Topics

orthoplastic approach

Negative Pressure Wound Therapy (NPWT)

A wound management technique applying controlled negative pressure via a sealed dressing system Promotes wound healing by: Removing exudate Reducing oedema Improving local perfusion Commonly used as a temporary bridge in orthoplastic management

Updated: Today
orthoplastic approach

Open Tibia Fractures – Orthoplastic Approach

Open fracture of the tibial shaft with associated soft tissue disruption Characterised by bone exposure and contamination Requires combined orthopaedic stabilisation + plastic surgical soft tissue management

Updated: Today
orthoplastic approach

Infection and Biofilm in Orthoplastic Surgery

Infection in orthoplastic surgery refers to microbial colonisation of bone, soft tissue, or implants, often complicated by biofilm formation, which makes bacteria resistant to antibiotics and host immunity.

Updated: Today
orthoplastic approach

Debridement Principles

Surgical removal of devitalised, contaminated, and non-viable tissue The most critical step in managing open fractures and complex limb injur

Updated: Today
orthoplastic approach

Bone Defect Management (Masquelet vs Bone Transport)

Management of segmental bone defects resulting from: Trauma Infection Tumour resection Requires restoration of: Mechanical stability Biological environment

Updated: Today
hand

Brachial Plexus Injuries and Current Surgical Approaches

Updated: Today
deformity limb-lengthening

Elbow Deformity Correction

Surgical or non-surgical management of angular, rotational, or combined deformities around the elbow Most commonly involves: Distal humerus deformities (supracondylar malunion)

Updated: Today
pediatrics

Cavovarus Foot in Pediatrics

Pes cavus is defined as an abnormal elevation of the medial longitudinal arch that maintains its shape and does not flatten with weight-bearing. It is a complex deformity typically consisting of forefoot equinus, hindfoot varus, and adduction of the forefoot. The condition is often a manifestation of an underlying progressive neurological disorder.

Updated: Today
trauma

Talus Fracture

Updated: Yesterday
trauma

Tibial Shaft Fractures

Updated: Yesterday
trauma

Proximal Humerus Fractures

Updated: Yesterday
trauma

HUMERAL SHAFT FRACTURES

Updated: Yesterday
trauma

SUBTROCHANTERIC FEMUR FRACTURES

Updated: Yesterday
trauma

INTERTROCHANTERIC FRACTURES

Updated: Yesterday
trauma

FEMORAL NECK FRACTURES

Updated: Yesterday
trauma

FEMORAL HEAD FRACTURES

Updated: Yesterday
trauma

Damage Control Orthopaedics (DCO)

DCO-Early Total Care (ETC)
Updated: Yesterday
shoulder elbow

Throwing Athlete Injuries

Updated: Yesterday
shoulder elbow

Distal Biceps Rupture

Updated: Yesterday
shoulder elbow

Distal Triceps Rupture

• Rarest major tendon rupture — <1% of all tendon injuries; most common in males aged 30–50 • Mechanism: eccentric load on a contracting triceps (FOOSH, fall on elbow, direct blow) • Insertion at the olecranon tip — bony avulsion is the most common pattern (~75%) • Strong association with systemic risk factors: anabolic steroids, chronic renal failure, hyperparathyroidism, fluoroquinolone use • Clinical diagnosis: palpable gap at olecranon tip + weak or absent active elbow extension • Thompson squeeze test: squeeze triceps belly — elbow should extend; no extension = complete rupture • Complete rupture → surgical repair; partial rupture (<50%) → non-operative if extension is maintained • Repair within 2–3 weeks strongly recommended — chronic tears require tendon reconstruction

Updated: Yesterday
shoulder elbow

SHOULDER ANATOMY

Updated: Yesterday
shoulder elbow

Monteggia Fractures

Updated: Yesterday
shoulder elbow

Olecranon Fractures

Updated: Yesterday
spine

Endoscopic Spine Surgery (ESS)

Updated: 2 days ago
shoulder elbow

Elbow Stiffness

Updated: 2 days ago
shoulder elbow

Radial Head Fractures

Fractures of the radial head, most commonly resulting from a fall on an outstretched hand (FOOSH) Frequently associated with elbow instability injuries

Updated: 2 days ago
shoulder elbow

Rotator Cuff Tears

Updated: 2 days ago
shoulder elbow

ELBOW ANATOMY

Updated: 2 days ago
shoulder elbow

Acromioclavicular (AC) Joint Injury

Updated: 2 days ago
shoulder elbow

Coronoid & Terrible Triad Injuries / Ligament Injuries (UCL, LCL)

