About This Course
The UCSF Ortho Arthroplasty Core provides educational content related to orthopaedic surgery for arthroplasty specialty.
Requirements
The UCSF Ortho Arthroplasty Core is meant to be an educational resource for orthopaedic trainees. Learners should be practicing surgeons or surgeons in training.
Course Staff
Faculty Contributor:
Dr. Jeff Barry
Knee Examination
Recorded Lecture
Evaluation of a Knee Patient - Dr. Barry
- Additional Readings
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Additional Resources
External Videos
Link to Orthobullets Knee Examination
Link to Vumedi Knee Examination
Hip Examination
- Additional Reading
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Additional Resources
External Videos
Link to Hip Examination
Additional Reading
1. Wilson JJ, Furukawa M. Evaluation of the patient with hip pain. American Family Physician. 2014;89(1):27-37.
Knee Radiographic Evaluation
- Additional Reading
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Additional Resources
External Video
Link to the Examination and Imaging on the Knee and Leg (start at 22 min)
Additional Reading
1. Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Annals of the Rheumatic Diseases. 1957;16:494.
Hip Radiographic Evaluation
- Additional Reading
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Additional Resources
External Video
Link to a Hip Radiographic Examination Geared Towards Scope/FAI
Additional Reading
1. Weber MA, Merle C, Rehnitz C, Gotterbarm T. Modern radiological imaging of osteoarthritis of the hip joint with consideration of predisposing conditions. Rofo. 2016;188(7):635-651. doi: 10.1055/s-0042-104511
Radiographic Severity and Outcome - Natural History
- Additional Reading
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Additional Resources
Additional Readings
1. Keurentjes JC, Fiocco M, So-Osman C, Onstenk R, Koopman-Van Gemert AWMM, Poll RG, Kroon HM, et al. Patients with severe radiographic osteoarthritis have a better prognosis in physical functioning after hip and knee replacement: A cohort study. PLoS ONE. 2013;8(4): 1-8.
2. Leyland KM, Hart DJ, Javaid MK, Judge A, Kiran A, Soni A, et al. The natural history of radiographic knee osteoarthritis: A fourteen-year population-based cohort study. Arthritis and Rheumatism. 2012;64(7):22422251. doi: 10.1002/art.34415
Osteoarthritis and Rheumatoid Basic Science
- Additional Reading
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Additional Resources
External Videos
Link to Osteoarthritis Overview (causes, pathophysiology, investigations, treatment)
Link to Rheumatoid Arthritis Pathophysiology (signs and symptoms)
Hip OA AVN Overview
- Additional Reading
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Additional Resources
External Video
Link to Osteonecrosis of the Hip Stages and Treatment
Additional Reading
1. Murphy NJ, Eyles JP, Hunter DJ. Hip osteoarthritis: Etiopathogenesis and implications for management. Advances in Therapy. 2016;33:1921-1946. doi: 10.1007/s12325-016-0409-3
Nonoperative Hip
- Additional Reading
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Additional Resources
External Videos
Link to Nonop Treatment Hip OA
Link to Ortho AUC for Hip OA
Hip Templating and Importance of Offset
- Additional Reading
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Additional Resources
External Videos
Link to Vumedi Preoperative Planning and Templating in THA
Additional Readings
1. Charles, M.N., Bourne, R., et al., Soft-Tissue Balancing of the Hip. (2004). Journal of Bone & Joint Surgery, 86A(5).
Posterior and Lateral Approaches
- Additional Reading
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Additional Resources
External Videos
Link to Posterior Approach
Link to Lateral Approaches
Anterior Hip
Cemented Hip
- Additional Reading
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Additional Resources
External Videos
Link to Vumedi "The Sexy Cemented Hip"
Link to Vumedi How to Cement a Femur
Additional Reading
Dorr, LD., Faugere, MC., et al. Structural and Cellular Assessment of Bone Quality of Proximal Femur. (1993). Bone, 14 (231-242).
Link to Full-Text
Link to PubMed Scanelli, JA., Reiser, GR., et al. Cemented Femoral Component. (2019). The American Academy of Orthopaedic Surgeons, 27(4).
