Publications by authors named "Jonathan G Yerasimides"

There has been increased interest and literature on the efficacy of direct anterior approach (DAA) for total hip arthroplasty (THA). Developments in surgical technique and instrumentation, along with exposure earlier in orthopaedic residency training, may augment the adoption of this approach among practicing orthopaedic surgeons. With the increasing number of primary THA performed through the DAA, understanding the indications and techniques associated with revision THA via the DAA has proved increasingly important.

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Background: Anterior column deficiency of the pelvis may pose a serious threat to the stability of the acetabular component after total hip arthroplasty and, thus, jeopardize the overall success of the procedure.

Methods: After Institutional Review Board approval, a retrospective review was undertaken to identify all patients undergoing revision total hip arthroplasty with anterior column augmentation through an extended direct anterior approach. Demographics and surgical details were collected, and subjects were followed for a 2-year minimum period to measure patient outcomes and to evaluate for the stability of construct fixation.

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Total hip arthroplasty through a single-incision anterior approach is a minimally invasive surgical (MIS) technique that allows component placement without violation of the posterior hip capsule or "hip deltoid." This allows faster recovery without dislocation precautions. The Fitmore® hip stem (Zimmer, Warsaw, Ind) is a bone-conserving stem designed for use in MIS techniques.

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Over 230,000 total hip arthroplasties (THA) are performed annually, and many of these patients will seek or be referred to a physical therapist to assist them in their recovery. Improvements in understanding of joint replacement technology have allowed earlier weight bearing and return to function. With the anterior surgical approach, patients are permitted weight bearing as tolerated immediately after surgery and can resume nearly all prior activities upon returning home.

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The reduction of displaced pelvic ring injuries remains a technical challenge, especially when treatment is delayed. A pelvic frame (Orthopaedic Systems Inc, Union City, California) provides a means of external skeletal fixation, rigidly stabilizing the intact hemipelvis to the operating room table. The fractured and displaced fragments can then be manipulated around the securely fixed uninjured hemipelvis, allowing the application of more directions and magnitudes of force for reduction maneuvers than allowed by the traditional means of pelvic reduction.

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