Updated: 2 days ago
shoulder elbow

Shoulder and Elbow Imaging

Updated: 2 days ago
shoulder elbow

Elbow Physical Examination

Updated: 2 days ago
shoulder elbow

Shoulder Physical Examination

Updated: 2 days ago
foot ankle

Vascular Anatomy of the Ankle

Updated: 3 days ago
foot ankle

Muscular Anatomy of the Lower Leg and Foot

Updated: 3 days ago
foot ankle

Foot and Ankle Ligament Anatomy and Clinical Relevance

Updated: 3 days ago
foot ankle

Osseous Anatomy of Foot and Ankle and Its Clinical Relevance

Updated: 3 days ago
foot ankle

Ankle Fractures

Updated: 3 days ago
foot ankle

Foot Puncture Wounds

Updated: 3 days ago
foot ankle

⁠Anatomy, Biomechanics, and Clinical Significance of the Plantar Fascia    

Updated: 3 days ago
foot ankle

Neuroanatomy of the Foot and the Ankle

Updated: 3 days ago
foot ankle

Talus Fractures

Updated: 3 days ago
trauma

Acetabular Fractures

Updated: 3 days ago
trauma

Pelvic Ring Injuries

Updated: 3 days ago
foot ankle

Diabetic Foot Disease

Updated: 3 days ago
foot ankle

Plantar Fasciitis and Heel Pain

Updated: 3 days ago
foot ankle

Achilles Tendinopathy (Insertional and Non-Insertional)

Updated: 3 days ago
foot ankle

Ankle Arthrosis (Tibiotalar Osteoarthritis)

Updated: 3 days ago
foot ankle

Hallucal Sesamoid Disorders

Updated: 3 days ago
foot ankle

Lisfranc Injuries

Updated: 3 days ago
foot ankle

Orthotics & Supportive Devices Biomechanical Role in Deformity Correction

Updated: 3 days ago
foot ankle

Gait Analysis

Updated: 3 days ago
foot ankle

Radiographic Evaluation of the Foot & Ankle

Updated: 3 days ago
foot ankle

Morton’s Neuroma

Updated: 3 days ago
foot ankle

Tarsal Tunnel Syndrome (TTS)

Updated: 3 days ago
foot ankle

Deep Peroneal Nerve (DPN) Entrapment

Updated: 3 days ago
foot ankle

Leg Nerve Entrapment Syndromes

by Alparslan Uzun

Updated: 3 days ago
foot ankle

Acquired Spastic Equinovarus Deformity

by Alparslan Uzun

Updated: 3 days ago
musculoskeletal oncology

3D Printed Implant Solutions in Pelvic Resections

3dpelvic tumorspsi
Updated: 4 days ago
trauma

TIBIAL PLATEAU FRACTURES

Updated: 4 days ago
trauma

SCAPHOID FRACTURES

Updated: 4 days ago
trauma

OPEN FRACTURES

by Abdullah Tatlı

Updated: 4 days ago
trauma

CRUSH SYNDROME

Updated: 4 days ago
trauma

Forearm Fractures (Diaphyseal Radius and Ulna)

Updated: 4 days ago
trauma

Calcaneal Fractures

Updated: 4 days ago
trauma

ANKLE FRACTURE

Updated: 4 days ago
trauma

Acute compartment syndrome

Updated: 4 days ago
foot ankle

Poliomyelitis

Updated: 5 days ago
spine

Thoracic Spine Fractures

Updated: 5 days ago
spine

Cervical Facet Dislocations

Updated: 5 days ago
spine

Adult Pyogenic Vertebral Osteomyelitis

Updated: 5 days ago
spine

Neuromuscular Scoliosis

Spinal deformity occurring in patients with underlying neuromuscular disorders Characterised by: Progressive coronal curvature Associated pelvic obliquity Results from muscle imbalance, weakness, or paralysis

Updated: 6 days ago
spine

Pediatric Spondylolysis and Spondylolisthesis

Spondylolysis: Defect or stress fracture of the pars interarticularis Spondylolisthesis: Forward translation of a vertebra due to bilateral pars defect Most commonly occurs at L5–S1

Updated: 6 days ago
pediatrics

Cerebral Palsy

Updated: 6 days ago
pediatrics

Osteogenesis Imperfecta

Updated: 6 days ago
pediatrics

Tarsal Coalition

Updated: 6 days ago
pediatrics

Infatile Tibia Vara (Blount’s Disease)

