Jian Wang, MD, PhD, FCMDA
@OrthoJianWANG
Followers
1,867
Following
4,852
Media
1,234
Statuses
1,787
Aspiring Orthopedic Surgeon👨⚕️｜Nanfang Hospital, SMU🏥｜Member of Orthopedic Branch of CMDA🇨🇳｜Consultant Surgeon🧔｜Arthroplasty & Arthroscopy🛠️
Joined January 2023
Don't wanna be here?
Send us removal request.
Explore trending content on Musk Viewer
Madison Square Garden
• 1436133 Tweets
Puerto Rico
• 529197 Tweets
Tony
• 218817 Tweets
Nazis
• 201776 Tweets
MSNBC
• 150796 Tweets
Latinos
• 146252 Tweets
Bears
• 141182 Tweets
Dr. Phil
• 116472 Tweets
Hail Mary
• 102348 Tweets
49ers
• 64957 Tweets
Cowboys
• 58305 Tweets
紙の保険証
• 45259 Tweets
せなけいこさん
• 30839 Tweets
絵本作家
• 30405 Tweets
ねないこだれだ
• 24795 Tweets
#MondayMotivation
• 24231 Tweets
George Lopez
• 20576 Tweets
Nick Bosa
• 19843 Tweets
#صباح__الخير
• 18236 Tweets
#VINIDAY
• 17844 Tweets
Purdy
• 14663 Tweets
BINI FOR VOGUE PH
• 14602 Tweets
Kittle
• 14156 Tweets
#C295MadeInIndia
• 11941 Tweets
Rayados
• 11806 Tweets
Niners
• 11193 Tweets
大阪・豊中市
• 10010 Tweets
不在者投票525人分
• 10005 Tweets
WOW！😍
The first anatomical talus printed in China🇨🇳 using tantalum alloy for ankle fusion surgery.👏
The operation is expected to be performed next week.
4
79
359
Direct lateral approach for hip joint replacement surgery.
Part 1: Exposure
(Non-preservation of the joint capsule)
#MedTwitter
#orthotwitter
5
22
143
The backstory of this case is rather unusual. As you can see, the femoral head has migrated into the pelvic region. Do you happen to know how this came about?
The patient's hip was dislocated outward and upward as a result of trauma, and no fractures to the femoral neck or
15
37
133
Is this "reaming and fire extraction"?
No.
This is a joint replacement surgery for avascular necrosis of the femoral head, where the surgeon is using a spherical ream to grind the diseased femoral head.
This is done to obtain "bone debris" which will be used to fill the "bone
3
16
127
Given only this X-ray, can you initially determine the disease the patient is suffering from?
#MedTwitter
#ortho
25
17
107
Have you heard of the concept of 1.5-stage revision after TKA infection?
We know that 1-stage revision has become one of the main options in revision of THA infection. However, 1-stage revision is rarely used in revision of TKA infection because of the high probability of
10
16
80
16y, female.
R hip pain for 4ys.
What should be done as her limp and pain are worsening now?
18
6
66
This is another patient who came to see me because of knee pain ...
#MedTwitter
#orthotwitter
7
8
60
Breast cancer with bone metastasis all over the body and pathological fracture of proximal femur. How would you deal with this patient?
1. Steel plate screws
2. Intramedullary nail
3. Long stem hemi replacement
4. Bone traction
#MedTwitter
#orthotwitter
34
11
59
Preserving the joint capsule is indeed helpful in improving limb length differences.
Case performed yesterday.
#MedTwitter
#orthotwitter
4
6
56
Rare case:
Surgery performed at the age of 3, and now the steel plate has grown into the femoral medullary cavity.
#MedTwitter
#orthotwitter
5
6
61
The goal of a hip joint replacement surgery that involves preserving the joint capsule is not to prevent dislocation, but rather to minimize excessive limb lengthening caused by loosening on the side that was operated on.
The case in the picture shows a difference in limb length
1
5
58
This patient has gone through a prolonged period of misdiagnosis and has received treatment for knee pain at other hospitals.
However, she sought my consultation this time as she desired to undergo knee arthroscopy surgery here.
During my initial assessment, I noticed that she
11
9
52
If there is an allergic reaction to metal skin staples at the site of a skin incision, but it is not yet time to remove the stitches, what should be done?
#MedTwitter
#orthotwitter
35
7
52
Would you kindly share your treatment recommendations for this case?
For a femoral neck fracture that failed to unite after 18 months following internal fixation surgery, I would consider either revising the fixation or performing a hip arthroplasty.
Revising the fixation would
37
7
47
Winter has arrived, and elderly people need to pay special attention to preventing falls.
