A Tour of the Most Expensive Screw in the WORLD

A Tour of the Most Expensive Screw in the WORLD
The Doubtful Technician

Watching this I was reminded of IAman's old landlord who worked for a shop that made all kinds of implant pieces. Sounds like it ought to be a pretty good job. He hated it. Of course, it might not have had anything to do with the work, it may have been the people. You just never know how anyone will react to a given situation.

Your Tax Dollars at Work

First Ball and Socket
Replaced in Second Surgery

Just got a statement from UnitedHealthcare. It has my total medical expenses from last year, which means it includes my hip joint replacement surgery.

Show and Tell Tuesday

Implant Samples
Planks in the table top are six inches wide

IAman brought some samples of mechanical bits used to repair broken bones in people. I found the variety astounding. Of course, I'm used to dealing with ordinary nuts and bolts, not imaginary stuff from a different galaxy.

Bone Collector

Knee Implant / Prosthesis

Once upon a time, back when Osmany was living in Cuba, he became acquainted with a guy who collected bones. He got these bones from graves in cemeteries (no details on the circumstances available). Of particular interest were bones from people who had been subjected to surgery to repair injuries. One prime example was a femur where the knee end of the bone had been replaced with prostheses made of platinum. The prostheses must have weighed a pound and in the free world that much platinum would be worth $10K, but since he was in Cuba where there is no free market, it was worth nothing except as a curiosity to be added to his macabre collection.

Broken Wrist

Acu-Loc Wrist Repair Plate

My wife tripped over a kindergärtner and fell down a couple of weeks ago and broke her wrist. It looked like she might be able to get away with just having a cast until we went to see the bone doctor. Now surgery to install a small plate to hold the bones in alignment becomes a viable option. The two advantages to having surgery were that she could get by with a smaller cast because the plate would be doing most of the alignment work, and there was a possibility that without the plate she would encounter some pain when she turned her wrist. If she was 20 years older, they wouldn't recommend the surgery. So we went ahead and got it done. Picked her up from work at 2PM and were home by 9PM. Work was done at the clinic, not the hospital. The worst part was they used a nerve block on her arm which meant is was virtually dead for 24 hours. There was no pain, but she was also unable to control her arm. Left alone it would just hang by her side.

A little info about wrist fractures:

A Colles' fracture -- or distal radius fracture -- is often called a ''broken wrist.'' Technically, it's a break in the larger of the two bones in your forearm. The bone breaks on the lower end, close to where it connects to the bones of the hand on the thumb side of the wrist.
Colles' fractures are very common; they're the most frequently broken bone in the arm. In the United States, one out of every 10 broken bones is a broken wrist. - WebMD

Leg Bones

An X-ray showing a right hip (left of image) has been replaced, with the ball of this ball-and-socket joint replaced by a metal head that is set in the femur and the socket replaced by a white plastic cup (clear in this X-ray).

I'm in Vail, Arizona, babysitting my 230 pound little brother who is going in for hip joint replacement surgery tomorrow morning. He is a little concerned about how the surgeon is going to fix the length of his leg. The surgeon's plan is to compare kneecaps. Iaman's concern is that the reference leg also needs a joint replacement, so that leg might not be the right length either, and so should not be used as a reference.
    This reminds me of a couple of horror stories I heard. Not to worry, they turned out okay. One was from a woman I know in Iowa. She was in an auto accident in her younger years and both of her legs were severely injured. When they put her back together she was four inches shorter than she had been. Her legs, from what I have seen of them, are not disfigured. There might be a couple of scars, but nothing prominent. Then again, she could have been pulling my leg. I have no corroborating evidence.
    The other story is about a young man in Ohio, He was a few years ahead of me in high school. He got a job as a lineman working for the power company. He fell 80 feet from a power pole. He landed on soft ground, which I suppose saved his life. He sustained severe injuries, mostly to his hip joints. The doctors were able to put him back together, though he too ended up several inches shorter than before.

P.S. Operation was a success.

Arthroplasty Notes

Hip & Knee devices, next to femur model. Titanium, Oxinium and polyethylene.

Iaman reports:

Hi, I'm scheduled for my Hip Arthroplasty (the surgical reconstruction or replacement of a joint) [this November], by surgical scheduler Narcy. I cannot drive for 2 weeks.

Notes from Orthopedic Surgeon Consultation.

• "Yep, your hip was bad a year ago". No range of motion right leg, limited on left.
• I've exhausted my cortisol shot effectiveness limit of 2 shots.
• No bilateral replacements in same operation, have to wait at least 6 weeks.
• Doc has done 10,000 + hip arthroplasties then he stopped counting.
• He does about 6 operations a day 2 days a week, Mondays & Tuesdays.
• He stopped Birmingham Hip Resurfacing (BHR) after doing 500, a smaller device, yet more invasive.....but worse were certain patients, but not all, with gout interacting with the synovial fluid would have enough metal on metal erosion to warrant a revision(go in again & fix, in this case with a conventional device). An unexpected bad outcome, after thousands had been installed.
• Doc has used the Smith & Nephew hip device for years a primary feature is their patented Oxinium ball that has significantly less wear. Oxinium is Zirconium alloy (used to clad nuclear reactors). S&N not part of the Warsaw Cartel.
• Doc really doesn't like ceramic, "just try to clean out the glass when one shatters", from athletic hits,falls, or car crashes.
• Doc uses the standard proven posterior approach, "imagine a line between your jeans front & back top of the pockets." This allows good access to the head of the femur for pounding the device into the femur with a 3 pound hammer. If anything happens, bone breaking etc., there is full access. Versus the touted new minimal anterior approach where a special table and a assistant is needed to contort the body to access the femur head, at an angle. If something goes wrong the posterior approach is needed to fix anything.
• None of the docs provide quality stats, though google says this is a essential part of the vetting process.
• Bones density varies per person from Balsa softness to Ebony like hardness.
• The standard angle between the head and femur is 135 dgrees, though it varies per person by +- 7 degrees, causing knock-knee or bow-legs.
• Doesn't glue device into femur, the glue acts as a barrier to bone adhesion, pressure fit of titanium which bone will attach to within 6 weeks.
• Though he uses computer alignment on knees, doesn't use on the "universal ball joint" of the hip. The placement of the marker screws is more painful that the results warrant.
• High protein diet 2 weeks before operation significantly improves healing.
• No recliner-chairs post-op for 6 weeks, stresses hip joint.
• Post-op antibiotics for all dental work, curiously mouth bacteria have a affinity to metal joints.
• I like this Docs private practice better than the big bone factories. Direct telephone to live person. Staff is personable, not so fatigued. Small quiet reception area versus crowded airport terminal like setting. Zoey, a Bichon , roams the office unobtrusively.
• Learned new word Kinematics, which describes the motion of objects without consideration of the causes of motion.
• Bones are innervated, they have nerves in them.