Adult DDH
- Additional Reading
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External Videos
Link to Vumedi Crowe I/II Hip Pearls
Link to Della Valle Crowe III/IV Hips
Additional Reading
Karachalios, T., Hartofilakidis, G. Congenital Hip Disease in Adults. (2010) The Journal of Bone and Joint Surgery.
Hip-Spine Interactions
External Video
Link to the Effect of Pelvic Mobility on THA
- Additional Reading
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Additional Reading
Buckland, A.J., Miyamoto, R., et al. Differentiating Hip Pathology from Lumbar Spine Pathology: Key Points of Evaluation and Management. (2017). J Am Acad Orthop Surg, 25 (2).
Total Joint Arthroplasty
Periprosthetic Joint Infection - Dr. Ward
Nonoperative Treatment Knee OA
- Additional Reading
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Additional Readings
1. McAlindon TE, Bannurur RR, Sullivan MC, Arden NK, Berenaum F,Bierma-Zeinstra SM, et al. OARSI guidelines for the non-surgical management of knee osteoarthritis. Osetoarthritis and Cartilage. 2014:363-388.
2. Jevsevar DS. Treatment of osteoarthritis of the knee: evidence-based guideline, 2nd edition. Journal of the American Academy of Orthopaedic Surgeons. 2013;21(9):571-576.
TKA Planning
External Video
Link to Vumedi preoperative planning
- Additional Reading
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Additional Reading
1. Tanzer M, Makhdom AM. Preoperative planning in primary Total Knee Arthroplasty. Journal of the American Academy of Orthopaedic Surgeons. 2016;24(4):220-230.
Knee Surgical Anatomy
Gap Balancing vs. Measure Resection
Additional Resources
External Video
Link to Vumedi gap balancing
- Additional Reading
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Additional Reading
1. Sheth NP, Husain A, Nelson CL. Surgical techniques for Total Knee Arthroplasty: Measured resection, gap balancing, and hybrid. Journal of the American Academy of Orthopaedic Surgeons. 2017;25(7):499-508. doi: 10.5435/JAAOS-D-14-00320.
Kinematic Alignment Debate
Balancing Knees
Additional Resources
External Videos
Link to Vumedi Balancing Varus Knee
Link to Vumedi Balancing Valgus Knee
CR and PS TKA
Additional Resources
External Video
Link to Vumedi Balancing the PCL
- Additional Reading
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Additional Reading
1. Jiang C, Liu Z, Wang Y, Bian Y, Feng B, Weng x. Posterior cruciate ligament retention vs posterior stabilization for Total Knee Arthroplasty: A meta-analysis. PLoS One. 2016;11(1):e0147865. doi: 10.1371/journal.pone.0147865.
Partial Knee Replacement
Unicondylar Knee Arthroplasty - Dr. Barry
Total Knee Arthroplasty
Kinematic Alignment - Dr. Bini
Epidemiology and Evaluation
Additional Resources
External Video
Link to Vumedi Evaluation Painful THA
- Additional Reading
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Additional Reading
Gwam, CU., Mistry, JB., et al. Current Epidemiology of Revision Total Hip Arthroplasty in the UnitedStates: National Inpatient Sample 2009 to 2013. (2017). Journal of Arthroplasty.
Revision THA Exposure
Recorded Lecture
Rev THA Core Curriculum 2020
- Additional Resources
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Additional Resources
External Videos
Link to Vumedi THA Exposure and Implant Removal
Additional Reading
Mardones, R., Gonzalez, C., et al. Extended Femoral Osteotomy for Revision of Hip Arthroplasty. (2005). The Journal of Arthroplasty 20(1).
Bone Loss and Loosening Classifications
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Additional Reading
Paprosky, WG., Perona, PG., et al. Acetabular Defect Classification and Surgical Reconstruction in Revision Arthroplasty. (1994). Journal of Arthroplasty, 9(1).
Ibrahim, DA., and Fernando, ND. Classifications in Brief: The Paprosky Classification of Femoral Bone Loss. (2017). Clin Orthop Relat Res, 475:917-921.
Gruen, T.A., McNeice, G.M., et al. Modes of Failure of Cemented Stem-Type Femoral Components. (1978). Clinical Orthopaedics and Related Research.
