Professional network for orthopaedic surgeons designed to improve orthopaedic education and collaboration. 😷🦴 #orthotwitter
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Here are intraop & postop images of yesterday's case by Dr. Anas Malkawi @AnasMal02356762 and Kreiskrankenhaus Mechernich.
TKA EXTENSOR MECHANISM FAILURE AND LOW-GRADE INFECTION IN 82F
PROCEDURE: DEBRIDEMENT, EXPLANTATION OF THE PROSTHESIS, AND ARTHRODESIS
Here is the link to the clinical presentation and the pre-op imaging: nitter.cf/orthobullets/status/21…
Do you agree with the treatment? Why or why not?
Leave a comment and keep the great conversation going! #orthotwitter
Vote on this case for CME: orthobullets.tiny.us/2p8v5b2…
Here is a new case by Dr. Anas Malkawi @AnasMal02356762 and Kreiskrankenhaus Mechernich.
TKA EXTENSOR MECHANISM FAILURE AND LOW-GRADE INFECTION IN 82F
HPI: An 82-year-old female presents with progressive knee pain, persistent wound drainage, and an inability to perform a straight leg raise three months after revision distal femoral replacement for a periprosthetic distal femur fracture following total knee arthroplasty (TKA), with concomitant tibial tubercle osteotomy. She denies any recent trauma. Joint aspiration revealed Staphylococcus epidermidis susceptible to antibiotics.
PMH: No significant medical comorbidities.
PE: Lower extremity examination reveals a healed incision with a small area of dehiscence at the distal pole and serous drainage without erythema or warmth. Moderate knee effusion is present. The patient is unable to perform a straight leg raise and has tenderness with palpable screws inferior to the patella. Neurovascular status is intact.
How would you manage this #orthotwitter?
Vote on this case for CME: orthobullets.tiny.us/2p8v5b2…
Can you answer our free question of the day?
A 30-year-old male presents with right knee pain. He denies any weakness or paresthesias in his right foot. A radiograph of his knee is shown in Figure A. He undergoes a biopsy, and it shows diffuse multinucleated cells with a background of stromal cells.
Which of the following is the best treatment option given the pathology and location of the lesion?
1. Denosumab therapy
2. Extended curettage
3. Radiofrequency ablation with interventional radiology
4. Observation
5. En-bloc resection of the mass
QID: 220829
Comment your answer below, then check to see if you got it correct by clicking the link below to see the answer & explanation.
bit.ly/3Ulz5nB
#orthopedics #orthopedicsurgeon #orthopaedics #orthopaedic #orthopedic #ortholife #orthobullets #orthoresidents #orthoresident #orthoresidency #medicalschool #medicalstudent #medstudent #doctor
Here’s a clip from our latest episode of CoinFlips & Controversies, “Acute Hip Pain 1 Month s/p Conversion THA in Diabetic 76M.”
Watch Drs. @KevinParkMD and Harper discuss “Synovial Fluid Testing for Periprosthetic Joint Infection.”
Click here to learn more and watch their full webinar on Orthobullets: orthobullets.tiny.us/1029202…
#orthotwitter
Can you answer our free question of the day?
A 4-month-old male with arthrogryposis presents to your clinic with a known right foot deformity since birth. On exam, he has limited ankle range of motion and a prominent talar head. Radiographs taken in the office are shown in Figures A and B.
What is the most appropriate next step to perform for this patient?
1. Educate the parents that this deformity will resolve with time
2. Recommend physical therapy and stretching exercises
3. Obtain a forced plantarflexion radiograph
4. Perform serial casting to correct deformity
5. Surgical release and talonavicular reduction and pinning
QID: 220804
Comment your answer below, then check to see if you got it correct by clicking the link below to see the answer & explanation.
bit.ly/3VQwjat
#orthopedics #orthopedicsurgeon #orthopaedics #orthopaedic #orthopedic #ortholife #orthobullets #orthoresidents #orthoresident #orthoresidency #medicalschool #medicalstudent #medstudent #doctor
Here is a clip from our latest episode of CoinFlips & Controversies, “Reverse Shoulder Arthroplasty Recurrent Instability in 63M” featuring expert faculty from the 2026 New York Shoulder Arthroplasty Conference taking place Dec 11-12th in New York, NY.
