Ebook Basic musculoskeletal imaging: Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook Basic musculoskeletal imaging: Part 2
Ebook Basic musculoskeletal imaging: Part 2
Orthopedic Hardware and ComplicationsReza Dehdari, MDMinal Tapadia, MD, JD, MA10IntroductionJoint Prosthetic ComplicationsJoint ReplacementSpinal Fusi Ebook Basic musculoskeletal imaging: Part 2ionHip ProsthesesSpinal InstrumentationKnee ProsthesesSurgical ApproachesAnkle ProsthesesPostoperative Evaluation and ComplicationsShoulder ProsthesesFracture FixationElbow ProsthesesTechniques in Fracture FixationWrist and Hand prosthesesConclusionINTRODUCTIONInterpretation of postoperative orthope Ebook Basic musculoskeletal imaging: Part 2dic radiographs comprises a significant portion of the practice of not only subspecialized musculoskeletal radiologists but also general radiologists.Ebook Basic musculoskeletal imaging: Part 2
A good foundation and understanding of the most common performed orthopedic procedures is essential for accurate interpretation of postoperative radiOrthopedic Hardware and ComplicationsReza Dehdari, MDMinal Tapadia, MD, JD, MA10IntroductionJoint Prosthetic ComplicationsJoint ReplacementSpinal Fusi Ebook Basic musculoskeletal imaging: Part 2res performed by orthopedic surgeons. In addition, the postoperative evaluation of various orthopedic hardware including the imaging findings for common complications will be discussed.JOINT REPLACEMENTJoint replacement is one of the most common orthopedic procedures performed. Generalized indicatio Ebook Basic musculoskeletal imaging: Part 2ns for joint replacement include severe osteoarthritis, avascular necrosis, trauma, and inflammatory arthropathies such as rheumatoid arthritis. AbsolEbook Basic musculoskeletal imaging: Part 2
ute contraindications for joint replacementinclude active local or systemic infection. Relative contraindications include obesity, remote infection, uOrthopedic Hardware and ComplicationsReza Dehdari, MDMinal Tapadia, MD, JD, MA10IntroductionJoint Prosthetic ComplicationsJoint ReplacementSpinal Fusi Ebook Basic musculoskeletal imaging: Part 2 joint included joint arthrodesis (e.g., joint fusion), osteotomy, nerve division, and joint debridement. Patients were afforded significant improvement in quality of life with the development of joint replacement techniques; however, older joint replacement components often suffered from premature Ebook Basic musculoskeletal imaging: Part 2wear. Recent advances in biomaterials and joint replacement technology have led to marked improvements in the longevity of joint prostheses. OrthopediEbook Basic musculoskeletal imaging: Part 2
c surgeons can now choose between a vast array of prosthetic devices, many based on preference and familiarity. Though it is impossible for the radiolOrthopedic Hardware and ComplicationsReza Dehdari, MDMinal Tapadia, MD, JD, MA10IntroductionJoint Prosthetic ComplicationsJoint ReplacementSpinal Fusi Ebook Basic musculoskeletal imaging: Part 2rent prostheses.The main components of any modern joint arthroplasty include a metal alloy and a plastic polyethylene liner. The low coefficient of friction between the metal alloy component and the polyethylene component simulates movements of212CHAPTER 10normal joints. Alloys represent the metalli Ebook Basic musculoskeletal imaging: Part 2c component of the prostheses. They are combinations of different metals such as chromium-cobalt, chromium-cobalt-titanium, or chromium-cobalt-molybdeEbook Basic musculoskeletal imaging: Part 2
num.' These different alloys have individual biomechanical properties based on their metal composition, and differ in terms of their resistance to strOrthopedic Hardware and ComplicationsReza Dehdari, MDMinal Tapadia, MD, JD, MA10IntroductionJoint Prosthetic ComplicationsJoint ReplacementSpinal Fusi Ebook Basic musculoskeletal imaging: Part 2e the prosthesis, the prosthesis may either be press fit into the bone or cemented to the bone. Polymethylmethacrylate is the most commonly used cement to secure the prosthesis into the medullary cavity of the bone. Cement is seen as a radiopaque lining surrounding the prosthesis. Alternatively, por Ebook Basic musculoskeletal imaging: Part 2ous-coated press-fit cementless prosthesis demonstrate an irregular surface coated with lucent bone growth-stimulating material to ensure adherence toEbook Basic musculoskeletal imaging: Part 2
the surface? Another concept to be familiar with is the resistance of a prosthetic implant to motion, whether in the anteroposterior (AP) direction oOrthopedic Hardware and ComplicationsReza Dehdari, MDMinal Tapadia, MD, JD, MA10IntroductionJoint Prosthetic ComplicationsJoint ReplacementSpinal Fusi Ebook Basic musculoskeletal imaging: Part 2ly one direction. In a nonconstrained prosthesis, it is the muscles, ligaments, and tendons that provide stability with no connection between the two prosthetic parts. This not only provides the greatest possible range of motion but is also most prone to joint subluxation or dislocation. Semiconstra Ebook Basic musculoskeletal imaging: Part 2ined prosthesis allow intermediate motion in a given direction.’The postoperative radiograph evaluation includes at least two radiographic views of thEbook Basic musculoskeletal imaging: Part 2
