Dual-mobility (DM) implants have been used in total hip arthroplasty since 1974. Modular DM implants have seen an increase in use in primary and revision total hip arthroplasties given the theoretical decreased dislocation rate. DM constructs have 2 articulation sites, one between the acetabular shell and a polyethylene liner, as well as one between the liner and the femoral head component. However, dislocations with modular DM implant dislocations can still occur. These dislocations occur via an extraprosthetic or intraprosthetic mechanism. Intraprosthetic dislocation is a phenomenon in which the smaller femoral head dissociates from the polyethylene liner. We present a case of intraprosthetic dislocation in an 81-year-old female with migration of the polyethylene liner into her gluteal muscles after 2 attempted closed reductions
Spontaneous Unilateral Chiari I Secondary to Acquired Tonsillar Hypertrophy/Pseudomass With Syringomyelia in a Juvenile With Progressive Scoliosis
Chiari type 1 malformation (CM-1) is a structural defect of the central nervous system in which part of the cerebellar tonsils descend below the level of the foramen magnum, sometimes with associated syringomyelia. Although Chiari malformations were traditionally believed to be congenital, several cases of acquired CM-1 with syringomyelia have been reported. Usually associated with repeat lumbar puncture, increased intracranial pressure, and craniocephalic disproportion, CM-1 in the absence of an underlying etiology is rare. We report a rare case of spontaneous idiopathic tonsillar hypertrophy causing unilateral CM-1 with syringomyelia associated with progressive scoliosis in a juvenile with a previously normal neonatal MRI brain and no known underlying pathology.