Watch Drs. Virk (@ShoulderElboDoc) and Throckmorton (@ThomasThrockmo6), discuss “Closed Reduction Techniques for Reverse Shoulder Dislocation.”
Click here to learn more about NYSAC and watch their full webinar on Orthobullets: orthobullets.tiny.us/102826v…
#orthotwitter
Here is a new case by Dr. Anas Malkawi @AnasMal02356762 and Kreiskrankenhaus Mechernich.
TKA EXTENSOR MECHANISM FAILURE AND LOW-GRADE INFECTION IN 82F
HPI: An 82-year-old female presents with progressive knee pain, persistent wound drainage, and an inability to perform a straight leg raise three months after revision distal femoral replacement for a periprosthetic distal femur fracture following total knee arthroplasty (TKA), with concomitant tibial tubercle osteotomy. She denies any recent trauma. Joint aspiration revealed Staphylococcus epidermidis susceptible to antibiotics.
PMH: No significant medical comorbidities.
PE: Lower extremity examination reveals a healed incision with a small area of dehiscence at the distal pole and serous drainage without erythema or warmth. Moderate knee effusion is present. The patient is unable to perform a straight leg raise and has tenderness with palpable screws inferior to the patella. Neurovascular status is intact.
How would you manage this #orthotwitter?
Vote on this case for CME: orthobullets.tiny.us/2p8v5b2…
Can you answer our free question of the day?
A 58-year-old woman is treated with a lateral locked plate after sustaining an intra-articular distal femur fracture. Unfortunately, she presents to the clinic with pain, progressive deformity, and radiographs as shown in Figure A. She is taken for revision of fixation without bone grafting and achieves union at six months postoperatively, as shown in Figure B.
Which property of the initial treatment construct most likely led to her nonunion?
1. High strength
2. High stiffness
3. Long working length
4. Poor vascularity
5. Plate thickness
QID: 220574
Comment your answer below, then check to see if you got it correct by clicking the link below to see the answer & explanation.
bit.ly/3WrtBIt
#orthopedics #orthopedicsurgeon #orthopaedics #orthopaedic #orthopedic #ortholife #orthobullets #orthoresidents #orthoresident #orthoresidency #medicalschool #medicalstudent #medstudent #doctor
Here is a clip from our latest episode of CoinFlips & Controversies, “Reverse Shoulder Arthroplasty Recurrent Instability in 63M” featuring expert faculty from the 2026 New York Shoulder Arthroplasty Conference taking place Dec 11-12th in New York, NY.
Watch Drs. Virk (@ShoulderElboDoc) and Fu, discuss “CT-Based Planning for Revision Shoulder Arthroplasty.”
Click here to learn more about NYSAC and watch their full webinar on Orthobullets: orthobullets.tiny.us/1027202…
#orthotwitter
Can you answer our free question of the day?
A 28-year-old female patient undergoes an arthrodesis procedure for the pathology shown in Figure A after failed nonoperative management. During the surgery, the surgeon attempts to correct the deformity. During postoperative examination, the patient is noted to have a motor deficit.
Which of the structures shown in Figure B was likely injured with the reduction attempt?
1. A
2. B
3. C
4. D
5. E
QID: 220540
Comment your answer below, then check to see if you got it correct by clicking the link below to see the answer & explanation.
bit.ly/4skAdEx
#orthopedics #orthopedicsurgeon #orthopaedics #orthopaedic #orthopedic #ortholife #orthobullets #orthoresidents #orthoresident #orthoresidency #medicalschool #medicalstudent #medstudent #doctor
Here is a clip from our latest episode of CoinFlips & Controversies, “Reverse Shoulder Arthroplasty Recurrent Instability in 63M” featuring expert faculty from the 2026 New York Shoulder Arthroplasty Conference taking place Dec 11-12th in New York, NY.