Acquired growth disorder of the proximal medial tibial physis Leads to progressive genu varum

Updated: 6 days ago
foot ankle

DIABETIC NEUROPATHY AND CHARCOT NEUROARTHROPATHY

Updated: 6 days ago
foot ankle

OSTEOCHONDRAL LESIONS OF THE TALUS (OLT)

Updated: 6 days ago
foot ankle

Achilles Tendon Rupture

Updated: 6 days ago
foot ankle

Phalangeal Fractures

(Toe Fractures, Intra-articular Involvement)

Updated: 6 days ago
foot ankle

Metatarsal Fractures

Other then metatars base fractures

Updated: 6 days ago
foot ankle

Fifth Metatarsal Base Fractures

Updated: 6 days ago
foot ankle

Low Ankle Sprains (Lateral Ankle Ligament Injuries)

Updated: 6 days ago
foot ankle

High Ankle Sprains -(Syndesmosis Injuries)

Updated: 6 days ago
foot ankle

PILON FRACTURES (TIBIAL PLAFOND FRACTURES)

Updated: 6 days ago
foot ankle

Functional Anatomy: Muscle Forces and Foot Deformities

Updated: 6 days ago
foot ankle

Pes Cavus

Updated: 6 days ago
orthoplastic approach

Limb Salvage vs Amputation

Decision-making process between attempting to preserve a severely injured limb or proceeding with primary amputation

Updated: 1 weeks ago
orthoplastic approach

Flap Selection

Selection of appropriate soft tissue coverage technique for defects involving: Skin Muscle Bone (exposed structures) Goal: Provide durable, well-vascularised coverage to support healing and prevent infection

Updated: 1 weeks ago
orthoplastic approach

Timing of Soft Tissue Coverage

Refers to the optimal timing of definitive soft tissue reconstruction (flap or graft) after trauma A key determinant of outcomes in open fractures and complex limb injuri

Updated: 1 weeks ago
orthoplastic approach

Fix and Flap Principle

Combined approach involving: Early skeletal stabilisation (fixation) Early soft tissue coverage (flap) Typically performed in a single stage or closely timed stages Core concept in orthoplastic management of open fractures

Updated: 1 weeks ago
orthoplastic approach

Flap Selection for Tibial Defects

Soft tissue reconstruction in open tibial fractures is primarily guided by the location of the defect, the size of the defect, and the condition of surrounding tissues.

Updated: 1 weeks ago
basic science

Orthoses

Purpose: Support function, control deformity, reduce pain Types: Static: Stabilize joint Dynamic: Facilitate movement Design principles: Simplicity, lightness, durability, aesthetics; consider rigidity/flexibility and tissue tolerance

orthoses-
Updated: 1 weeks ago
basic science

Biomaterials

Biomaterials are synthetic substances, derived from organic or inorganic components, designed to interact with biological systems. Their properties are determined by their structure (elemental composition, atomic bonding, crystalline configuration) and their processing methods (casting, forging, extrusion, sintering, etc.).

biomaterials-metal-ceramic-composite
Updated: 1 weeks ago
basic science

Bone Grafts, BMP, and Bone Substitutes

Bone GraftsBMPBone Substitutes
Updated: 1 weeks ago
basic science

Clinical Research, Statistical Concepts, and Tests

statistics-clinicalresearch-tests
Updated: 1 weeks ago
pediatrics

Supracondylar Fracture - Pediatric

Updated: 1 weeks ago
basic science

Anticoagulants

anticoagulant-heparin-DVT
Updated: 1 weeks ago
basic science

Musculoskeletal Infections and Microbiology

infection-musculoskeletal-microbiology
Updated: 1 weeks ago
basic science

Cellular and Molecular Biology, Immunology and Genetics Terminology

Updated: 1 weeks ago
pediatrics

Pediatric Diaphyseal Both-Bone Forearm Fractures

Updated: 1 weeks ago
basic science

Biomechanics

kinematics -
Updated: 1 weeks ago
basic science

Articular Cartilage: Structure, Components, and Clinical Relevance

Spot Knowledge – Articular Cartilage Composition: 95% ECM (water, collagen, proteoglycans), 5% chondrocytes Water: 65–80%, enables load-bearing, nutrient transport Collagen: >50% dry weight, mainly type II (90–95%); tensile strength Proteoglycans: 10–15% dry weight; aggrecan + GAGs provide compressive resilience Zones: Superficial (parallel collagen, friction reduction) Transitional (irregular, load distribution) Deep (vertical, compressive strength) Calcified (anchors to bone) Functions: Low-friction motion, load distribution, joint stability, resistance to forces Clinical relevance: Limited healing (avascular) Water/collagen/PG imbalance → osteoarthritis Collagen II & X defects → chondrodysplasias PG loss → elasticity ↓, cartilage breakdown