THA Bone Loss Management
THA Instability
Additional Resources
External Video
Link to Vumedi How to Prevent Dislocation
- Additional Reading
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Additional Reading
Rowan, F.E., Pietrak, J.R. Prevention of Dislocation After Total Hip Arthroplasty. (2018). The Journal of Arthroplasty, 33:1316-1324.
Metal on Metal THA
Additional Resources
External Video
Link to Vumedi ALTR/Trunionosis
- Additional Reading
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Additional Reading
Van Lingen, C.P., Zara, L.M., et al. Sequelae of Large-Head Metal-On-Metal Hip Arthroplasties: Current Status and Future Prospects. (2016). EFFORT Open.
THA Periprosthetic Fractures
Additional Resources
External Video
Link to Vumedi Hip PPx Fx
- Additional Reading
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Additional Reading
Masri, B.A., Meek, R.M.D., Duncan, C.P. Periprosthetic Fractures Evaluation and Treatment. (2003). Clin Orthop, 420.
Epidemiology and Evaluation
Additional Resources
External Video
Link to the Management of Common TKA Complications
- Additional Reading
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Additional Readings
1. Delanois RE, Mistry JB, Gwam CU, Mohamed NS, Choksi US, Mont MA. Current epidemiology of revision total knee arthroplasty in the United States. The Journal of Arthroplasty. 2017;32:2663-2668.
2. Flierl MA, Sobha AH, Culp BM, Baker EA, Sporer SM. Evaluation of the painful Total Knee Arthroplasty. Journal of American Academy of Orthopaedic Surgeons. 2019;27(20):743-751.
Revision TKA Exposures
Recorded Lecture
Total Knee Arthroplasty Revision - Dr. Hansen
- Additional Resources
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Additional Resources
External Videos
TKA Instability
Recorded Lecture
Instability, Stiffness, EM Issues - Dr. Tan
- Additional Resources
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Additional Resources
External Video
Link to Managing Instability
Additional Reading
1. Sheth NP, Bonadio MK. Bone loss in revision Total Knee Arthroscopy: Evaluation and management. Journal of American Association of Orthopaedic Surgeons. 2017;25:347-357.
Arthrofibrosis
- Additional Resources
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Additional Resources
External Video
Link to Management of Arthrofibrosis
Additional Reading
1. Cheuy VA, Foran JRH, Paxton RJ, Bade MJ, Zeni JA, Stevens-Lapsley JE. Antifibrosis associated with Total Knee Arthroplasty. The Journal of Arthroplasty. 2017;32(8):2604-2611.
TKA - Periprosthetic Fracture
- Additional Resources
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Additional Resources
External Video
Link to Total Knee Arthroplasty Periprosthetic Fracture and Distal Femur Fractures
Additional Reading
1. Hart GP, Kneisl JS, Springer BD, Patt JC, Karunakar MA. Open reduction vs distal femoral replacement arthroplasty for comminuted distal femur fractures in the patients 70 years and older. The Journal of Arthroplasty. 2017;32:202.206.
TKA - Extensor Mechanism
- Additional Resources
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Additional Resources
External Videos
Link to Vumedi Extensor Mechanism Deficiency: A Synthetic Mesh Approach
Link to Vumedi Evaluation and Management of Extensor Mechanism Dysfunction
Additional Reading
1. Abdel MP, Salib CG, Mara KC, Pagnano MW, Perry KI, Hanssen AD. Extensor mechanism reconstruction with use of marlex mesh: A series study of 77 Total Knee Arthroplasties. The Journal of Bone and Joint Surgery. 2018;100-A(15):1309-1318.
THA Biomechanics and Basic Principles
PJI Overview
- Additional Resources
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Additional Resources
External Video
Link to Vumedi Overview PJI Treatment
Additional Reading
Parvizi, J., Tan, T.L., et al. The 2018 Definition of Periprosthetic Hip and Knee Infection: An Evidence-Based and Validated Criteria. (2018). Journal of Arthroplasty, 33:1309-1314.
I and D - DAIR - for Acute PJI
- Additional Resources
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Additional Resources
External Videos
Link to Vumedi I&D for Acute Infection
Additional Reading
Chung, A.S., Niesen, M.C., Graber, T.J., et al. Two-stage Debridement with Prosthesis Retention for Actue Periprosthetic Joint Infections. (2019). The Journal of Arthroplasty, 14: 1207-1213.