Watch Drs. Virk (@ShoulderElboDoc) and Brolin, discuss “EMG Evaluation for Recurrent Shoulder Instability.”
Click here to learn more about NYSAC and watch their full webinar on Orthobullets: orthobullets.tiny.us/1026202…
#orthotwitter
Can you answer our free question of the day?
A 5-year-old male is transferred to the emergency department overnight following the injury shown in Figures A and B after falling off a trampoline earlier this evening. Upon initial presentation, the injury is closed. He notes mild paresthesias, and his radial pulse is palpable with a warm and well perfused hand. He is splinted in a position of comfort overnight in anticipation of surgical fixation in the morning.
Of the following overnight scenarios, which would prompt emergent surgical intervention in this child?
1. Well perfused hand with mild improvement in strength of radial pulse
2. Persistent paresthesias in the radial nerve distribution with grossly intact sensation
3. Increased anxiety and need for narcotic overnight
4. Difficulty performing an "A-OK" sign on exam
5. Moderate pain with flexion/extension of fingers
QID: 220532
Comment your answer below, then check to see if you got it correct by clicking the link below to see the answer & explanation.
bit.ly/4BG2xWn
#orthopedics #orthopedicsurgeon #orthopaedics #orthopaedic #orthopedic #ortholife #orthobullets #orthoresidents #orthoresident #orthoresidency #medicalschool #medicalstudent #medstudent #doctor
Here are intraop & postop images of yesterday's case by Drs. Aws Hammad and Christopher Bush with Corewell Health.
ARM AND LEG PAIN IN 77M WITH MULTIPLE MYELOMA
PROCEDURE 1: ORIF OF RIGHT PERIPROSTHETIC HUMERUS FRACTURE
PROCEDURE 2: PROPHYLACTIC INTRAMEDULLARY NAILING OF LEFT FEMUR, PROPHYLACTIC INTRAMEDULLARY NAILING OF LEFT HUMERUS
Here is the link to the clinical presentation and the pre-op imaging: nitter.cf/orthobullets/status/21…
Do you agree with the treatment? Why or why not?
Leave a comment and keep the great conversation going! #orthotwitter
Vote on this case for CME: orthobullets.tiny.us/yckv9en…
Here is a new case by Drs. Aws Hammad and Christopher Bush with Corewell Health.
ARM AND LEG PAIN IN 77M WITH MULTIPLE MYELOMA
HPI: The patient is a 77-year-old male who presents to the emergency department following a ground-level fall. He reports right upper extremity pain that preceded the fall, as well as significant left thigh pain with weight-bearing. He was recently diagnosed with multiple myeloma and is awaiting initiation of treatment. He denies additional pain in the remaining upper and lower extremities.
PMH: Past medical history is significant for multiple myeloma, chronic obstructive pulmonary disease (COPD), and prior right reverse total shoulder arthroplasty (rTSA).
PE: Examination of the right upper extremity demonstrates a well-healed surgical scar and tenderness to palpation over the proximal arm. The neurovascular examination is intact. Examination of the left lower extremity reveals tenderness to palpation over the mid-thigh, with pain elicited during log roll and axial loading.
How would you manage this #orthotwitter?
Vote on this case for CME: orthobullets.tiny.us/yckv9en…
Here is a new case by Drs. Aws Hammad and Christopher Bush with Corewell Health.
ARM AND LEG PAIN IN 77M WITH MULTIPLE MYELOMA
HPI: The patient is a 77-year-old male who presents to the emergency department following a ground-level fall. He reports right upper extremity pain that preceded the fall, as well as significant left thigh pain with weight-bearing. He was recently diagnosed with multiple myeloma and is awaiting initiation of treatment. He denies additional pain in the remaining upper and lower extremities.
