Michael Decker

Bio: Michael Decker is an academic researcher from University of New Mexico. The author has contributed to research in topics: Medicine & Surgery. The author has an hindex of 2, co-authored 5 publications receiving 22 citations.

Direct anterior approach for femoral component revision: Surgical technique for extended trochanteric osteotomy and anterior cortical window

Abstract: Objective Direct anterior approach (DAA) is becoming a popular option for both primary and revision total hip arthroplasty (THA). Adequate exposure is crucial in the setting of revision THA. The purpose of this article is to describe two different techniques for expanded femoral exposure through the DAA, the anterior extended trochanteric osteotomy and anterior cortical window. Methods Extensile exposure were carried out in cadavers, using the contralateral hip as a control. The exposure and technical viability were assessed. Results It was demonstrated that both extensile techniques can be carried out safely. Conclusions Extensile exposures including femoral osteotomies can be safely carried out for revision THA via DAA.

The Impact of Free Radical Stabilization Techniques on in vivo Mechanical Changes in Highly Cross-Linked Polyethylene Acetabular Liners.

Abstract: Introduction Numerous thermal free radical stabilization techniques are used in the production of highly cross-linked polyethylene (HXLPE) to improve oxidative stability. Little knowledge exists on the effects of in vivo time on the mechanical properties of HXLPE. The purpose of this study was to determine if free radical stabilization of HXLPE impacts mechanical properties as well as oxidative stability of acetabular liner rims after extended in vivo time. Methods Retrieved and control remelted, single annealed and sequentially annealed HXLPE liner rims were tested for mechanical properties. Oxidation was measured with FTIR spectroscopy and crystalline phase composition measured with Raman spectroscopy. Results No correlation was found between in vivo, ex vivo time and hardness for annealed groups. A statistically significant difference in hardness was identified between free radical stabilization groups. No correlation between maximum rim oxidation and in vivo time was found. Detectable levels of rim oxidation were present in 100% of single annealed, 75% of sequentially annealed, and 25% of remelted retrieved liners. Single and sequentially annealed liners demonstrated oxidation and increased crystallinity. Rim mechanical properties change in vivo for implant types. With in vivo time, retrieved remelted HXLPE demonstrated decreased mechanical properties, whereas retrieved single and sequentially annealed HXLPE properties remained stable. All liner cohorts demonstrated evidence of rim oxidation. Subsequent changes in crystallinity were only observed in oxidized annealed liners. Conclusion HXLPE acetabular liner rims show evidence of in vivo mechanical property degradation, notably in remelted HXLPE, which may be a risk factor in rim fracture and catastrophic implant failure.

Well Leg Compartment Syndrome after Contralateral Femoral Neck ORIF.

Abstract: The authors present a case of WLCS after femoral neck fracture fixation. While this is a rare complication, a high index of suspicion should exist. Surgeons should use well leg holders with caution and limit utilization time. Alternative methods of positioning to allow for fluoroscopic imaging exist. WLCS remains a clinical diagnosis; intracompartmental measurements can be used but should be cautiously interpreted. When the diagnosis of WLCS is made, emergent fasciotomies of the affected compartments should be performed. Surgeons should be aware of this complication when using a well leg holder and the potential catastrophic consequences if left ignored.

Management of The Failed Latarjet Procedure: Outcomes of Revision Surgery With Fresh Distal Tibial Allograft:

Abstract: Background:Patients with recurrent anterior glenohumeral instability after a failed Latarjet procedure remain a challenge to address. Complications related to this procedure include large amounts o...

Restoration of Articular Geometry Using Current Graft Options for Large Glenoid Bone Defects in Anterior Shoulder Instability.

Abstract: Purpose The purpose of this cadaveric study was to compare standard and modified coracoid transfer procedures, bicortical and tricortical iliac crest autografts, and tibial plafond and glenoid allografts with respect to glenoid surface curvature restoration. Methods Computed tomography scans of 8 cadaveric shoulders were acquired in 9 conditions: (1) intact, (2) 25% width defect, (3) classic Latarjet, (4) modified congruent-arc Latarjet, (5) tricortical iliac crest inner table, (6) outer table, (7) bicortical iliac crest, (8) distal tibia, and (9) glenoid allograft. Outcome measures included articular surface area, width, depth, axial and coronal radius of curvature, and subchondral articular step-off, analyzed in bone and soft-tissue window. Results Reconstruction of the articular surface area was optimal with the glenoid allograft (99.4%), classic Latarjet (97.4%), and iliac crest bicortical graft (93.2%). Depth was best restored by the congruent-arc Latarjet (101.0%), tibial (98.9%), and glenoid (95.3%) allografts. Axial curvature was closely matched by the glenoid allograft (97.5%), classic Latarjet (108.7%), and iliac bicortical graft (91.2%). Coronal curvature was most accurately restored by the glenoid allograft (102.6%), the tibial allograft (115.0%), and the classic Latarjet (55.9%). The articular step-off was smallest using the glenoid allograft. Conclusions Overall, glenoid allografts most accurately restored articular geometry. Alternative grafts provided restoration of some parameters but not others. Classic Latarjet performed well in axial and coronal curvature on average but exhibited large variability. Tibial allograft produced the poorest results in axial curvature, despite excellent coronal curvature reconstruction. The congruent-arc Latarjet did not restore the axial curvature accurately and overcorrected coronal curvature. Graft geometry must be weighed against availability, morbidity, and the role of additional stabilizers. Clinical Relevance Accurate graft morphology may help prevent postoperative osteoarthritis. Grafts differ significantly regarding geometric parameters. The findings of this study will help surgeons select the most appropriate graft for glenoid reconstruction.

Predictors of Unplanned Reoperation After Operative Treatment of Pelvic Ring Injuries.

Abstract: Objectives:To evaluate the incidence of unplanned reoperations after pelvic ring injuries and to develop a risk prediction model.Design:Retrospective review.Setting:Level I Trauma Center.Patients:The medical records of 913 patients (644 male and 269 female patients; mean age, 39 years; age range, 16

Comparison of a Distal Tibial Allograft and Scapular Spinal Autograft for Posterior Shoulder Instability With Glenoid Bone Loss

Abstract: Background:Posterior glenoid bone deficiency can occur with recurrent glenohumeral instability Glenoid reconstruction with a distal tibial allograft (DTA) has been reported to successfully restore