Conversion to prostalac

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2. Primery care Degenerative joint disease, left hip, secondary to post-septic

2. Women’s health center Degenerative joint disease, left hip, secondary to post-septic

1. Definition of home health care Left conversion to total hip arthroplasty with antibiotic impregnated

1. Health care laws DePuy Prostalac size 4, high, short stem with a 32+9 metal 12/14 head,

Cement was three commercially available tobramycin impregnated antibiotic

cement each bag with 1 g of vancomycin and 1.2 g of tobramycin for a total

antibiotic dosage of 3 g of vancomycin and 6.6 g of tobramycin.

INDICATIONS: XXXXXX is a 55-year-old gentleman who had an acute

septic arthritis of the left hip approximately 7 or 8 months ago. Health insurance exemption He had

an urgent irrigation and debridement in the operating room by one of my

colleagues. Dental health care He subsequently recovered from this, but developed post-septic

arthritis with complete loss of the articular cartilage of the hip. Health care sites Prior

to surgery, his workup was equivocal for eradication of infection with

significant inflammation and a question of osteomyelitis in the femoral

head and acetabular bone on MRI scan from October. Us health insurance Sed rate and CRP had

not normalized by December. Health insurance services So, it was felt that appropriate surgical

intervention to address his severe pain, degenerative arthrosis and erosion

of the femoral head would be a stage total hip arthroplasty. Women’s health institute It was

decided to convert him to a total hip arthroplasty with the cement

articulating high-dose antibiotic cement spacer and a complete debridement

of the tissues followed by a total hip arthroplasty once confirmed

eradication of the infection was completed. Intermountain healthcare careers The patient understood the

plan and risks and benefits associated with this procedure and freely

DESCRIPTION OF PROCEDURE: The patient was taken to the operating room and

placed in the supine position on the operating room table. Home health care industry General

endotracheal anesthesia was induced. Health insurance cheap The patient was placed in the right

lateral decubitus position and the left lower extremity was prepped and

draped in the usual sterile fashion. Primary health care trenton ga A 5-point check was carried out to

confirm site verification. Home health care certification The patient received Ancef and vancomycin for

After confirmation of site, an 18 cm posterolateral incision was made

directly over the left hip. Cheap health insurance for international students Sharp dissection was carried down to the level

of fascia. Health insurance license The IT band and gluteus maximus fascia was incised

longitudinally and the GMax muscle was split bluntly. Women’s health obgyn The short external

rotators were identified, tagged, and taken down as a sleeve. Health insurance florida A posterior

trapezoidal capsular flap was made and tagged. Health insurance michigan The superior and inferior

capsular remnant was excised and the hip was dislocated with flexion,

The proximal femoral anatomy was examined. Uk women’s health There appeared to be erosive

biofilm type of appearance with a chronic infectious appearance as well as

significant sinotubular irritation and inflammation. Home health care insurance There was

considerable oozing until the blood loss was higher than normal with this

debridement. Women’s health group columbia tn We did not use the Cell Saver device for concern of a chronic

The femoral neck resection was made approximately 1.2 cm proximal to the

level of the lesser trochanter. Pillars of primary health care The femoral head had multiple pitting

areas that appeared to be erosions from infectious material and this was

sent for culture. Women’s health and surgery center The femoral head was sent for pathology. Prime care health The bone

quality at the femoral neck seemed appropriate on the femoral side to

Attention was then turned to the acetabulum. Cheap medical insurance dubai Retractors were placed.

There is a considerable amount of debridement carried out circumferentially

that reestablished the acetabular margin. Private health insurance uk There was considerable amount of

erosion and active inflammation that was carefully debrided as well and

hemostasis was attained. Women’s health norfolk ne There was diffuse erosive change of the

acetabular subchondral bone and a reamer was used to tough this gently to

debride some of the irregularities, but I was careful not to remove any

particular bone. Women’s health study The pelvic bone was in continuity and did not have any

column deficiencies. Health insurance cost Pulse irrigation now at this point was used to

debride and irrigate the deep and superficially for approximately 3 liters.

The sponge was placed in the acetabulum. Health insurance mississippi Attention was turned back to the

The Box chisel opened the canal proximally and the awl opened the canal

distally. Access healthcare Sequential broaches were used starting with size 1 up to size 4.

The size 4 had appropriate medial lateral fit and fill. Caring healthcare Pulse irrigation,

At this point, the size 4, high offset PROSTALAC stem was opened and the

43/32 cemented PROSTALAC liner was opened. Importance of health insurance Three bags of tobramycin

impregnated cement were mixed each bag with 1 g of vancomycin and 1.2 g of

tobramycin additional. Health insurance 101 This was then used to fabricate the stem using the

appropriate PROSTALAC molds. What is primary care The remaining cement was then gently

pressurized into the acetabular bed and the liner was held in place at

about 45 degrees of abduction and 30 degrees of anteversion. Benefits of health insurance The cement

The mold was removed from the stem and the stem was carefully applied into

the proximal femur and had excellent intrinsic stability. Home health care franchises The hip was

reduced and I felt that overall was short by about a cm due to the

patient’s high offset enlarged relatively femoral anatomy. Private health insurance companies The +9 femoral

head trial was also showing shortening, so we decided to cement the

proximal portion of the stem proud by a cm to allow for appropriate leg

length reconstitution and stabilization of the hip. Health insurance discounts One bag of tobramycin

impregnated cement were mixed and placed around the top 2 cm of the femoral

stem. Home health care training This was then pressurized into the canal proximally. Women’s health cover The cement was

allowed to harden. Healthcare world The hip was reduced down and the leg lengths were equal

at the knee and the foot. Cheap health care The overall offset and stability was much

improved. Emergency health care The 32+9 metal 12/14 head was tamped on a clean trunnion and the

hip was reduced. Health care provider It was snapped into the stem constraint liner

appropriately. Primary health care marshalltown iowa The stability was improved with flexion in 90, IR 60

hyperextension and external rotation was appropriate and shuck was

Copious irrigation, removed debris again. Cheap health insurance in n c Hemostasis was obtained. Health insurance maryland A #2

Quill closed the capsule in a running fashion. Home health care near me #3 Vicryl repaired the

posterior trapezoidal capsular flap as well as the short external rotators.

The sciatic nerve was palpated and felt to be intact with no evidence for

undue tension. Affordable health insurance for college students #1 PDS was run deep, 2-0 Vicryl subcutaneously, 3-0

Monocryl subcuticularly. Women’s health news A sterile bandage was applied. Healthcare communities The patient

tolerated the procedure well, was allowed to awaken from anesthesia and

I did not explant any components on this patient. Nursing health care He had a recurrent hip infection of a native hip, and so he was converted to a prostalac. Health care department He did have a prior infection I&D done, so this surgery represents a surgery subsequent to a prior surgery. Health care programs The prostalac implant is nearly identical to a total hip implant, so I felt the operation that was closest to the operation performed was conversion to total hip. Affordable health insurance plans I put the 11981 code as well because the prostalac is fabricated out of antibiotic cement so it is also an antibiotic cement spacer device.

The other option I was considering would be a resection arthroplasty (girdlestone procedure) and antibiotic spacer placement, which would also be reasonable for the surgery performed.

I don’t think this should be submitted as a conversion to a THR because it is only an articulating antibiotic spacer.

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