Hip fractures are known as the "last fracture in life".
#MedTwitter
#orthotwitter
6
5
44
The patient with ankylosing spondylitis had previously undergone a right THA at another hospital.
It is evident that the acetabular cup chosen was too small.
This time, we have selected a dual-mobility THA with an super-oversized acetabular cup for left hip.
6
5
42
Severe dislocation requires femoral osteotomy for successful reduction.
Furthermore, for this kind of size of cup, metal femoral head and highly cross-linked polyethylene may be the noly choice.
To minimize wear, it is recommended to use a black zirconium-niobium alloy femoral
7
7
43
After six months of intramedullary nail fixation for femoral neck fracture, there is persistent pain in the hip joint.
🤔Do you think the pain could be caused by the screw protruding beneath the articular cartilage of the femoral head?
#MedTwitter
#orthotwitter
#MedTwitter
18
4
43
Do you know the names of the manufacturers for each of these stems?
5
7
39
In DDH THA, when considering the change in rotation center to improve acetabular cup coverage, which approach would you prefer, 'superior shift' or 'medial shift'?
I would lean towards the "medial shift" rather than the "superior shift".
The superior shift may result in an
4
3
39
Bilateral hip osteoarthritis with indications for joint replacement surgery on both sides raises two considerations.
Firstly, should the surgeries be performed together or in staged procedures?
Secondly, if staged procedures are chosen, what is the optimal time interval
18
6
38
Before 2008, I used to be a spine surgeon and had managed a patient as following.
However, now I am no longer familiar with current practices in spine surgery. I'm not sure if there are routine measures in place to prevent DVT during spine surgery. If there are, what specific
2
4
36
He was overjoyed because after the surgery, he could finally sit on a chair. 😁
(A patient who had hip joint fusion for over a decade).
I am also extremely delighted.😆
#MedTwitter
#orthotwitter
4
2
37
Before surgery, neat and tidy.
After surgery, mess.
0
1
36
Oxinium is a material used by Smith&Nephew in their medical implants.
It is an oxidized zirconium alloy that undergoes a unique manufacturing process, resulting in a ceramicized metal material.
Has this material the potential to reduce revision rates and prolong prosthetic
3
5
33
Following a left acetabular fracture, more than 20 years after left hip arthroplasty, what would be your surgical plan?
How would you reconstruct the acetabular side?
What type of femoral stem would you use on the femoral side?
#MedTwitter
#orthotwitter
5
2
31
Direct lateral approach for hip joint replacement surgery.
Part 3: Limb Length Control
#MedTwitter
#orthotwitter
2
4
31
It is very common in stage of post-THA/TKA, will you stop using anticoagulants?
15
2
31
This is another case of a patient who was misdiagnosed with lumbar disc herniation when they actually had femoral head necrosis.
My assessment is that the previous doctor did not conduct a thorough physical examination, but instead relied on the patient's medical history and
2
6
31
Direct lateral approach for hip joint replacement surgery.
Part 2: Angle and Position
#MedTwitter
#orthotwitter
2
3
32
49y, male, ankylosing spondylitis.
Dual mobility, SERF, French.
Although ankylosing spondylitis is characterized by excessive bone formation, the bone quality in affected individuals is generally poor.
Based on my experience, when performing hip cup implantation, it is not
1
3
32
＃Hipreplacement for intertrochanteric fractures, femoral stem + titanium cable, equivalent to strong
#internalfixation
#MedTwitter
#orthotwitter
11
7
30
Appreciate the excellent coating of this cup, which makes the surgery easier.
It is a DDH with the femoral head located in the false acetabulum, the upward displacement distance is not significant.
Therefore, after adequate loosening, reduction of the hip joint is not
4
3
26
Infection after anterior cruciate ligament reconstruction surgery, guess what pathogen has been cultivated?
Aspergillus flavus.
3
4
30
Popliteal cysts are notorious for their high rate of recurrence after surgery, which is why they are often considered a challenging problem for orthopedic surgeons.
The key focus of surgical treatment is to completely ligate the fistula that connects to the knee joint, as
1
4
25
Please note that this is not necrosis of the femoral head, it is osteoarthritis secondary to developmental dysplasia of the hip joint.
Although the treatment method is the same in the end stage, both using joint replacement, the pathological mechanisms of these two diseases are
1
4
25
Another case with a similar presentation was encountered in the outpatient department today (a highly similar patient was seen last week as well). The patient has developmental dysplasia of the hip (DDH) and underwent autogenous iliac bone grafting for acetabular reconstruction
3
6
25
Six years after left
#hipreplacement
, Slight pain of Hip has recently appeared.
