Kasr Al-Ainy Arthroplasty and Pelvic Trauma Unit

07/03/2023

*Advantages of using larger Head size in THR

1- Provide wider impingement-free ROM

2- ↑↑ jumping distance , ↓↓risk of dislocation.

3-Big heads are more anatomical –mimics native femoral head- may provide better functional results.

*Disadvantages:
Concerns about -increased wear
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*Head size and risk of dislocation after THA:
Jumping distance: degree of lateral transition of head centre relative to centre of acetabular component required to dislocate.

↑ head size - ↑↑ the jumping distance  lower dislocation rates
Jumping distance also depends on acetabular component inclination and anteversion
Most of studies showed a significant difference in the incidence of dislocations between the groups, favouring the use of 36 mm heads.
But
Late dislocations - occur 2ry to bearing wear therefore. Increasing the head size can not be examined irrespective of the bearing surface

And most of studies showed ; Increased revisions due to dislocation for 36 mm MoXLPE compared with 36 mm CoXLPE and CoC THA at nine-year follow-up.

07/03/2023

Inviting you all to the weekly pevic trauma and reconstruction scientific meeting.
Under supervision of Prof F**d Zamel.

Agenda for Wednesday 8/3/23

Focus on pertrochanteric fracture

8:00a.m : classification and management of pertrochanteric fractures, presented by R/Omar Hilal

9:00 a.m: 3D classification of pertrochanteric fractures, presented by L/Mostafa Shawky

https://acrobat.adobe.com/link/review?uri=urn:aaid:scds:US:70ad0008-d443-3075-8347-82bc6266ad50

10:00 a.m : ward round

27/02/2023

Inviting you all to the weekly pevic trauma and reconstruction scientific meeting.
Under supervision of Prof F**d Zamel.

Agenda for Wednesday 1/3/23

8:00am Journal club:

1- Technical considerations and avoiding complication in total hip arthroplasty -

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9668563/

2- How to Deliver an Effective Lecture & Improve Presentation Skills - Prof Mahmoud Abdelkarim

10:00am ward round

Total hip arthroplasty (THA) is considered to be the surgical procedure of the 20th century. Current projections show that by 2030, primary THA is expected to grow by 171%, with revision THA expected to increase by 142% in the same time frame. Although ...

21/02/2023

Important paper discussed in our last week journal club and scientific meeting :

FFP " Fragility fractures of pelvis" are an emerging entity in the old and very old segment of our populations. They exhibit specific characteristics, which are not present in pelvic ring disruptions of the younger population. A new, comprehensive classification provides a frame for analyzing the morphology and degree of instability of FFP. To date, there is no consensus about the optimal treatment regimen of patients with FFP. A multidisciplinary geriatric comanagement, including treatment of comorbidities and starting prevention of secondary fractures, helps reducing morbidity and mortality. *The goal of in-hospital treatment is reducing pain and regaining early mobility and independency for activities of daily life*. Surgical fixation is an important pillar of treatment.
The surgery should be as less invasive as possible and provide the stability needed for early mobilization and uneventful healing.
Perfect fracture reduction is less important. There are several fixation techniques of iliosacral screw fixation, sacroplasty, transiliac bridging osteosynthesis, transsacral bar osteosynthesis, and lumbopelvic fixation for fractures of the posterior pelvic ring, which use different principles as compression, buttressing, and bridging. They have their specific advantages and limitations and may be used alternatively for the fixation of different fracture configurations. When a combination of an anterior with a posterior pelvic ring fracture exists, fixation of both locations of instability is recommended. Less invasive fixation techniques like anterior external fixation, anterior internal fixation, and retrograde transpubic screw fixation are also available for anterior pelvic ring fractures. In highly unstable FFP, a combination of fixation methods for the posterior pelvic ring and plate and screws osteosynthesis of the anterior pelvic ring provide the highest stability. There is little evidence about the outcome of patients with FFP at present. More clinical and biomechanical work is needed to shed light on the specific challenges and optimal management of patients with FFP.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6394185/ #!po=21.7742

12/02/2023

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6394185/

Fragility fractures of the pelvis (FFP) are an entity with an increasing frequency. The characteristics of these fractures are different from pelvic ring fractures in younger adults. There is a low energy instead of a high energy trauma mechanism. Due ...

08/02/2023

Hot topics discussed in today's weekly scientific round, that,we could clarify throughout the week
1-Drains in TKR
2- Criteria of a good Trochanteric Flip osteotomy
3- Indications for acute THR after acetabular trauma
4- an interesting case of neglected Malreduced vertical shear fracture pelvis Revised by our department
5- Role of fixation in Geriatric Pelvic fractures

07/02/2023

Posterior column/wall tips and tricks by Professor Dr.F**d Zamel

07/02/2023

Welcome to our page through which we can keep in contact with educational videos , interesting cases and continuous medical education could be acheived together with weekly scientific activities and conferences and any scientific updates will be delivered through this channel.
Opening discussion for hot topics and cases will be carried on later.
We are pleased for your share in our page, hoping each one can get maximum benefit especially those who are interested in pelvis, acetabulum or arthroplasty