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Questions related from Panayot Tanchev
In the past, pelvis and proximal femur correction osteotomies were very often applied to ameliorate the biomechanics of dysplasic hips, not only in childhood, but also in adults. What is the...
26 July 2018 1,494 5 View
This question is addressed to the contemporary surgeons engaged with scoliosis surgery. Nowadays, there is a mass practice of instrumentations involving and fixing many spinal segments with a big...
06 March 2017 4,864 5 View
The patient is adult. There is no neurologic deficit. This is a hypothetical question, because this injury is very rare and I myself never encountered a similar injury in my practice. But it...
06 March 2017 8,641 2 View
Osteoarthritis means inflammation of the joint. Osteoarthrosis means degeneration of the joint which is correctly used in German, Russian,French, etc. Why? It is time for change in the terminology?
25 February 2017 5,101 31 View
This is a very unhappy situation and every surgeon fears meeting with it. 3D navigation systems are more exact, but also here screw misplacements are possible. The literature presents data far...
04 January 2017 5,023 13 View
Spinal engagement is common. Why not prosthetic infection in patients with Brucellosis? To my knowledge surgeons do not take into consideration this specific infection.
15 November 2016 7,112 8 View
This 10-year old girl fell from a horse on her left shoulder. What would be your treatment ? Some colleagues express controversial opinions, although at a glance it seems to be an easy case.
11 August 2016 1,305 18 View
There are still controversial opinions. What is your experience ? What combination wears less and slowly ?
05 July 2016 8,868 10 View
In the past, the excellent early and middle-terms results after the mould arthroplasty of Smith-Petersen provided a significant popularity. Later, this technique faded in oblivion. After that the...
25 March 2016 318 12 View
Patients with postoperative haematoma with ot without persistent wound drainage, elevated markers for inflammation, increased body temperatures (< 38 degrees), etc. are subjected to surgical...
10 February 2016 1,669 5 View
What is right ? To continue with pharmaceutical prophylaxis for fearing DVT or stop (reduce) it to avoid wound complications ?
05 February 2016 480 15 View
Sometimes, It is difficult to differentiate between postoperative hematoma and imminent deep infection the first postoperative days after THA. Early debridement is reported to be very effective if...
03 February 2016 1,646 9 View
Some authors still apply classic casting (Risser, Cotrel, etc.) in cases of progressive infantile scoliosis. Others prefer early surgery. What is your opinion and experience ?
21 October 2015 5,493 21 View
Or just start an ambulatory regime on crutches and let the formation of pseudarthrosis ?
26 July 2015 8,649 29 View
Sometimes such a migration may cause serious, even fatal injury to important organs, vessels,etc. Could the primary surgeon be subjected to litigation process ?
14 July 2015 2,942 2 View
There are still different preferences. What are yours ?
10 July 2015 1,635 7 View
Hip arthroscopy is getting more and more popular, especially for femoroacetabular impingement syndrome. Is there a rationale to apply it in cases with femoral head osteonecrosis, for example for...
26 May 2015 1,900 16 View
In the last 10-15 years there is a certain trend to the appliaction of this type of hip replacement. In any case, I do not know if the long-term results are satisfactory. In the past, some 30-40...
31 March 2015 8,964 10 View
Is it obsolete today or there is still place for synovectomy in refractory to medications cases ?
30 March 2015 1,562 23 View
Detection of beginning infection in the early postoperative period is important for the adequate treatment ? There are controversies about the issue which are the reliable markers for early...
12 March 2015 1,366 4 View
This is a very rare case, but it happens sometimes. What procedure do you propose?
23 February 2015 7,788 8 View
Some colleagues prefer conservative treatment, while others stabilize the fracture on an emergency base. What is your experience if you have some because this injury is relatively rare and when...
23 February 2015 3,316 11 View
There are some reported data about a trial of this procedure started in Great Britain including several elite hospitals. The results might be ready in 2017. Eventually, positive results could make...
02 February 2015 2,021 4 View
Sometimes the differential diagnosis between specific and non-specific spondylitis/spondylodiscitis is difficult when using only clinical and imaging signs. What is your personal experience and...
02 February 2015 1,103 4 View
Some surgeons prefer cephalosporins of first or second generation, while other colleagues prefer wider spectrum antibiotics. The dosage and duration also differs in the practice of different...
05 January 2015 691 10 View
The results in the literature are very controversial. One can find some sort of disagreement when comparing clinical results with advertising papers (TV, media, etc.). There is also another...
29 December 2014 3,264 12 View
This issue is very controversially or undiscussed at all in the pertinent literature. On the one hand this kind of surgery may last for hours, and on the other hand this prophylaxis is not...
13 December 2014 8,213 29 View
Is the implant infected or the bone structures it is fixed to ? I believe it could be called "periostitis", "osteitis", " osteomyelitis", "spondylodiscitis", "spondylitis". etc.
05 December 2014 4,709 5 View
This aspect was mentioned in a discussion on psychological, clinical and social characteristics of the complaints of a patient treated surgically for scoliosis. It seems to be an attractive...
05 December 2014 1,515 10 View
Some hospital care standards require pharmacologic DVT prophylaxis for orthopedic operations (even minor surgeries) in pediatric patients. Is it necessary indeed or this a hypermeasure taken...