extracellular matrix - Chondrocyte
Updated: 1 weeks ago
basic science

Peripheral Nerve Structure and Function

myelinaxon
Updated: 1 weeks ago
spine

Adult Isthmic Spondylolisthesis

Updated: 1 weeks ago
spine

Timing of Surgery

Updated: 1 weeks ago
spine

Pediatric Spine Trauma

Updated: 1 weeks ago
spine

Vertebral Compression Fractures (VCFs)

Updated: 1 weeks ago
musculoskeletal oncology

Myths and Misconceptions

Evidence-based clarification of common myths in orthopaedic oncology, highlighting diagnostic pitfalls, biopsy planning, and surgical decision-making principles.

benignbiopsymetastase
Updated: 1 weeks ago
basic science

Articular Cartilage

cartilagecollagenchondrocytes
Updated: 1 weeks ago
basic science

Skeletal Muscle

musclesarcomere
Updated: 1 weeks ago
spine

Lumbar Spine Fractures

Updated: 1 weeks ago
basic science

Bone and Joint Biology

bone-biomechanics-musculoskeletal-biology
Updated: 1 weeks ago
pediatrics

Pediatric Tibia Eminence and Tubercle Fractures

Pediatric tibial eminence (spine) fractures and tibial tubercle fractures are two distinct injury patterns in growing knees. They differ in mechanism, age groups, treatment approach, and complications. Understanding classification, imaging, surgical indications, and outcomes is crucial for optimal care.

eminence-tubercle-acl
Updated: 1 weeks ago
pediatrics

Pediatric Proximal Humerus Fractures

Updated: 1 weeks ago
pediatrics

Pediatric Tibial Diaphyseal Fractures

tibia shaft
Updated: 1 weeks ago
pediatrics

Pediatric Pelvis Fractures

pelvis-acetabulum-torode-zieg-watts
Updated: 1 weeks ago
pediatrics

Peditric Femoral Shaft Fractures

femur diaphysis
Updated: 1 weeks ago
pediatrics

Pediatric Abuse

This article provides a clinical overview of Non-Accidental Trauma (NAT), commonly referred to as orthopedic child abuse. Recognizing these patterns is critical for healthcare providers, as orthopedic injuries are the second most common presentation of child abuse after skin lesions. Child abuse is the second most common cause of death among children. Children under one year of age are reportedly the most frequently abused age group. Treatment requires reporting the abuse to the relevant authorities and hospitalisation for a multidisciplinary evaluation. Occasionally, surgical treatment of fractures may be necessary.

Updated: 1 weeks ago
pediatrics

Pediatric Lateral Humeral Condyle / Epicondyle Fractures

Updated: 1 weeks ago
pediatrics

Pediatric Medial Epicondyle Fractures

Updated: 1 weeks ago
pediatrics

Pediatric Proximal Femoral Fractures

Updated: 1 weeks ago
pediatrics

Pediatric Radial Head and Neck Fractures

Updated: 1 weeks ago
pediatrics

Septic Arthritis

Septic arthritis can be defined as the infection of the joint space. The incidence is higher in the first years of life. It can be diagnosed with history, physical examination, laboratory studies and imaging. It is an acute surgical emergency and it needs to be diagnosed and treated rapidly.

Updated: 1 weeks ago
spine

Occipitocervical Injuries

Updated: 1 weeks ago
spine

Chance Fractures (Flexion-Distraction Injuries)

Posterior Ligamentous Complex disruption-Chance Fractures
Updated: 1 weeks ago
spine

Lumbar Spinal Stenosis

Updated: 1 weeks ago
spine

Spinal Cord Monitoring

Spinal cord monitoring is an essential intraoperative tool used to prevent neurological injury during spinal surgery. The main modalities include somatosensory evoked potentials (SEP) for dorsal column function, motor evoked potentials (MEP) for corticospinal tracts, and electromyography (EMG) for nerve root integrity. SEPs are reliable and anesthetic-resistant but limited to sensory pathways, while MEPs are highly sensitive to anterior spinal ischemia yet affected by anesthesia. EMG, both spontaneous and triggered, helps identify nerve irritation or pedicle screw breaches in real time. A >50% reduction in signal amplitude or latency prolongation indicates potential cord compromise requiring immediate correction. Combined multimodal monitoring significantly improves intraoperative safety and postoperative neurological outcomes.

