CONTENT

During the fourth quarter of 2009, Magnifi Group will launch the Interactive Educational Program (IEP) for Total Joint. Following the model pioneered  by IEP for Spine, IEP for Total Joint delivers the most comprehensive internet-based knowledge source for Total Joint Professionals. The content of the IEP includes  the following sections:

1.       Anatomy

2.       Basic Science

3.       Hip Degenerative Conditions

4.       Knee Degenerative Conditions

5.       Trauma

6.       Tumors

7.       Infection

8.       Inflammatory Conditions

9.       Inherited Disorders

10.    Miscellaneous Conditions

Each condition will include the associated history, diagnosis, work-up, treatment (non-operative and operative) and complications. The Treatments sections will feature industry- specific techniques and products.

Program Sections

The Program will have learning objectives, standardized presentation formats and reliable evaluation methods based on adult learning and education principles. The following is the draft overview of the Hip Degenerative Conditions section.

HIP DEGENERATIVE CONDITIONS

1.       Natural History – etiology                                                          

1.1.     Familial                                                                                               

1.2.     Developmental Dysplasia                                                              

1.3.     Perthes                                                                                               

1.4.     SCFE                                                                                                   

1.5.     Femoroacetabular impingement                                  

2.       Osteonecrosis                                                                                            

2.1.     Post-traumatic                                                                   

2.2.     Atraumatic                                                                                          

2.2.1.  Introduction-incidence, epidemiology, demographics

2.2.2.  Pathophsiology                                                                       

2.2.3.  Pathology                                                                  

2.2.4.  Diagnosis                                                                 

2.2.4.1.    Clinical Evaluation                                     

2.2.4.2.    Radiographic Evaluation                          

2.2.4.3.    Other tests?                                                 

2.2.5.  Staging and Classification                                    

2.2.6.  Treatment Options                                                  

3.       Conservative Management

3.1.     Oral Medications                                                                               

3.2.     Tylenol vs. ASA                                                                  

3.3.     OTC Antinflammatories vs. Prescripton, COX-2 Inhibitors

3.4.     Chondroprotective Agents-Chondroitins                     

3.5.     Analgesics- Narcotics and Others                

3.6.     Activity Modification                                                           

3.7.     Bracing/ Orthotics                                                                             

3.8.     Cane—How it reduces forces                                        

3.9.     Hip Muscle Strengthening                                                              

3.10. Injections—Corticosteroids                                                                            

3.11. Viscosupplementation                                    

4.       Surgical management

4.1.     Hip Arthroscopy                                                                 

4.2.     Head Impingement (open vs. arthroscopy), debulking, etc.

4.3.     Femoral Osteotomy                                                                         

4.4.     Pelvic Osteotomy                                                                              

4.5.     Resection Arthroplasty                                                    

4.6.     Femoral Head replacement 

4.7.     Femoral Head resurfacing

4.8.     Bipolar replacement        

4.9.     Total hip replacement                                                      

4.9.1.  Indications                                                                                

4.9.2.  Pre-operative planning / templating   

4.9.3.  Fixation                                                                      

4.9.4.  Cemented                                                                                

4.9.5.  Cementless                                                                             

4.9.6.  Comparison of Results of Cemented/Cementless Epidemiology  

4.9.7.  Types of Components (Design Issues)