e prosthesis at right angles to one another (e.g., orthogonal views) in addition to any specific views particular for the joint imaged. For example, aOrthopedic Hardware and ComplicationsReza Dehdari, MDMinal Tapadia, MD, JD, MA10IntroductionJoint Prosthetic ComplicationsJoint ReplacementSpinal Fusi Ebook Basic musculoskeletal imaging: Part 2 the patella. The entire prosthesis and surrounding bone need to be imaged on the examination. The technical factors of the radiograph must allow the examiner to distinguish between metal-bone, metal-cement, and cement-bone interfaces. Other radiologic examinations such as arthrography, ultrasonogra Ebook Basic musculoskeletal imaging: Part 2phy, computed tomography (CT), magnetic resonance imaging, and nuclear scintigraphy also have specific roles in evaluating joint replacement.HIP PROSTEbook Basic musculoskeletal imaging: Part 2
HESESThree types of hip prosthesis exist: unipolar hemiarthroplasty, bipolar hemiarthroplasty, and total hip arthroplasty (Figures 10-1 and 10-2). A uOrthopedic Hardware and ComplicationsReza Dehdari, MDMinal Tapadia, MD, JD, MA10IntroductionJoint Prosthetic ComplicationsJoint ReplacementSpinal Fusi Ebook Basic musculoskeletal imaging: Part 2 either a noncemented or cemented femoral stem with a femoral head that articulates directly with the native acetabulum. This is the least common hip prosthesis and is typically performed in patients with femoral head or femoral neck fractures and decreased life expectancy. A bipolar hip arthroplast Ebook Basic musculoskeletal imaging: Part 2y▲ Figure 10-1. Bipolar prosthesis. AP view of the bipolar right hemiarthroplasty, with separate acetabular cup. Note the radiolucent native articularEbook Basic musculoskeletal imaging: Part 2
cartilage surface.includes a femoral stem with a small diameter femoral head and a separate acetabular cup (Figure 10-1). The outer portion of the acOrthopedic Hardware and ComplicationsReza Dehdari, MDMinal Tapadia, MD, JD, MA10IntroductionJoint Prosthetic ComplicationsJoint ReplacementSpinal Fusi Ebook Basic musculoskeletal imaging: Part 2ar surface is unaltered. This design is most prone to dislocation as motion can occur between both the femoral head and acetabular component and external surface of the acetabular component and the native acetabulum. The total hip arthroplasty is the most common type of performed hip arthroplasty (F Ebook Basic musculoskeletal imaging: Part 2igure 10-2). In a total hip arthroplasty, the articular surface of both the femur and the acetabulum is replaced. These components may either be cemenEbook Basic musculoskeletal imaging: Part 2
ted or noncemented. The metallic acetabular cup includes a radiolucent polyethylene liner that articulates directly with the metallic femoral head.TheOrthopedic Hardware and ComplicationsReza Dehdari, MDMinal Tapadia, MD, JD, MA10IntroductionJoint Prosthetic ComplicationsJoint ReplacementSpinal Fusi Ebook Basic musculoskeletal imaging: Part 2easure the angle of inclination that is optimal at 30-55° (Figure 10-2), and the lateral film is used to measure the angle of anteversion that is optimal around 15°.u The femoral component should beORTHOPEDIC HARDWARE AND COMPLICATIONSI ▲ Figure 10-2. Total hip replacement. AP view of the total hip Ebook Basic musculoskeletal imaging: Part 2arthroplasty, consisting of both the femoral and acetabular components. The polyethylene liner separating the acetabular cup from the femoral head isEbook Basic musculoskeletal imaging: Part 2
radiolucent. The AP view best Illustrates the angle of inclination (normal between 30 and 55s).either parallel to the femoral shaft or in slight valguOrthopedic Hardware and ComplicationsReza Dehdari, MDMinal Tapadia, MD, JD, MA10IntroductionJoint Prosthetic ComplicationsJoint ReplacementSpinal Fusi Ebook Basic musculoskeletal imaging: Part 2 femoral cortex is most often injured. Regardless of the location of the periprosthetic fracture, revision to a longer-stemmed revision prosthesis is often needed. The femoral component should also be symmetric in the center of the acetabular component. Smooth 2 mm or less radiolucent lines at the b Ebook Basic musculoskeletal imaging: Part 2one-cement interface can be normal if not progressive. Subsidence (sinking in of the prosthesis) of less than 2 mm is also within normal limits.’KNEEEbook Basic musculoskeletal imaging: Part 2
PROSĨHESESMost knee replacements are total knee replacements involving resurfacing of the femoral condyle and the tibial plateau (Figure 10-4). Tire pOrthopedic Hardware and ComplicationsReza Dehdari, MDMinal Tapadia, MD, JD, MA10IntroductionJoint Prosthetic ComplicationsJoint ReplacementSpinal Fusi Ebook Basic musculoskeletal imaging: Part 2ip prosthesis. (A) AP radiograph shows significant femoral stem loosening (arrows) and varus alignment of the femoral stem tip. (B) Arthrogram of the hip reveals contrast accumulation in between the bone and cement interface indicating loosening of the prosthesis stem (arrows).214 J Ebook Basic musculoskeletal imaging: Part 2Gọi ngay
Chat zalo
Facebook