Updated: 1 weeks ago
spine

Spinal Cord Injury Management

Acute spinal cord injury (SCI) is a devastating condition resulting in high morbidity and long-term disability. Management focuses on rapid diagnosis, spinal immobilization, airway protection, and maintenance of perfusion with a target mean arterial pressure of ≥85–90 mmHg. The pathophysiology involves a primary mechanical insult followed by secondary injury cascades—ischemia, inflammation, and apoptosis—which are key therapeutic targets. High-dose steroids are no longer routinely recommended due to limited benefit and adverse effects. Early surgical decompression, ideally within 24 hours, has been shown to improve neurological outcomes in selected patients (STASCIS trial). Emerging therapies such as neuroprotective agents, stem cell transplantation, and neuroprosthetic technologies are under investigation. A structured multidisciplinary approach combining early stabilization, evidence-based acute care, and long-term rehabilitation remains the cornerstone of SCI management.

Updated: 1 weeks ago
spine

Degenerative Spondylolisthesis

Degenerative spondylolisthesis is the forward or backward slip of one vertebra over another due to facet and disc degeneration, most commonly affecting the L4–L5 level in elderly women. It presents with mechanical back pain, neurogenic claudication, or radiculopathy secondary to spinal stenosis. Standing lateral radiographs confirm diagnosis and grading, while MRI assesses canal and neural compression. Conservative treatment—including physiotherapy, anti-inflammatories, and injections—is first-line for low-grade, stable cases. Surgical decompression with or without fusion is reserved for patients with persistent pain, neurological deficits, or instability, providing superior outcomes compared with nonoperative care.

Updated: 1 weeks ago
spine

Burst Fractures

A spinal burst fracture involves disruption of both the anterior and middle columns of the vertebral body under axial-compression load. Retropulsion of posterior wall fragments into the spinal canal is typical and may cause neurological injury through direct compression or secondary deformity. The thoracolumbar junction (T11–L2) is most often affected because it transitions from rigid thoracic to mobile lumbar segments. Common mechanisms include falls from height and motor-vehicle accidents.

Updated: 1 weeks ago
spine

Subaxial Cervical Spine Fractures

Subaxial cervical spine injuries (C3–C7) are common consequences of high- to moderate-energy trauma, though even low-energy mechanisms can cause significant damage in elderly or ankylosed spines. They result from flexion, extension, compression, or burst mechanisms, most frequently between C5 and C7. Diagnosis begins with ATLS evaluation and cervical immobilization, followed by neurologic assessment and imaging. Standard radiographs (AP, lateral, odontoid) are complemented by CT for fracture detail and MRI for disco-ligamentous complex (DLC) and cord evaluation. Classification systems such as AOSpine, SLIC, and Allen–Ferguson guide management. Stable compression fractures without posterior ligamentous involvement may be managed conservatively using a rigid orthosis, whereas unstable or displaced injuries—especially burst and flexion teardrop fractures—require surgical decompression and fixation. Prognosis depends on the initial neurological deficit, fragment displacement, and timing of surgery; patients with ankylosing spondylitis are at higher risk of neurological deterioration and often need long-segment stabilization.

Updated: 1 weeks ago
spine

Spine Trauma Classifications

Early systems such as Denis’ three-column model and Allen–Ferguson’s mechanism-based classification emphasized anatomical and mechanical concepts of instability. Over time, modern systems evolved to integrate neurological evaluation and clinical relevance, resulting in improved surgical decision-making. For cervical injuries, multiple region-specific classifications exist — including Anderson–Montesano for occipital condyle fractures, Traynelis for occipito–atlantal dislocation, Fielding–Hawkins for atlantoaxial rotatory fixation, and Anderson–D’Alonzo for odontoid fractures. In the thoracolumbar region, progression from Holdsworth’s two-column theory to Denis’ three-column model, followed by Magerl’s AO classification, established the foundation for contemporary systems. The Thoracolumbar Injury Classification and Severity Score (TLICS) and its evolution — the AO Spine Thoracolumbar Classification (AO TLS) — combine morphology, neurological status, and modifiers, guiding evidence-based operative versus nonoperative management.

Updated: 1 weeks ago
spine

Neurologic Assessment

Concise clinical guide covering motor, sensory, and reflex examination of spinal segments, with key diagnostic patterns, special tests, and upper vs. lower motor neuron distinctions.