PMH: Past medical history is significant for multiple myeloma, chronic obstructive pulmonary disease (COPD), and prior right reverse total shoulder arthroplasty (rTSA).
PE: Examination of the right upper extremity demonstrates a well-healed surgical scar and tenderness to palpation over the proximal arm. The neurovascular examination is intact. Examination of the left lower extremity reveals tenderness to palpation over the mid-thigh, with pain elicited during log roll and axial loading.
How would you manage this #orthotwitter?
Vote on this case for CME: orthobullets.tiny.us/yckv9en…
Can you answer our free question of the day?
A 39-year-old male presents with recurrent knee pain and swelling after his third surgery for removal of the lesions shown in Figures A and B. He now has significant bony erosions of the femur and pain with walking and squatting at his day job as a plumber.
If he is started on Pexidartinib by his medical oncologist for adjunct treatment, which of the following side effects should the patient be warned about, and what is the causative mechanism of action?
1. Alopecia caused by activation of colony-stimulating factor 1 (CSF-1) receptor
2. Cardiac toxicity and congestive heart failure caused by cytostatic anthracycline activity
3. Edema around the eyelids caused by inhibition of tyrosine kinase receptor (RTK) activation
4. Hair depigmentation caused by inactivation of colony-stimulating factor 1 (CSF-1) receptor
5. Ulcerations of the mouth caused by inhibition of interleukin-1 (IL-1) receptor activation
QID: 220561
Comment your answer below, then check to see if you got it correct by clicking the link below to see the answer & explanation.
bit.ly/4zPeVS4
#orthopedics #orthopedicsurgeon #orthopaedics #orthopaedic #orthopedic #ortholife #orthobullets #orthoresidents #orthoresident #orthoresidency #medicalschool #medicalstudent #medstudent #doctor
Here is a clip from our latest CoinFlips & Controversies Webinar Implant Discussion, titled “Bunion Deformity in 53F”.
In this CoinClip, Dr. Foote* from MercyOne Waterloo Podiatry Care and Dr. Campbell* from Atlantic Orthopaedic Specialists discuss improving lapidus correction with AI powered software and patient-matched guides when performing definitive fixation of a bunion deformity with the VIRTUGUIDE™ System.
Click the link to watch the full CoinFlip & Controversies webinar on Orthobullets: orthobullets.tiny.us/1024202…
*Disclosures: Dr. Foote and Dr. Campbell are key opinion leaders of DePuy Synthes.
#orthotwitter
Can you answer our free question of the day?
A 28-year-old female was involved in a bike crash and sustained an open talar neck fracture as demonstrated in Figure A. She was taken for debridement and reduction within 24 hours of injury. Due to hemodynamic instability from abdominal trauma, definitive open reduction and internal fixation were not performed until one week later via a lateral approach. At her three-month follow-up, sclerosis and articular collapse are noted on radiographic evaluation.
Which of the following factors placed this patient at increased risk of developing this complication?
1. Delayed definitive fixation
2. Presence of other traumatic injuries
3. Lateral approach
4. Open fracture
5. Time to initial reduction
QID: 220558
Comment your answer below, then check to see if you got it correct by clicking the link below to see the answer & explanation.
bit.ly/489KOJ2
#orthopedics #orthopedicsurgeon #orthopaedics #orthopaedic #orthopedic #ortholife #orthobullets #orthoresidents #orthoresident #orthoresidency #medicalschool #medicalstudent #medstudent #doctor
Here’s a clip from our latest episode of CoinFlips & Controversies, “Acute Hip Pain 1 Month s/p Conversion THA in Diabetic 76M.”
Watch Drs. @KevinParkMD and Neff discuss “Using Hip Aspiration to Guide Surgical Planning.”
Click here to learn more and watch their full webinar on Orthobullets: orthobullets.tiny.us/1023202…
#orthotwitter