21 August 2014 9,875 11 View
A number of surgeries, incl. all possible osteosynthesis devices, shock wave therapy, fixateur externe, osteoplasty, vascularized fibula graft, fibula pro tibia reconstruction, etc., failed to...
18 August 2014 193 10 View
Is this necessary? What is the rationale? Is not the spacer another foreign body that could maintain the infection?
18 August 2014 6,520 13 View
This is a very unhappy situation and presents a serious intraoperative and postoperative challenge. Unfortunately, it happens sometimes in cases with poor bone quality and deficient bone stock. On...
02 August 2014 1,373 7 View
This issue is important because this benign tumor-like nosology has a good prognosis and tendency to spontaneous regression without any treatment. However, differential diagnosis with...
29 July 2014 4,485 2 View
This is a problematic hip nosology, especially in bilateral hip dislocation. Although similar cases are getting rarer, they still exist. Some of the patients insist on getting a THR in spite of...
28 July 2014 2,819 12 View
Sometimes it is problematic to remove the bone cement from the femoral canal. Some risk for femur fracture also exists if you are very ambitious to separate and remove well fixed parts of cement...
28 July 2014 9,959 11 View
In the past the Girdlestone procedure has been practiced for severe OA of the hip. In cases of bilateral Girdlestone very poor results have been reported in the 1950's and 60's as far as walking...
11 July 2014 1,183 8 View
In spinal echinococcosis a complete removal of the cysts is not always possible. Some authors recommend treating the site with hyperosmolar solutions in an attempt to damage and eliminate the rest...
22 June 2014 5,869 5 View
The results are very controversial. Some authors add a stage IIa where the core decompression is not efficient at all. What is your experience and long-term results ?
20 June 2014 6,618 1 View
This is an interesting treatment modality for some orthopaedic conditions. In any case, it is not very popular and there are a lot of controversies with regard to the indications. Some colleagues...
20 June 2014 3,496 7 View
Is it a matter of health care system standard, hospital regulation or health insurance institution requirement ?
20 June 2014 8,723 3 View
Urethral catheters are frequently associated with urinary infections. This may set the arthroplasty at risk for early or late infections. Nevertheless many surgeons and anesthesiologists use...
22 May 2014 8,243 8 View
Urethral catheters are associated with urinary infections which could set an arthroplastry at risk for early or late infection. Nevertheless, some surgeons and anesthesilogists use urethral...
22 May 2014 1,066 5 View
This relatively new device is designed to close the annulus fibrosus defect and prevent reherniation. In any case it makes the discectomy more expensive. According to short-term observations this...
13 May 2014 4,129 5 View
I consider eventual risk of DVT and PE. If one prescribes stopping contraceptive medication, how long is the interval to the planned surgery? Some authors do not recommend it at all in relatively...
12 May 2014 4,070 6 View
There is little information in the pertinent literature. The application in the clinical practice is controversial because the effect is difficult to be precisely assessed.
09 December 2013 9,658 5 View
Some recent studies recommend cementless revision hip replacement. I think it is problematic in severe cases with major bone loss and defects, with periprosthetic fractures, with cured infection...
26 November 2013 9,770 12 View
I see that the arthroscopic synovectomy gains in popularity nowadays. However, the idea of synovectomy in RA is to remove possibly the whole synovial membrane (total or subtotal synovectomy) so...
24 November 2013 5,674 5 View
The data in the literature is scarce and somewhat controversial. The results seem to be temporary. Long-term follow-ups and RCTs are not available.
21 November 2013 9,235 0 View
The so-called "Tennis elbow" is a frequent condition which, unfortunately, does not always answer positively to conservative treatment, Very often it becomes a chronic pathology that causes severe...
18 November 2013 9,616 2 View
There are controversies in regard of the age for performing of surgical correction and the choice of surgical technique.
14 November 2013 4,664 2 View
In the literature there are some reports of such practice. Is it recommendable at all or should it be performed in selective cases?
05 November 2013 9,572 7 View
Some colleagues believe this technique is obsolete or preserved for adolescents or younger adults in case of hip dysplasia. What is your experience ?
04 November 2013 8,138 3 View
Some colleagues are trying to save the well fixed THR perofrming more than one debridement and intravenous antibiotics. Others are sceptic in regard of this tactics an a long-term basis.
01 November 2013 1,408 4 View
Blood loss in scoliosis surgery can be significant. Wide spongiosa surfaces predispose for postoperative bleeding. Young patients are not predisposed to DVT even after major surgery .
21 October 2013 4,708 1 View
Some colleagues believe the wake-up test is out of fashion. However, in case of electrophysiologically positive signs for deterioration of the spinal cord function what should be done first -...
21 October 2013 7,879 10 View
Some papers of English, Italian, American authors present the advantages of short stem hip prosthesis and publish very good mid-term results. In my opinion the primary stability of the short stem...
13 October 2013 1,201 4 View
Some surgeons do not use any drainages. The problem is that the routine use of anticoagulant prophylaxis and the uncemented prosthesis increase the risk of postoperative wound hematomas,...
09 October 2013 9,295 4 View
