TKA complications Increased risk with notching anterior femur, surgical trauma to quadriceps, distal femur exposure and periosteal stripping, and postop manipulation under anesthesia, and high lumbar BMD
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Which of the following has not been shown in the literature to increase the risk of heterotopic ossification?
Prolonged ventilator time in multiply traumatized patients
Spinal cord injury
Amputation through the zone of injury in patients injured in blasts
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A 27-year-old man is involved in a motor vehicle crash and sustains a closed head injury and right intertrochanteric hip fracture with ipsilateral femoral head fracture. He undergoes operative stabilization of his right hip. At 1 year follow-up he has limited rotation and abduction of the hip. Radiographs are shown in Figures A and B. What intervention during his initial treatment could have potentially prevented this outcome?
700 cGy of radiation within 72 hours of surgery
Pulsed administration of recombinant PTH 1,34 postoperatively for 1 year
3 cycles of VAC (Vincristine, Actinomycin D, and Cyclophosphamide)
700 cGy of radiation 2 weeks prior to surgery
3 treatments of 700 cGy of radiation divided over 1 week after surgery
A 24-year-old male presents with a painful, stiff elbow after sustaining an injury 4 months ago. A radiograph is shown in Figure A. Which of the following statements is true about his condition?
Early excision has been found to decrease rate of recurrence compared to excision after maturity
Radiographs may be used to assess maturity of the lesion
Bone scan will always be negative once the lesion is considered mature
The lesion is considered mature 12 months after initial radiographic findings are seen
Alkaline phosphatase level measurements are used to determine the maturity of the lesion
Which amputation patient would have the highest risk of developing heterotopic ossification at the amputation site?
75-year-old diabetic with an ischemic limb undergoing a transtibial amputation
45-year-old woman that had a propane tank explode near her thigh undergoing a transfemoral amputation
25-year-old army captain with a complex blast injury to his shin undergoing transfemoral amputation
65-year-old with necrotizing fasciitis of his lower leg undergoing knee transfemoral amputation
35-year-old woman with a grade IIIC open distal tibia fracture who elects for a below the knee amputation
A 32-year-old male sustains a the injury shown in Figure A after a high-speed motor vehicle collision. Which factor has been found to have the highest direct correlation with severe heterotopic ossification after traumatic knee dislocation?
Injury Severity Score (ISS)
Glascow Coma Scale (GCS)
Timing of knee reconstruction
Number of ligaments reconstructed
Open ligament reconstruction
Heterotopic ossification has been recognized as a rare complication from Steinmann pins placed in which location for traction purposes?