Technique over technology, Chief of Arthroplasty @medtrustkochi, Hip section Editor Indian J of Orthop, Fellowship trained hip surgeon
Kerala, India
Joined February 2012
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Percutaneous quilting is a simple but very useful technique in large Morel-Lavalle lesions like these. Addresses the primary pathology.
Mark out the boundary of the lesion first using a suction tip. Then apply sutures using 1 ethilon or similar from periphery to centre. 1/2
In our population, especially women, small acetabular cups are often needed, yet companies typically supply cups from 44 mm upwards.
Tip: Use a 36 mm ball marker for templating. If the fem head looks smaller, arrange bantam cups in advance.
Here,we used a 40 cup with a 22 head.
Looks like the surgery took shorter than signing a consent form. Hope the implant lasted longer than the surgery.
Not sure who awards these certificates.
🤖 Made with AI
Stress fracture versus subchondral insufficiency fracture (SPONK) in tibia.
The first two MR pictures show a stress fracture with an intact meniscus in a runner. Third and fourth pics show typical SIF with a ghost sign in an elderly lady.
Dysplastic hip : When native isnt safe!
DAA THR elsewhere: Antr dislocation 10 days post-op
CT: 40° cup + 40° femoral version,.
Revision through Postr, Exeter stem to reduce version, DM
Approach≠ stability. Component position/ stability checks are still crucial
Bipin Theruvil FRCS (T&O),FRCS (Ed&Glasg),MS AIIMS retweeted
Hello #OrthoTwitter
In this # pattern, how do you determine the PFN entry point when the greater trochanter is fractured at the usual entry site? Or would a plate be a better option in this case?
@traumaticum @InvictaOrtho @Gnomelover1970 @bonesmith_ @centerofhip @sportsdoc2016
70-year-old lady planned for TKR. She sustained a PCL avulsion fracture from a fall around 2 years ago and now presents with a posterior sag.
Would you consider an ultra-congruent insert sufficient in this scenario, or would you prefer a cruciate-sacrificing TKA?
How many of you do hemiarthroplasty in intertroch fractures ? This study includes A1.2 -A3.3 fractures treated with uncemented hemi. 3 reoperations: 1 infection, 2 dislocations in 40 patients
Fix or replace?
Most intertrochanteric femur fractures are managed with open reduction and internal fixation. However, in this study, authors report good outcomes utilizing an uncemented, tapered, fluted cone stem.
Do you trust this technique?
arthroplastytoday.org/articl…
Review of TKA alignment philosophies
🫸 Alignment in TKA exists on a spectrum 🫷
From neutral mechanical alignment to patient-specific kinematic strategies, this review summarizes seven philosophies and what they prioritize.
arthroplastytoday.org/articl…
What is your target? 🎯
@DrPeterSculco @jmaratt @roboticknee
Diagnosis? THR done 14 years ago. Presents with right groin pain for 2 years. X rays are a year apart
What's the problem?
What next?
#orthotwitter
#orthoX
Percutaneous quiliting in a Morel-Lavalle lesion overlying trochanter.
#orthotwitter
#orthoX
Bipin Theruvil FRCS (T&O),FRCS (Ed&Glasg),MS AIIMS retweeted
🧵regarding the Gigli saw:
A simple but effective tool for cutting bone. As usual, we'll go over its design, how to use it, and why such a basic device still exists in the surgical toolbox in 2026.
We'll also cover its history and the tragic fate of Leonardo Gigli.
(1/ )
"this large, randomised trial showed that surgical fixation for displaced medial epicondyle fractures in children offers no clinically meaningful benefit compared with non-surgical care, and resulted in more frequent complications"
Great work @MrDanPerry and team!
This Post is from an account that no longer exists. Learn more
Bipin Theruvil FRCS (T&O),FRCS (Ed&Glasg),MS AIIMS retweeted
Same goal. Different solutions.
Intraoperative wound irrigation practices vary across orthopaedic surgeons. Here’s what the data show:
arthroplastytoday.org/articl…
What do you use? @ParviziJavad @dr_arthroplasty @centerofhip
#ProstheticJointInfection #OrthoTwitter #Surgery
Grade 3A open segmental humerus fx in a 20m
Many of you would treat this with a long straight or a twisted PHILOS
Here I used two implants which makes surgery easier imo.
Thoughts on this construct #orthotwitter?
Who would have used a nail?