Updated: 1 weeks ago
spine

Spinal Stability Principles

Updated: 1 weeks ago
knee sports

Osgood-Schlatter Disease

Osgood-Schlatter Disease-pediatric knee
Updated: 1 weeks ago
knee sports

Spontaneous Osteonecrosis of the Knee (SONK)

sonk
Updated: 1 weeks ago
knee sports

Overuse Injuries of the Knee

Patellar Tendinitis-Iliotibial Band Friction Syndrome (ITBFS)-Prepatellar bursitis-Quadriceps Tendonitis

Patellar Tendinitis-Iliotibial Band Friction Syndrome (ITBFS)-Prepatellar bursitis-Quadriceps Tendonitis
Updated: 1 weeks ago
knee sports

Anterior Cruciate Ligament Tear

Updated: 1 weeks ago
knee sports

Knee Dislocation

dislocation
Updated: 1 weeks ago
knee sports

Posteromedial Corner (PMC) Injuries of the Knee

pmc-posteromedial corner-medial menisci-meniscus tear
Updated: 1 weeks ago
knee sports

Posterolateral Corner Injury

posterolateral corner- pcl- lateral mensicus
Updated: 1 weeks ago
knee sports

Medial Colletaral Ligament(MCL) Injury of the Knee

Updated: 1 weeks ago
knee sports

 Patellar and Trochlear Osteochondritis Dissecans

Updated: 1 weeks ago
knee sports

Sinding-Larsen-Johansson Syndrome

Updated: 1 weeks ago
knee sports

Patellofemoral Instability

Updated: 1 weeks ago
knee sports

Extensor Mechanism Ruptures

Updated: 1 weeks ago
musculoskeletal oncology

Basic Tumor Biology

Musculoskeletal tumours are diverse, historically classified by morphology and histology. WHO classification is the gold standard.

molecular biology - cytogenetics - genom
Updated: 2 weeks ago
spine

Anatomy & Biomechanics

The human spine is a complex, segmented column providing both mobility and stability for the body. It consists of 33 vertebrae: 7 cervical, 12 thoracic, 5 lumbar, 5 fused sacral, and 4 fused coccygeal segments. These vertebrae are interconnected through discs, ligaments, and muscles, forming a biomechanically dynamic structure that supports axial load, enables movement, and protects the spinal cord. Each vertebra comprises a vertebral body and a posterior arch. The body, primarily cancellous bone, functions as the main weight-bearing element. The posterior arch, composed mainly of cortical bone, includes pedicles, laminae, and spinous and transverse processes, which provide attachment points for ligaments and muscles. Between adjacent vertebral bodies lie the intervertebral discs, acting as flexible cushions that absorb compressive forces while allowing controlled motion.

Updated: 2 weeks ago
basic science

Imaging in Orthopaedics

Updated: 2 weeks ago
arthroplasty

Myths and Misconceptions in Arthroplasty

Despite rapid advances in implant design, navigation, and perioperative protocols, arthroplasty surgery remains surrounded by persistent misconceptions — many of which influence both surgeon behavior and patient expectations. Understanding and debunking these myths is essential for evidence-based orthopaedic care.

Updated: 2 weeks ago
arthroplasty

Robotic Assisted UKA

Robotic unicompartmental knee arthroplasty (R-UKA) is an evolution of traditional unicompartmental knee replacement, developed to improve component accuracy, reduce outliers, and enhance short-term recovery. It is indicated for isolated medial or lateral compartment osteoarthritis (Kellgren–Lawrence grade IV) when the remaining compartments are intact. Approximately 20% of knee OA cases are unicompartmental — most involve the medial side.

Updated: 2 weeks ago
arthroplasty

Patellofemoral Arthroplasty

Updated: 2 weeks ago
arthroplasty

Ligament Balancing in TKA

• The basic aim is to get both extension and flexion gaps rectangular, equal and balanced. This balanced tension is important for implant stability and long-term survival. • Two popular knee replacement techniques currently practiced are: “measured resection” which depends on tibial and femoral bone cuts through resection guide and “balanced resection” which depends on optimising ligament tensioning. Both affect ligament balancing during the operation. • A stepwise approach for sequential ligament releases, according to the type of deformity, is essential to good outcomes.