2 Stage exchange for PJI
- Additional Resources
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Additional Resources
External Video
Link to Vumedi Two Stage Exchange in Chronic PJI
Additional Reading
Petis, S.M., Abdel, M.P., et al. Long-Term Results of a 2-Stage Exchange Protocol forPeriprosthetic Joint Infection Following Total Hip Arthroplasty in 164 Hips. (2019). Journal of Bone and Joint Surgery, 101(1):74-84.
Basic Science of Osteolysis - Wear Particles in THA
Recorded Lecture
Biomaterials, Wear, Osteolysis
- Additional Resources
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Additional Resources
External Videos
Link to Vumedi Wear Particles of THA
Additional Reading
Olivere, B., Wimhurst, J.A., et al.Instructional Review: General Orthopaedics Current Concepts in Osteolysis. (2012).The Journal of Bone and Joint Surgery, 94:10-15.
Acetabular Osteolysis
- Additional Resources
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Additional Resources
External Video
Link to Vumedi When to Keep the Socket
Additional Reading
Narkbunnam, R., Amanatullah, D.F., et al. Outcome of 4 Surgical Treatments for Wear and Osteolysis of Cementless Acetabular Components. (2017). Journal of Arthroplasty, 32: 2799-2805.
Heterotopic Ossification
- Additional Resources
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Additional Resources
Additional Reading
Legosz, P., Otworowski, M., et al. Heterotopic Ossification: A Challenging Complication of Total Hip Arthroplasty: Risk Factors, Diagnosis, Prophylaxis, and Treatment. (2019). BioMed Research International.
TXA - Management of DMARDs
- Additional Resources
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Additional Resources
External Video
Link to Use of Tranexamic Acid
Additional Reading
1. Goodman SM, Springer B, Guyatt G, Abdel MP, Dasa V, George M, et al. 2017 American College of Rheumatology/ American Association of Hip and Knee Surgeons guideline for the perioperative management of anti-rheumatic medication in patients with rheumatic diseases undergoing elective Total Hip or Total Knee Arthroplasty. Arthritis Care and Research. 2017;69(8):1111-1124. doi: 10.1002/acr.23274.
UKA Tips
- Additional Resources
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Additional Resources
External Videos
Link to UKA Tips and Tricks
Link to Medial UKA Techniques
Revision TKA Principles and Workflow
- Additional Resources
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Additional Resources
External Video
Femoral Neck Fractures
- Additional Resources
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Additional Resources
External Video
Link to Femoral Neck Fractures
Additional Readings
1. Lewis DP, Waever D, Thorninger R, Donnelley WJ. Hemiarthroplasty vs Total Hip Arthoplasty for the management of displaced neck of femur fractures: A systematic review and meta-analysis. The Journal of Arthroplasty. 2019;34(8): 1837-1843.
2. Langslet E, Frihagen F, Opland F, Madsen JE, Nordsletten L, Figved W. Cemented vs uncemented hemiarthroplasty for displaced femoral neck fractures: 5-year followup of a randomized trial. Clinical Orthopaedics and Related Research. 2014;472(4):1291-1299. doi:10.1007/s11999-013-3308-9.
Robotics
- Additional Resources
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Additional Resources
External Videos
Link to Pro-Conventional Instruments
Link to Pro-Robot
Additional Reading
1. Lonner JH, Fillingham YA. Pros and cons: A balanced view of robotics in knee arthroplasty. The Journal of Arthroplasty. 2018;33(7):2007-2013. doi: 10.1016/j.arth.2018.03.056.
Preoperative Optimization
- Additional Resources
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Additional Resources
External Video
Link to Vumedi Prevention of Infection: Pre-Operative Patient Optimization
Additional Reading
1. Alamanda VK, Springer BD. Perioperative and modifiable risk factors for Periprosthetic Joint Infections (PJI) and recommended guidelines. Current Reviews in Musculoskeletal Medicine. 2018;11(3):325-331. doi: 10.1007/s12178-018-9494-z.
Outpatient Total Joints
- Additional Resources
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Additional Resources
External Video
Link to Outpatient Total Joint Arthroplasty: Patient Selection and Other Considerations