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Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)
Dr. Adam Rosen is an orthopedic surgeon who specializes in total joint replacement. He created this podcast which is aimed at interns, residents, fellows, and general orthopedists who are looking to dive into the details of total knee replacements, hip replacement, and classic articles.
Be sure to check out my YouTube page: https://www.youtube.com/playlist?list=PL226EPMMG9vZmOiuDpmmh36nNzyPrYcRS
(Disclaimer: This is my opinion. Any information gathered is not medical education. Practitioners need to use their education and experience to determine how to treat their own patients.)
Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)
Gruen and Modes of Failure
"Modes of Failure" of Cemented Stem-type Femoral Components
Gruen, McNeice and Amstutz
CORR 1979
Seven Gruen zones
1 - proximal lateral 1/3
2 - central lateral 1/3
3 - distal lateral 1/3
4 - tip
5 - distal medial 1/3
6 - central medial 1/3
7 - proximal medial 1/3
Modes of Failure
I. Pistoning
Ia. stem pistons in cement (punch-out crack)
Ib. cement pistons in bone (halo)
II. Medial Midstem Pivot - medial migration of proximal stem, lateral migration of tip
III. Calcar Pivot - medial-lateral toggle of tip (windshield)
IV. Cantilever Bending - loss of proximal support, tip is fixed