Imaging examination revealed
#osteolysis
of proximal femur.However, the distal end of the stem still grows with the femoral bone.
Is now the best time for
#revision
?
10
2
25
Those are routine instruments for THR surgery, and when encountering complex surgeries or revision surgeries, there may be three to five such workbenches.
#MedTwitter
#orthotwitter
2
2
25
Follow-up on case:
A 34-year-old male who underwent hip replacement surgery is now 34 days post-operation.
The patient was able to discontinue the use of crutches on the 28th day after the procedure.
#MedTwitter
#orthotwitter
1
3
24
One year after knee replacement in other hospital, the patient complained of pain in the proximal tibia, and there was a transparent line between the tibial prosthesis and the bone. Is this aseptic loosening?
#MedTwitter
#ortho
7
1
24
Necrosis? or Rheumatoid arthritis?
No hematological evidence of rheumatism.
#MedTwitter
#orthotwitter
3
6
24
The state of muscle relaxation during general anesthesia can affect the degree of hip joint laxity. Even if we minimize excessive disturbance to the joint capsule and avoid excessive loosening, the traction test on the hip joint during surgery may still exhibit an abnormal
3
2
18
For early-stage avascular necrosis of the femoral head, orthopedic surgeons skilled in microsurgery highly recommend the use of vascularized fibular grafting.
My question is, how many cases of vascular anastomosis have successfully restored blood flow without occurrence of
3
5
23
What's the diagnosis and what is your surgical plan for this case?
(Male, 19y, height less than 1.5 meters)
#MedTwitter
#orthotwitter
15
5
21
Which is your most common option?
What are the factors that affect your choice?
7
5
22
3
2
21
Studies have indicated that wearing two masks can contribute to a decreased infection rate in joint replacement procedures.
However, I believe that the core issue lies in the efficacy of mask sealing.
#MedTwitter
#orthotwitter
#PJI
0
6
19
Her knee is completely asymptomatic, but she exhibits an abnormal gait pattern. The body sway becomes more pronounced with prolonged walking.
X-rays reveal severe osteoarthritis.
✅Would you consider recommending knee joint replacement for her?
✅Have you encountered cases of
17
6
21
Today, we are attempting to perform joint capsule preservation for patients with hip dysplasia.
By moderately medial shifting the acetabular cup and reducing soft tissue loosening, the suturing of the joint capsule was ultimately achieved.
2
2
20
The case we are going to analyze today involves a severe hip osteoarthritis with a bone cyst at the superior aspect of the acetabulum. The main focus of the analysis is the impact of the bone cyst on the choice of acetabular reconstruction and implant selection for total hip
1
0
18
If the price of a 3D printed coated cup was the same as a conventional titanium plasma sprayed cup, would you definitely choose the 3D printed option without hesitation?
Yes, affected by the centralized procurement policy, the prices of these two kinds of cups are the same in
0
2
21
How many surgeons utilize X-ray fluoroscopy during surgery to confirm the following:
1. The position and angle of the acetabular cup.
2. Whether the acetabular cup screw has entered the pelvic cavity.
3. Whether the stem is fully filled in the marrow cavity.
4. Whether the limb
0
4
17
This fully coated revision femoral stem is very user-friendly to use, and I believe its advantage over S-ROM lies in its distal biological coating, which can integrate well with the distal end of the femur.
Even if there is non-union at the osteotomy site, the proximal and
2
2
17
Hip replacement surgery with preservation of hip joint capsule, using shoelace suture method to suture the joint capsule onto the cortex of the greater trochanter.
#MedTwitter
#ORTHOTWITTER
1
0
17
The progress of medical technology relies on advancements in industrial technology. With the gradual improvement of coating technology, the likelihood of aseptic loosening has significantly decreased.
#medtwitter
#orthotwitter
During the current surgery, the prostheses implanted
0
3
17
Sodium hyaluronate has long been considered a placebo because many studies have found it to be ineffective.
We need to delve deeper into the underlying reasons for its poor efficacy:
❎Firstly, some studies have used it in cases of severe osteoarthritis with significant
4
4
18
This is an astonishing discovery made by our colleagues in the anesthesiology department:
They utilized transesophageal echocardiography during the procedure to observe the heart.
(1) Starting from the acetabular reaming, intermittent snowflake-like images appeared within the
0
5
18
Some knee surgeons would never touch a partial knee replacement, even if the patient's only issue is wear and pain on the medial side of the knee.
Have you encountered such a situation before?
What do you think could be the possible reasons for this?
