Orthopedic Principles — A Resident's Guide by David Ip MBBS (HKU), FRCS (Ed) Orth, FHKCOS, FHKAM

By David Ip MBBS (HKU), FRCS (Ed) Orth, FHKCOS, FHKAM (Orthopaedic Surgery), LFIBA (UK) (auth.)

The scope of orthopedic wisdom has extended to one of these measure that it has turn into more and more tough to take care of a basic seize of the necessary wisdom base. this is often compounded by the point constraints on grownup studying, with the scholar or practitioner confronted with ever-increasing calls for on their time. this article is a far wanted source of orthopedic wisdom, for you to end up precious not just to these in education but additionally to these confronted by means of the ever-increasing calls for of certification and recertification examinations. good illustrated and arranged into 8 chapters extending from simple technology to each uniqueness of orthopedic surgical procedure (such as hand, foot and ankle, activities drugs, and backbone) and recommend in define shape, the reader will locate it effortless to find info on a selected topic for direct sufferer care, meetings or rounds, or exam assessment. on the other hand, the association of every bankruptcy enables an total evaluate of the subject material. via advantage of its succinct variety of presentation, this article is going to turn out particularly worthwhile to scholars and practitioners during the world.

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G. 11 Diagnosis and Investigation n Most seen initially on X-ray (including a tunnel view is helpful) n Bone scan ± sensitive in diagnosis and follow-up of OCD lesion in children since indicates blood flow (and hence potential of healing). g. 15 Operative Rn n Arthroscopic drilling and fixation ± Based on the theory that the lesion is regarded as a fracture nonunion, works by penetration of the subchondral bone to initiate inflammatory cascade ± Types: antegrade versus retrograde drilling, an undesirable consequence of antegrade drilling, is the creation of permanent drill holes in the articular surface that fill with fibrocartilage [retrograde drilling with bone graft (BG) sometimes advocated for in situ lesions with intact overlying articular cartilage] ± Fixation of osteochondral lesions increase the likelihood of maintaining joint congruity during healing and potential to allow early range of motion (ROM; by means of K-wires, Herbert, Acutrak) ± important to bury screw head n Abrasion chondroplasty and microfracture ± Again, stimulation of cartilage regeneration by penetration of the subchondral bone to release pluripotential stem cells 36 1 Orthopaedic Basic Science and Commmon Injuries ± Subchondral drilling ± fibrin clot formation ± stem cell migration ± chondrocyte differentiation ± repair the defect ± Histology: fibrous or mixed fibro- and hyaline cartilage.

G. 9 Why Occur at the Classic Location? n Classic location ± lateral aspect of the medial femoral condyle and possible role of trauma/impingement n Why this site? g. 11 Diagnosis and Investigation n Most seen initially on X-ray (including a tunnel view is helpful) n Bone scan ± sensitive in diagnosis and follow-up of OCD lesion in children since indicates blood flow (and hence potential of healing). g. 15 Operative Rn n Arthroscopic drilling and fixation ± Based on the theory that the lesion is regarded as a fracture nonunion, works by penetration of the subchondral bone to initiate inflammatory cascade ± Types: antegrade versus retrograde drilling, an undesirable consequence of antegrade drilling, is the creation of permanent drill holes in the articular surface that fill with fibrocartilage [retrograde drilling with bone graft (BG) sometimes advocated for in situ lesions with intact overlying articular cartilage] ± Fixation of osteochondral lesions increase the likelihood of maintaining joint congruity during healing and potential to allow early range of motion (ROM; by means of K-wires, Herbert, Acutrak) ± important to bury screw head n Abrasion chondroplasty and microfracture ± Again, stimulation of cartilage regeneration by penetration of the subchondral bone to release pluripotential stem cells 36 1 Orthopaedic Basic Science and Commmon Injuries ± Subchondral drilling ± fibrin clot formation ± stem cell migration ± chondrocyte differentiation ± repair the defect ± Histology: fibrous or mixed fibro- and hyaline cartilage.

G. 15 Operative Rn n Arthroscopic drilling and fixation ± Based on the theory that the lesion is regarded as a fracture nonunion, works by penetration of the subchondral bone to initiate inflammatory cascade ± Types: antegrade versus retrograde drilling, an undesirable consequence of antegrade drilling, is the creation of permanent drill holes in the articular surface that fill with fibrocartilage [retrograde drilling with bone graft (BG) sometimes advocated for in situ lesions with intact overlying articular cartilage] ± Fixation of osteochondral lesions increase the likelihood of maintaining joint congruity during healing and potential to allow early range of motion (ROM; by means of K-wires, Herbert, Acutrak) ± important to bury screw head n Abrasion chondroplasty and microfracture ± Again, stimulation of cartilage regeneration by penetration of the subchondral bone to release pluripotential stem cells 36 1 Orthopaedic Basic Science and Commmon Injuries ± Subchondral drilling ± fibrin clot formation ± stem cell migration ± chondrocyte differentiation ± repair the defect ± Histology: fibrous or mixed fibro- and hyaline cartilage.

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