Updated: 2 weeks ago
arthroplasty

Revision Knee Arthroplasty

Revision TKA is a complex reconstructive procedure performed to address implant failure due to infection, aseptic loosening, instability, periprosthetic fracture, or stiffness. Proper diagnosis requires a combination of clinical, radiographic, and laboratory evaluation to identify the cause of failure. Management aims to restore joint stability, mechanical alignment, and bone stock while minimizing complications. Modern evidence supports the use of modular stemmed and constrained implants to improve fixation, with either cemented or press-fit stems achieving comparable alignment outcomes. Prevention of periprosthetic joint infection (PJI) remains crucial, and intraosseous antibiotic prophylaxis provides superior local drug concentrations and lower infection rates compared to traditional intravenous administration.

Updated: 2 weeks ago
arthroplasty

Dislocation & Instability

Despite advances in implant design, surgical technique, and perioperative protocols, instability continues to challenge both surgeons and patients.Hip dislocation remains one of the most feared complications following total hip arthroplasty (THA), associated with higher morbidity, increased healthcare costs, and up to 25% of all revision procedures.

Updated: 2 weeks ago
arthroplasty

Periprosthetic Hip Fractures

Vancouver B2 fractures—those with a loose stem but adequate bone stock—remain the most debated subtype in terms of optimal management, with recent meta-analyses redefining treatment algorithms.Periprosthetic femoral fractures (PPF) represent one of the most challenging complications after total hip arthroplasty (THA). Their incidence is rising sharply worldwide, driven by increasing THA volumes, aging populations, and poor bone health, particularly osteoporosis.

periprosthetic- fracture - vancouver
Updated: 2 weeks ago
arthroplasty

Revision Hip Arthroplasty

Revision Total Hip Arthroplasty (rTHA) addresses failure or complications of primary hip arthroplasty, including aseptic loosening, periprosthetic fracture, infection, and instability. As primary THA volumes increase globally, rTHA has become more common. Outcomes depend on etiology, implant selection, and restoration of biomechanics rather than mere component replacements.

Updated: 2 weeks ago
arthroplasty

Periprosthetic Joint Infection (PJI)

Periprosthetic Joint Infection (PJI) is one of the most devastating complications of arthroplasty. Although uncommon (≈1–2%), it is a leading cause of revision surgery and implant failure. Biofilm formation on implant surfaces makes eradication difficult and often necessitates complex surgical management.

Updated: 2 weeks ago
arthroplasty

Preoperative Planning for TKA

Digital templating for TKA assists in predicting implant sizes and alignment, aiming to optimize motion and minimize stiffness or loosening. However, its impact on postoperative function and alignment remains limited.

Updated: 2 weeks ago
arthroplasty

Preoperative Planning for THA

Updated: 2 weeks ago
musculoskeletal oncology

Soft Tissue Sarcomas

A diverse group of malignant tumours arising from mesenchymal tissues, commonly affecting extremities.

Updated: 4 weeks ago
musculoskeletal oncology

Chondrosarcoma

Updated: 4 weeks ago
musculoskeletal oncology

Multiple Myeloma

Multiple Myeloma is a malignant plasma cell disorder that causes bone marrow infiltration, excessive monoclonal protein production, and skeletal destruction through osteoclast activation and osteoblast suppression. It primarily affects older adults and commonly presents with bone pain, anaemia, renal dysfunction, and recurrent infections.

Updated: 4 weeks ago
musculoskeletal oncology

Ewing Sarcoma

Ewing sarcoma is a high-grade malignant small round cell tumor of bone and soft tissue, primarily affecting children and young adults. It represents the second most common primary malignant bone tumor after osteosarcoma. The hallmark of Ewing sarcoma is a chromosomal translocation involving the EWSR1 gene, most commonly t(11;22)(q24;q12), resulting in the EWSR1–FLI1 fusion gene.

Updated: 4 weeks ago
musculoskeletal oncology

Osteosarcoma

High-grade, malignant, osteoid-producing sarcoma of bone. Most common primary bone sarcoma. Arises predominantly in metaphysis of long bones (esp. around the knee).

Updated: 4 weeks ago
musculoskeletal oncology

Giant Cell Tumor (GCT)

GCBT is an aggressive benign bone tumour, classified as intermediate (locally aggressive) in the 2020 WHO classification. Accounts for 5–10% of all primary bone tumours.

Updated: 4 weeks ago
musculoskeletal oncology

Pigmented Villonodular Synovitis

Pigmented Villonodular Synovitis (PVNS), also known as tenosynovial giant cell tumor (diffuse type), is a benign but locally aggressive proliferative disorder of the synovium, tendon sheaths, and bursae. It is characterized by hemosiderin deposition, multinucleated giant cells, and synovial villous nodular overgrowth. Although histologically benign, PVNS can cause significant joint destruction if untreated.