#MedTwitter
#orthotwitter
4
3
17
Rheumatoid arthritis with suspected hip joint infection, hip joint reconstruction was performed six months after debridement surgery. (The patient strongly requests hip replacement due to poor quality of life and is willing to bear the risk of infection after the replacement
5
3
17
During the surgery for femoral neck cyst with bone grafting, do you use internal fixation to prevent potential intraoperative and postoperative pathological fractures?
This is an interesting case involving a middle-aged female patient who presented with hip discomfort.
2
4
19
7-years-old child with left knee joint pain for 1 week.
Diagnosis?
10
3
17
Microcrystalline ceramics produced in China implaned in a patient for 35 years.
It was an age of knowledge explosion and imagination explosion.
#MedTwitter
#orthotwitter
1
1
15
#Hammer
is one of the tools that
#orthopedic
surgeons often use, so orthopedic surgeons are also called as
#blacksmith
.
0
2
15
For patients with developmental dysplasia of the hip joint, it seems difficult to preserve the joint capsule because the limbs are always stretched, resulting in a large distance on both sides of the capsule that cannot be closed together.
Eager to know your technique to deal
3
0
15
THA today, SLE.
The most important thing is not how to perform the surgery, but how to minimize the probability of infection.
#MedTwitter
#orthotwitter
3
3
15
Modified Hardinge approach, with 100% preservation of joint capsule, can effectively improve the difference of limb length.
#MedTwitter
#orthotwitter
4
2
16
Thing 1:
Most hip replacement procedures lead to positive outcomes.
Hip replacement surgery has undergone significant advancements in recent years, leading to improved outcomes for patients. These advancements include technological innovations, better pain control, improved
1
4
16
An elderly woman who underwent knee replacement surgery at another hospital for 3 years came to my clinic today and complained of continuous discomfort after the surgery.
What factors do you think may cause her low satisfaction?
Do I need to take any intervention measures for
9
1
15
The operation was just finished.
The screw of acetabular posterior wall fracture enters the joint cavity, which leads to the wear and pain of the femoral head.
A hip replacement was performed, and there was a screw that blocked our acetabular cup from being implanted, so it was
1
1
15
The patient has pain in both knee, mainly on the left.
From the X-ray, the medial space is narrow, but the patient complained of more obvious pain in the front and lateral of the knee joint.
In this case, can UNI replacement be chosen?
#MedTwitter
#orthotwitter
17
7
16
🫣Will you administer PRP injections to patients during arthroscopic surgery?
🧑💼Let's continue sharing the findings from our published literature in 2019.
📋After analyzing previous studies, our conclusion regarding the use of PRP injection in surgery of the discoid lateral
1
1
15
Q:
What are the recent new orthopedic treatment methods or technologies?
A:
In recent years, there have been several exciting advancements in the field of orthopedics. Here are some noteworthy developments:
✅3D Printing Technology: The use of 3D printing technology has
1
3
14
Total knee replacement surgery is an art of compromise.
#MedTwitter
#orthotwitter
In total knee replacement surgery, achieving soft tissue balance and correcting the alignment of the joint are two key objectives. Optimal soft tissue balance means that the soft tissues
3
2
14
In the field of knee arthroplasty, our goal has always been to achieve a perfect force line, which means taking an X-ray of the lower extremities in a standing position after surgery, with the center points of the femoral head, knee joint, and ankle joint forming a straight line.
1
3
13
This anteversion and abduction of cup are the preferred angles for me via anterolateral approach in supine position.
Case completed this morning.
ZIMMER's tantalum hip.
0
0
11
This is happy ending.
Zimmer, ceramic-ceramic
1
0
14
I think it is possible to put the acetabular cup in without removing the screws.
#MedTwitter
#ortho
6
3
14
For successful matching of the two heads in the press-fit process of the dual mobility total hip joint, it is necessary to hear two distinct "popping" sounds.
1
2
15
This is the acetabular cup with trabecular coating.
From the perspective of X-ray imaging, there are visible porosity on the surface, which is not observed in titanium plasma-sprayed coatings.
@BunnieSPaige
Thank you for your question.
First of all, your question is not at all stupid. On the contrary, it is quite professional.
Moreover, this question involves a core issue in the survival of implants - osseointegration.
The speed and effectiveness of osseointegration depend on
0
0
2
0
0
10
Complex Movements of Thumb.
Source: 《trail guide to body》Andrew Biel
#medtwitter
#orthotwitter
0
4
12
Some people argue that the more measures and methods taken to prevent infection during joint replacement surgery, the better.
Recent evidence suggests that diluted povidone-iodine can effectively kill all bacterial microorganisms within 20 seconds when used for intraoperative
7
4
14