4.9.7.1.     Large head vs. standard                          

4.9.7.2.    Interfaces: MOM, MOP, COM, MOC, COC

4.9.7.3.    Proximally Coated vs. Fully Coated Cementless

4.9.7.4.    Modular vs. Non-Modular Femoral Components

4.9.7.5.    Offset Issues                                                               

4.9.7.6.     Small Stems                                                              

4.9.7.7.      Monoblock Acetabum vs. Modular   

4.9.7.8.     Acetabular Fixation-screw, spikes, pressfit, hemispherical

4.10. Instrumentation

4.10.1.      General retractors, etc.                      

4.10.2.      Special instrumentation—light head sets, curved inserters

5.       Techniques

5.1.     MIS issues         

5.2.     Lateral – traditional  

5.3.     Lateral – Direct            

5.4.     MIS Direct Lateral

5.5.     Posterior – traditional   

5.6.     Posterior – MIS  

5.7.     Anterior   

5.8.     Trochanteric slide             

5.9.     Trans –trochanteric  

5.10. Trans-femoral  

5.11. Component positioning

5.11.1.      Executing the pre-op. plan  

5.11.2.      Femoral goals, landmarks and intraoperative assessment

5.11.3.      Acetabular goals, landmarks and intraoperative assessment

5.11.4.      Intra-operative imaging (fluoroscopy / x-ray) 

5.12. Navigation  

5.13. THR – Special cases

5.13.1.      Girdlestone conversion  

5.13.2.      THR after osteotomy  

5.13.3.      Fusion takedown - Bilateral vs. Unilateral

5.13.4.      High DDH   

5.13.5.      Post Perthes, short neck  

5.13.6.      Paget’s   

5.13.7.      Deformed femur 

5.13.8.      After free fibular graft or other grafting 

5.13.9.      After Fracture

5.13.10.  Following sepsis

5.13.11.  Results—Expected in Standard Populations and in Special Situations 

5.13.12.  Elderly  

5.13.13.  JRA  

5.13.14.  Osteoporosis  

6.       Total hip resurfacing arthroplasty

6.1.     Indications (v. THR)  

6.2.     Pre-op. planning / templating  

6.3.     Getting exposure (v. THR)  

6.4.     Acetabular technical considerations  

6.5.     Femoral technical considerations  

6.6.     Cementing Considerations  

6.7.     Navigation  

6.8.     Anti-Navigation 

6.9.     Special Rehabilitation    

6.10. Failure mechanisms

6.11. Radiographic Evaluation 

6.12. Conversion to THR  

6.13. Expected Results in Various Population subgroups

7.       Post-op. Management

7.1.     In-patient rehab. 

7.2.     Out-patient rehab. 

7.3.     Pilates 

7.4.     Follow-up and post-op. evaluations  

8.       Treatment of complications

8.1.     Skin Tears  

8.2.     Drainage—early, persistent 

8.3.     Hematoma  

8.4.     Post-operative Fever –early vs. late—when and what workup needed  

8.5.     Limb-length Inequality

8.5.1.   Apparent---how to treat 

8.5.2.   True LLI  

8.6.     Dislocation  

8.6.1.  Understanding impingement mechanisms  

8.6.2.  Early 

8.6.3.  Late  

8.6.4.  Recurrent  

8.7.     Nerve / vascular injuries  

8.8.     Peri-prosthetic fractures 

8.9.     Intra-operative—hoop stress calcar or more severe  

8.10. Post-operative

8.10.1.      Classification  

8.10.2.      Treatments

8.10.3.      Femoral 

8.10.4.      Acetabular  

8.10.5.      Acetabular Fracture after THR

8.11. Nerve Injury 

8.12. Vascular Injury

9.       Failed total hip replacement

9.1.     Clinical evaluation  

9.2.     Laboratory evaluation  

9.3.     Wear and osteolysis  

9.4.     Loosening  

9.5.     stem failure 

9.6.     acetabular failure 

9.7.     Heterotopic  Ossification 

9.8.     Recurrent dislocation  

9.9.     Pain without apparent cause 

9.10. Epidemiology/Reasons  

10.    Revision THR

10.1. Pre-op. planning / templating  

10.2. What’s in there?  X-ray collection of implants for I.D.? 

10.3. Defect classification systems 

10.4. Revision after pelvic discontinuity  

10.5. Impaction grafting

10.6. Which exposure?  

10.7. Extended trochanteric osteotomy 

10.8. Implant removal

10.9. Hand tools 

10.10.       High speed / low toque (Midas; Anspach, etc.)  

10.11.       Ultrasound (Oscar; Ultra-drive, etc.) 

10.12.       Single component revision  

10.13.       Liner exchange (+/- bone grafting)  

10.14.       Position and modularity acceptable  

10.15.       Position or modularity unacceptable = cement in liner

10.16.       Revision THR – by defect classification; femoral and acetabular 

10.17.       Implants 

10.18.       Bone grafts / supplements  -- Impaction grafting revision 

10.19.       Metal augments (Tantalum and others) 

10.20.       Allograft-prosthesis composites  

10.21.       Heavy metal – segmental replacements  

10.22.       Girdlestone Arthroplasty; when, why and how 

10.23.       Hip disarticulation  

10.24.       Cage  

10.25.       Cemented femoral revision  

10.26.       Impaction grafting    

10.27.       Complex “shattered” femurs 

10.28.       Acetabular revisions  

10.29.       Proximally fixed modular stems