Updated: 4 weeks ago
musculoskeletal oncology

Fibrous Dysplasia

Fibrous dysplasia (FD) is a benign bone disorder characterized by the replacement of normal bone with fibro-osseous tissue, leading to pain, deformity, and fractures. It results from post-zygotic GNAS gene mutations that disrupt osteoblastic differentiation. FD may be monostotic (single bone) or polyostotic, the latter often occurring as part of McCune–Albright syndrome (MAS). Radiologically, it presents with a ground-glass appearance and possible deformities such as the “shepherd’s crook” in the proximal femur. Treatment is primarily symptomatic, involving bisphosphonates for pain control and surgery for deformity or fracture correction. Although benign, the disease may progress during growth and stabilize in adulthood, requiring periodic follow-up for skeletal deformity and functional assessment.

Updated: 4 weeks ago
musculoskeletal oncology

Chondroblastoma

Chondroblastoma is a rare, epiphyseal, benign bone tumor that exhibits locally aggressive behavior. It primarily affects skeletally immature individuals, most commonly males in their second decade of life. Most frequent locations include the distal femur, proximal tibia, proximal humerus, and less commonly the hip or calcaneus.

Updated: 4 weeks ago
musculoskeletal oncology

Non-Ossifying Fibroma (NOF)

Updated: 4 weeks ago
musculoskeletal oncology

Aneurysmal Bone Cyst (ABC)

Updated: 4 weeks ago
musculoskeletal oncology

Unicameral Bone Cyst (UBC)

Unicameral bone cyst (UBC) is a benign, fluid-filled intramedullary lesion typically located in the metaphysis or diaphysis of long bones in children and adolescents. It is usually unilocular and adjacent to the cortex. Pathological fracture is the most common presentation.

Updated: 4 weeks ago
musculoskeletal oncology

Enchondroma

Overview • Enchondroma is a benign hyaline cartilage tumor, accounting for 20-25% of benign bone tumors. • It arises from residual cartilage cells that fail to undergo necrosis after physeal growth. • Can be solitary or multiple (Ollier’s disease, Maffucci syndrome).

Updated: 4 weeks ago
musculoskeletal oncology

What the Pathologist Needs

Updated: 4 weeks ago
musculoskeletal oncology

Osteochondroma

Benign hamartomatous cartilaginous lesions derived from aberrant cartilage through the perichondral ring that may be in the form of solitary or associated with genetic conditions like Multiple Hereditary Exostosis (MHE) · They grow and mature according to typical enchondral ossification and do not occur in bones formed through membranous ossification (skull)

Updated: 4 weeks ago
musculoskeletal oncology

Principles of Surgical Resection & Margins

Tumour resection aims to achieve oncologic control while preserving function; margin status is critical for local recurrence risk.

Updated: Mar 30, 2026
musculoskeletal oncology

Staging Systems (Enneking, AJCC)

Updated: Mar 30, 2026
musculoskeletal oncology

Biopsy Principles

Updated: Mar 30, 2026
musculoskeletal oncology

Imaging Principles

Plain radiography remains the first-line and often diagnostic in most bone tumors, while CT provides detailed cortical and 3D anatomical evaluation. MRI offers superior soft-tissue and marrow contrast, essential for assessing intramedullary extension and surgical margins. PET/CT assist in detecting metastases and evaluating treatment response.

Updated: Mar 30, 2026
musculoskeletal oncology

Soft Tissue Tumor Classification

The WHO introduced the classification of soft tissue and bone tumors (fifth edition) in 2020. The new WHO classification of soft tissue and bone tumors, introduced in 2020 (fifth edition), has made significant improvements in classification and introduced many new diagnoses.

Updated: Mar 30, 2026
musculoskeletal oncology

Bone Tumor Classification

Overview of bone tumour classification systems and key characteristics that distinguish benign from malignant lesions.

Updated: Mar 30, 2026
musculoskeletal oncology

Radiotherapy For Extremity Sarcomas

Updated: Mar 30, 2026
musculoskeletal oncology

Metastatic Bone Disease

Metastatic bone disease (MBD) is the most common malignant condition of the skeleton, often originating from breast, prostate, lung, kidney, or thyroid cancers. Treatment targets fracture prevention, functional maintenance and pain relief.

metastasesarcomareanl cell
Updated: Mar 26, 2026
trauma

Romato

trauma
Updated: Mar 7, 2026