Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast) – Détails, épisodes et analyse

I am going to cover some of the things I consider when approaching Uni's

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This is an important episode because we are all at risk. If you are in trouble or suffering ask for help, get help, seek help and ask for help again. If you see a colleague or friend who is having trouble ask how you can help and be sure to check in with them or seek help from your attending or other supervisors.

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AR is something I am really excited about. Here is my two cents on the future of AR technology in total knees

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Here I discuss some of the things I look for when seeing patients in the office when I am deciding on what treatment options are appropriate.  Weight bearing x-rays are important.  Ask patients to describe their symptoms.  Do not simply ask someone to describe their pain on a scale of one to ten.  Find out how their knee has affected their quality of life.  Lastly, find out what treatment options have been tried and be sure to offer conservative treatment options to the patient before undergoing surgery.

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My name is Adam Rosen.  I am an orthopedic surgeon in Southern California.  I did my residency in Philadelphia and fellowship in La Jolla.  I have been in practice since 2005 performing total knee replacements.  I am part of a teaching fellowship program and I try to share my thought process with our fellows.  I am going to share my thought process here in an attempt to help you and potentially the patients that you care for.

This podcast series is really geared towards orthopedic residents or fellows or the community surgeon looking to pick up a pearl or two about total knee replacements.  I do not believe that my way is the best way or the only way to care for patients with knee arthritis.  I only offer my thoughts, opinions and treatment algorithms in the hopes that it will help you care for your patients.  This is my opinion.  You need to determine how to treat your own patients based on your experience, education and available scientific data.

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I am happy to share my new book THE KNEE BOOK - A GUIDE TO THE AGING KNEE

It was written for patients and it is written to patients in easy to understand language.

The book is a perfect recommendation for patients with knee pain that have questions.

I believe it is also a great resource for residents and young surgeons. In it I review the algorithm for treating patients with knee pain from the most conservative up to knee replacement.

What I think is the best benefit for young surgeons is all of the analogies I use to explain things to my patients. You can pick these up by reading the book so that you can better explain things to your patients.

It is also a great read for non-orthopedic doctors, PA's or NP's. Anyone that treats knee pain patients. It explains why we need weight bearing x-rays and not MRI's and more.

You can download the ebook at Amazon here:
https://www.amazon.com/Knee-Book-Guide-Aging-ebook/dp/B09NLL58LG/ref=tmm_kin_swatch_0?_encoding=UTF8&qid=1639946441&sr=8-2

You can get the paperback here:
https://www.amazon.com/Knee-Book-Guide-Aging/dp/B09NKWMYFN/ref=tmm_pap_swatch_0?_encoding=UTF8&qid=1639946441&sr=8-2

Available at Barnes and Noble as a Nook here:
https://www.barnesandnoble.com/w/the-knee-book-a-guide-to-the-aging-knee-adam-rosen/1140795276?ean=2940161052846

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I still do this every Friday (sooner if it is a complicated revision)
Check the patient, age, BMI, nasal swab, dvt proph. Check the x-rays and make sure the implants are ordered. Review the labs and any clearances that are needed.

Double check everything necessary with the patient the day of surgery.

Make sure the room is set up with everything you need prior to the patient coming into the room.

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Whether you are doing a hemi or total, cementing the femoral component takes some skill. Here I will share with you my tips on how to get a good cement mantle.

A link to the episode on cement grading:

https://www.buzzsprout.com/725061/episodes/7501843

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SSI is the number one reason for unplanned admission after TJA.

Biofilm can form within minutes and be mature within 24 hours. Biofilm contains approximately 80% ECM and 20% bacteria.

Check out this lecture by Next Science that was given at AAOS 2021

https://www.youtube.com/watch?v=5WPZ02t8hEs&list=PL226EPMMG9vYS9F1oDCU9SvOOBIqjJXze&index=6

And this two part series:

https://www.youtube.com/watch?v=cG3iOT4vZlA&list=PL226EPMMG9vYWosH11BTZh1_2g02R-M92&index=7&t=31s

https://www.youtube.com/watch?v=ZDXZFbCEilw&list=PL226EPMMG9vYWosH11BTZh1_2g02R-M92&index=8

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I discussed varus knees previously, here is my two cents on what I look for and how I approach the valgus deformity when performing a TKA

Krackow
I - min valgus
II - deformity > 10 degree, medial soft tissue stretching
III - severe, incompetent medial soft tissues, have constrained/hinge avail

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