Current opinions about coronal plane alignment in total knee arthroplasty?: A survey article / Emmanuel Thienpont in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.471-477 Titre : Current opinions about coronal plane alignment in total knee arthroplasty?: A survey article Type de document : texte imprimé Auteurs : Emmanuel Thienpont, Auteur ; O. CORNU, Auteur ; Johan Bellemans, Auteur Année de publication : 2015 Article en page(s) : p.471-477 Langues : Anglais (eng) Mots-clés : Knee arthroplasty  alignment  varus  survey Résumé : Purpose: To survey an audience of international knee surgeons about their current opinions on the analysis of coronal knee alignment and their objectives for postoperative alignment in total knee arthroplasty. Methods: Survey of 300 surgeons from 32 different countries with an audience response system allowing three possible answers being either a positive or negative answer or an abstention. Results: Surveyed surgeons perform rarely preoperative and postoperative full leg radiographs and evaluate radiological outcomes more with short films. The main trend in this survey was towards neutral mechanical alignment, however varus alignment is acceptable in constitutional varus patients. This residual varus should be obtained through a femoral varus cut rather than a tibial varus cut. The valgus knee can remain in slight valgus but most of the correction will be performed at the femoral level. The main objective of postoperative alignment in TKA is a joint line parallel to the floor and a central loadbearing axis through the middle of the arthroplasty. Surgeons prefer unicompartmental arthroplasty more for themselves than for their patients in case of medial bone on bone arthritis. Conclusions: Neutral mechanical axis with a joint line parallel to the floor and a centrally running load bearing axis remains the central scope of the surveyed surgeons. Because of the literature on residual varus it becomes more acceptable for the orthopaedic community to accept this type of outlier before aiming at a surgical correction. Permalink : ./index.php?lvl=notice_display&id=40923 [article] Current opinions about coronal plane alignment in total knee arthroplasty?: A survey article [texte imprimé] / Emmanuel Thienpont, Auteur ; O. CORNU, Auteur ; Johan Bellemans, Auteur . - 2015 . - p.471-477. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.471-477 Mots-clés : Knee arthroplasty  alignment  varus  survey Résumé : Purpose: To survey an audience of international knee surgeons about their current opinions on the analysis of coronal knee alignment and their objectives for postoperative alignment in total knee arthroplasty. Methods: Survey of 300 surgeons from 32 different countries with an audience response system allowing three possible answers being either a positive or negative answer or an abstention. Results: Surveyed surgeons perform rarely preoperative and postoperative full leg radiographs and evaluate radiological outcomes more with short films. The main trend in this survey was towards neutral mechanical alignment, however varus alignment is acceptable in constitutional varus patients. This residual varus should be obtained through a femoral varus cut rather than a tibial varus cut. The valgus knee can remain in slight valgus but most of the correction will be performed at the femoral level. The main objective of postoperative alignment in TKA is a joint line parallel to the floor and a central loadbearing axis through the middle of the arthroplasty. Surgeons prefer unicompartmental arthroplasty more for themselves than for their patients in case of medial bone on bone arthritis. Conclusions: Neutral mechanical axis with a joint line parallel to the floor and a centrally running load bearing axis remains the central scope of the surveyed surgeons. Because of the literature on residual varus it becomes more acceptable for the orthopaedic community to accept this type of outlier before aiming at a surgical correction. Permalink : ./index.php?lvl=notice_display&id=40923

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Knee Arthroplasty Surgeons : coping with the pressure of treating patients with high expectations / Emmanuel Thienpont in Acta Orthopaedica Belgica, Vol.81/4 (Décembre 2015)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.81/4 (Décembre 2015) . - p.563-564 Titre : Knee Arthroplasty Surgeons : coping with the pressure of treating patients with high expectations Type de document : texte imprimé Auteurs : Emmanuel Thienpont Année de publication : 2015 Article en page(s) : p.563-564 Langues : Anglais (eng) Permalink : ./index.php?lvl=notice_display&id=42334 [article] Knee Arthroplasty Surgeons : coping with the pressure of treating patients with high expectations [texte imprimé] / Emmanuel Thienpont . - 2015 . - p.563-564. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.81/4 (Décembre 2015) . - p.563-564 Permalink : ./index.php?lvl=notice_display&id=42334

