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Biomedical subjects

Wael K Barsoum

Publications and source records attributed to Wael K Barsoum.

7 recordsLinked to original sources
PubMed2006

Hip arthroscopy technique and indications.

The recent advances in hip arthroscopy have made it a useful minimally invasive approach to the diagnosis and treatment of intra-articular hip pathology. It offers the benefits of being an outpatient procedure with short rehabilitation and few reported complications and does not hinder opportunities for future surgical interventions. The lateral approach has been widely accepted, and technical details are discussed. Patients typically present with mechanical symptoms and persistent pain resistant to a reasonable trial of conservative treatment and are without significant joint space narrowing. Indications include debridement of labral lesions and loose bodies as well as treatment of impingement syndrome and avascular necrosis. Arthroscopy has also proven a useful tool in evaluation components in symptomatic patients after hip arthroplasty and in the treatment of native and replacement joint infections.

Arthroplasty, Replacement, Hip↗
PubMed2006

The use of proximal fixed modular stems in revision of total hip arthroplasty.

Proximally fixed femoral stems in revision of total hip arthroplasties (THAs) have had inconsistent results. Our aim was to determine the safety and efficacy of a new proximally fixed modular stem in THA revision. Fifty-three patients underwent THA revision with the Exactech AccuMatch M-Series (Gainesville, Fla) modular stem and were followed up prospectively for an average of 2.5 years with preoperative and postoperative Harris Hip Score and SF-12 scores. A small number of complications were reported. One stem was revised within 4 weeks due to subsidence. No later mechanical failure cases were reported. Postoperative Harris Hip Score and SF-12 improved significantly. The use of this modular stem system appears to be safe and efficacious regarding fixation and function in the short term.

Arthroplasty, Replacement, Hip↗
PubMed2006

Gap balancing in total knee arthroplasty.

It is well known that the success of total knee arthroplasty is collectively dependent on the proper recreation of the joint line, appropriate soft tissue balancing, and respectful management of the extensor mechanism. One of the most decisive factors within the surgeon's control is the reestablishment of proper knee kinematics through both medial-lateral and flexion-extension ligamentous balancing. This can be accomplished only by a comprehensive intraoperative evaluation in full flexion, mid flexion, and full extension to minimize potential gap mismatches. Most of the discussion will focus on this aspect of soft tissue balancing, but this does not undermine the importance of the other aforementioned principles of successful knee arthroplasty.

Arthroplasty, Replacement, Knee↗
PubMed2006

Hip and knee arthroplasty in the geriatric population.

Osteoarthritis is the leading cause of hip and knee pathology in the geriatric population. Hip and knee arthroplasty are the definitive interventions to alleviate pain and restore physical functioning. Complications related to these procedures do occur: the most com-mon of these are infection, thromboembolism, dislocations, and periprosthetic fractures. New improvements related to minimally invasive and computer-assisted navigation surgery techniques are promising and already have shown excellent outcomes in patients exposed to joint arthroplasty.

Aged↗
PubMed2006

Managing perioperative risk in the hip fracture patient.

Patients with hip fracture benefit from a multidisciplinary team approach for preoperative and postoperative care. Team members, consisting of the orthopedic surgeon, internal medicine consultant, and anesthesiologist, should each have a role in determining a patient's readiness for surgery and communicate with one another about appropriate management. How urgently a hip fracture needs repair depends on the type of injury. In general, most injuries should be repaired as soon as the patient can be medically optimized (preferably 24 to 48 hours), keeping in mind that procedures are often lengthy and maximally invasive, and frequently involve complications. Nondisplaced (impacted) femoral neck fractures, however, should be repaired within 6 hours if possible to avert avascular necrosis of the femoral head and the need for total hip replacement. The following interventions are helpful for preventing complications following hip fracture repair: perioperative prophylaxis against infection.

Aged↗
PubMed2005

Duration of anesthesia and venous thromboembolism after hip and knee arthroplasty.

OBJECTIVE: To determine whether longer duration of anesthesia predisposes patients undergoing orthopedic surgery to venous thromboembolism (VTE). PATIENTS AND METHODS: We conducted a secondary analysis of a retrospective case-control study that examined risk factors for postoperative VTE in postmenopausal women. We matched women aged 50 years and older with radiographically confirmed postoperative VTE (cases) by age, surgeon, year of surgery, and surgical joint (knee vs hip) with women without postoperative VTE (controls). Duration of anesthesia, operative variables, demographic data, comorbid illnesses, and laboratory data were determined by medical record review. RESULTS: Eighty-eight cases were matched with 181 controls. Duration of anesthesia of 3.5 hours or longer (corresponding to the upper tertile of patients) was strongly associated with postoperative VTE compared with a shorter duration of anesthesia (odds ratio, 3.58; 95% confidence Interval, 2.11-6.16; P < .001). This relationship was maintained after controlling for multiple covariates with propensity score methods, Including type of arthroplasty, route of anesthesia, type of antithrombotic prophylaxis, and surgical approach. In multivariate analysis, the Important predictors of VTE included anesthesia duration of 3.5 hours or longer, type of antithrombotic prophylaxis, revision (vs primary) arthroplasty, and allogeneic blood transfusion. CONCLUSION: We found a marked association between the duration of anesthesia and postoperative VTE in patients undergoing Joint arthroplasty. Although it is possible that unmeasured intraoperative variables account for this relationship, we suggest that duration of anesthesia may be an important risk factor for postoperative VTE after orthopedic surgery.

Anesthesia↗