Here I share with some some tips and tricks on what I look for and what I do when caring for the 50 and older patient with knee pain that does not have severe arthritis and does have a meniscus tear. I also share some tips on what to do during boards collections to make sure you have copies of the intra-op photos and how I discuss the surgical findings with my patients in the office. Support the show (https://www.patreon/TotalKneeTips)

Here is my take on the three new broach only collared hip stems Depuy Actis 130 degree neck shaft angle sizes 0-12 high offset 6mm (sizes 0-3) and 8 mm (sizes 4-12) Zimmer Avenier 135 neck shaft angle sizes 0-9 high offset 6mm collared and non-collared options coxa vara neck 126.5 degrees Stryker Insignia 130 degress neck shaft angle sizes 0-11 high offset 5 mm Support the show (https://www.patreon/TotalKneeTips)

LLD is a real issue. Here I will go over a number of things that can cause or lead to a LLD. I will share things I look for and how I talk to patients about LLD and what things you can do at the time of surgery to control for LLD. Support the show (https://www.patreon/TotalKneeTips)

What you are looking for in a fellowship is a personal decision. I covered this topic before but we are in the middle of fellowship applications and most applicants have the same questions. Here I discuss volume, autonomy, approaches, implants, technology, clinic, revisions and finding a job. Support the show (https://www.patreon/TotalKneeTips)

I used nav in 2005 and was looking forward to robotics when they came on the scene. First it was Mako and now Rosa and Velys. Unfortunately, the powers that be have not allowed them in our system yet. I think it is important for residents and fellows to be trained with robots. It is a part of education today. Robotic training will help you land a job. Robotics may help you attract patients. Augmented reality may offer some of the same information because that technology is advancing...

AR is something I am really excited about. Here is my two cents on the future of AR technology in total knees Support the show (https://www.patreon/TotalKneeTips)

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...

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. Support the show (https://www.patreon/TotalKneeTips)

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 Support the show (https://www.patreon/TotalKneeTips)

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...

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 Support the show (https://www.patreon/TotalKneeTips)

I had the chance to sit down for the second time with Dr. Colwell. In this episode we cover teaching fellows, running two rooms, bilateral total joints and more. If you haven't listen to the first episode you can listen here: https://podcasts.apple.com/us/podcast/interview-with-dr-colwell/id1507691532?i=1000536512016 Support the show (https://www.patreon/TotalKneeTips)

Know if it is fixed or correctable Assess the amount of osteophytes Release MCL around to semimembranous Assess PCL if using CR Consider downsizing tibial and removing additional medial bone Further Reading: Master Techniques Knee Arthroplasty - Lotke and Lonner Chapter 7 by Scuderi and Insall Advanced Reconstruction of the Knee AAOS Chapter 27 - Varus Knee - Windsor and Choi JAAOS Article Dr. Mihalko -  http://upload.orthobullets.com/journalclub/free_pdf/19948701_19948701.pdf Support...

I first met Dr. Colwell when I came west to interview for a fellowship at Scripps Clinic. I had the pleasure to sit down and ask him some questions about orthopedics and his career. We talked for an hour and a half and I could have spent all day listening to his stories. We didn't have time to get to every question that I had for him so I hope we can sit down again soon for a second Dr. Colwell interview. Support the show (https://www.patreon/TotalKneeTips)

References: Ng et al. Preoperative Risk Stratification and Risk Reduction for Total Joint Reconstruction. AAOS 2013 Aram et al. Estimating an Individual's Probability of Revision Surgery After Knee Replacement. Am J of Epid 2018 Gronbeck et at. Risk stratification in primary total joint arthroplasty. Arthroplasty Today 2019 Florschutz et al. Estimating patient specific mortality after joint replacement. Osteoarthritis and Cartilage 2019 Ziebma-Davis et al. Outpatient Joint Arthroplasty. J...

I find this topic a more difficult topic to teach than knee balancing. Everything is important to get a stable hip. You need a good approach, pre-op planning, implant positioning and the restoration of length and offset. You need to be aware of balancing and how to address anatomic on anatomic impingement, implant on anatomic and implant on implant impingement. Impingement with total hip replacement by Malik JBJBm 2007 - https://pubmed.ncbi.nlm.nih.gov/17671025/ Support the show...

These two tips can be used when performing a hemiarthroplasty for a hip fracture. You may also consider it even if doing a THA for a fracture or a THA for arthritis in certain patients such as parkinson's disease. Check out my other episode on a more detailed explanation of how I do my posterior approach to the hip. - https://www.buzzsprout.com/725061/episodes/4250591 Support the show (https://www.patreon/TotalKneeTips)

Its good to have an algorithm that works for you when describing an x-ray. Here I will go through my thought process to make sure that you cover everything and not miss things. Support the show (https://www.patreon/TotalKneeTips)

The kinematics of the knee are so complex. You can not overlook the PFJ. We are taught early on about medializing the button and lateralize the femur and make sure your femoral rotation is correct. If not you are taught to do a lateral release. The balancing of the PFJ is so important. Overstuff it and you have pain and limited range of motion.  Too loose and you lose efficiency of the extensor mechanism. Here I will share some tips and my thoughts on what I look for when I do a TKA...

A Comparison of Four Models of Total Knee Replacement Prostheses John Insall, Chitranjan Ranawat, Paolo Aglietti, John Shine JBJS 1976 Support the show (https://www.patreon/TotalKneeTips)