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The indirect cost of Patient-Specific Instruments / Emmanuel Thienpont in Acta Orthopaedica Belgica, Vol. 81/3 (Septembre 2015)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.462-470 Titre : The indirect cost of Patient-Specific Instruments Type de document : texte imprimé Auteurs : Emmanuel Thienpont, Auteur ; Frederic PATERNOSTRE, Auteur ; Charles VAN WYMEERSCH, Auteur Année de publication : 2015 Article en page(s) : p.462-470 Langues : Anglais (eng) Mots-clés : Patient specific instruments  indirect costs  cost-effectiveness  total knee arthroplasty  economics. Résumé : Purpose: To calculate the indirect costs of Patient Specific Instruments (PSI) based on an opportunity cost, cost of efforts and a supply chain cost model to compare PSI for value with conventional total knee arthroplasty (TKA). Methods: In 81 patients the total (direct + indirect) cost of PSI-assisted TKA was compared with conventional TKA. Surgical times and coronal mechanical alignment were measured to evaluate the effectiveness of the PSI system. Results: Indirect costs (459 euro) make up 40% of the total cost that can run up to 1142 euro for a patient operated with PSI guides. No difference in surgical times or coronal alignment was observed in between both groups. Conclusion: Considering the total cost of PSI no value was found for the use of PSI in primary TKA as measured by surgical times or for obtaining a neutral mechanical axis in the coronal plane. Permalink : ./index.php?lvl=notice_display&id=40922 [article] The indirect cost of Patient-Specific Instruments [texte imprimé] / Emmanuel Thienpont, Auteur ; Frederic PATERNOSTRE, Auteur ; Charles VAN WYMEERSCH, Auteur . - 2015 . - p.462-470. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 81/3 (Septembre 2015) . - p.462-470 Mots-clés : Patient specific instruments  indirect costs  cost-effectiveness  total knee arthroplasty  economics. Résumé : Purpose: To calculate the indirect costs of Patient Specific Instruments (PSI) based on an opportunity cost, cost of efforts and a supply chain cost model to compare PSI for value with conventional total knee arthroplasty (TKA). Methods: In 81 patients the total (direct + indirect) cost of PSI-assisted TKA was compared with conventional TKA. Surgical times and coronal mechanical alignment were measured to evaluate the effectiveness of the PSI system. Results: Indirect costs (459 euro) make up 40% of the total cost that can run up to 1142 euro for a patient operated with PSI guides. No difference in surgical times or coronal alignment was observed in between both groups. Conclusion: Considering the total cost of PSI no value was found for the use of PSI in primary TKA as measured by surgical times or for obtaining a neutral mechanical axis in the coronal plane. Permalink : ./index.php?lvl=notice_display&id=40922

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Unfolding the Remarkable Orthopedic Surgeon : How to unleash the quest for excellence and the sense of caring / Philippe Rosinski in Acta Orthopaedica Belgica, Vol.81/4 (Décembre 2015)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.81/4 (Décembre 2015) . - p.600-608 Titre : Unfolding the Remarkable Orthopedic Surgeon : How to unleash the quest for excellence and the sense of caring Type de document : texte imprimé Auteurs : Philippe Rosinski ; Emmanuel Thienpont Année de publication : 2015 Article en page(s) : p.600-608 Langues : Anglais (eng) Résumé : Orthopedic surgery is a challenging profession, both at the diagnostic and therapeutic level. Successful treatment of patients requires teamwork with different stakeholders, with various personalities and motives. Coping with the stress of the quest for the ultimate surgical result might not be easy for everyone. While some surgeons see their activities as a job or at best as a career, others who face similar difficulties seem to respond to a higher calling. They are the ones striving for continuous improvement and excellence, and are committed to serving their patients with a deep sense of caring. In this article, we introduce a surgeon typology based on these two variables. We also introduce global coaching as a novel approach to help surgeons on this potentially transformational journey. We focus on the qualities that global coaching can help to develop as well as briefly mention some of the models and tools that can be called upon. Evidence from the Harvard Grant longitudinal study confirms that humans continue to develop during their adulthood and suggests that the following hypothesis is likely to be accurate: remarkable surgeons committed to technical excellence and caring deeply for their patients are likely to be most successful both in their careers and in their lives. If necessary, surgeons have a chance, a choice and a responsibility to change course, to reconnect with their profession and to establish more intimate relationships with their patients, colleagues as well as in their personal lives. By growing into becoming remarkable surgeons, they will serve others as well as themselves. Permalink : ./index.php?lvl=notice_display&id=42340 [article] Unfolding the Remarkable Orthopedic Surgeon : How to unleash the quest for excellence and the sense of caring [texte imprimé] / Philippe Rosinski ; Emmanuel Thienpont . - 2015 . - p.600-608. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.81/4 (Décembre 2015) . - p.600-608 Résumé : Orthopedic surgery is a challenging profession, both at the diagnostic and therapeutic level. Successful treatment of patients requires teamwork with different stakeholders, with various personalities and motives. Coping with the stress of the quest for the ultimate surgical result might not be easy for everyone. While some surgeons see their activities as a job or at best as a career, others who face similar difficulties seem to respond to a higher calling. They are the ones striving for continuous improvement and excellence, and are committed to serving their patients with a deep sense of caring. In this article, we introduce a surgeon typology based on these two variables. We also introduce global coaching as a novel approach to help surgeons on this potentially transformational journey. We focus on the qualities that global coaching can help to develop as well as briefly mention some of the models and tools that can be called upon. Evidence from the Harvard Grant longitudinal study confirms that humans continue to develop during their adulthood and suggests that the following hypothesis is likely to be accurate: remarkable surgeons committed to technical excellence and caring deeply for their patients are likely to be most successful both in their careers and in their lives. If necessary, surgeons have a chance, a choice and a responsibility to change course, to reconnect with their profession and to establish more intimate relationships with their patients, colleagues as well as in their personal lives. By growing into becoming remarkable surgeons, they will serve others as well as themselves. Permalink : ./index.php?lvl=notice_display&id=42340

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