Windswept & Interesting: My Autobiography

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It provides replacement of both knees together (albeit a few months if planned as a staggered procedure) and can be done under a single admission and anesthesia, thereby saving on the financial overrun [ 30]. So now that you understand what is going on with windswept posture, my hopes are that you will be able to easily identify it on your quarterly screens and during the evaluation. Remember that windswept posture often accompanies a rotation or obliquity, and if that's the case, then follow the goals for the underlying cause of this posture. I assure you, the resident will thank you for it! Sharma L (2007) The role of varus and valgus alignment in knee osteoarthritis. Arthritis Rheum 56(4):1044–1047 The vessel WINDSWEPT (IMO 9399806, MMSI 563169400) is a Container Ship built in 2010 (13 years old) and The vessel is en route to the port of Tilbury, United Kingdom (UK), sailing at a speed of 0.1 knots and expected to arrive there on Oct 30, 21:00.

Arizono T, Ogata K, Sugioka Y (1989-1990) Windswept deformity of the knee in adult. Orthop Traumatol-Sur 38:1703–1170 Hence, the WSD should be approached as a single entity, and each knee should be considered as one-half of the problem. Treating the problem in its entirety makes sound clinical sense due to the following perspectives. Anatomy and biomechanical perspectivePublic transport stops at main promenade road. (approximately 200 metres from house). Level car park and ramp to the location of property.

Mündermann A, Dyrby CO, Andriacchi TP (2005) Secondary gait changes in patients with medial compartment knee osteoarthritis: increased load at the ankle, knee, and hip during walking. Arthritis Rheum 52(9):2835–2844 Zhou K, Zhou Z, Shi X et al (2018) Effect of individual distal femoral valgus resection in total knee arthroplasty for patients with a valgus knee: a retrospective cohort study. Int J Surg 52:309–313. https://doi.org/10.1016/j.ijsu.2018.02.048.Howell SM, Shelton TJ, Gill M, Hull ML (2020) A cruciate-retaining implant can treat both knees of most windswept deformities when performed with calipered kinematically aligned TKA. Knee Surg Sports Traumatol Arthrosc. https://doi.org/10.1007/s00167-020-05968-9 Wright JO, Nunley RM (2015) Complex primary total knee arthroplasty: management of valgus knee. In: Springer BD, Curtin BM (eds) Complex primary and revision total knee arthroplasty: a clinical casebook. Springer, New York, pp 13–27 Baldini A, Balato G, Franceschini V (2015) The role of offset stems in revision knee arthroplasty. Curr Rev Musculoskelet Med 8(4):383–389 Shetty GM, Mullaji A, Khalifa AA, Ray A (2017) Windswept deformities – an indication to individualize valgus correction angle during total knee arthroplasty. J Orthop 14(1):70–72 This project is run in partnership with The University of the Highlands and Islands (UHI) through her partners – UHI Moray, Environmental Research Institute (ERI), Institute of Northern Studies (INS) and the North of Scotland KTP Centre. It is funded by Innovate UK.

Windswept is passionate about adopting sustainability measures as part of everyday business. Our aim is to brew the best beer possible while having as small of an environmental impact as possible. Spend your days on the beach, or join the Pembrokeshire Coastal Path, to explore over the headland towards the picturesque harbour village of Little Haven; at low tide you can even reach it along the beach. It prevents duplication of perioperative procedures and scheduling of operation theatre rosters in a busy set-up [ 27].In Minecraft, the Windswept Forest is a biome in the Overworld. It is a mountain range that is covered in grass, spruce trees and oak trees. At higher elevations, you will find snow at the peaks of the mountains and on the tops of the trees. Vaishya R, Vijay V, KC KM, Agarwal AK (2018) Is simultaneous bilateral total knee arthroplasty safe in the geriatric population? A retrospective cohort study with up to 9 years follow up. J Clin Orthop Trauma 9(2):107–111 Sugioka et al. [ 13], in a retrospective study, reviewed five adult patients who had a WSD. They made an important observation that one side valgus angulation might cause a compensatory varus angulation on the contralateral side, although this finding was not substantiated by any further studies. Case et al. [ 14], in their presentation on the gait observational data in 53 patients, have opined that pain in one joint may directly and predictably affect loading in other joints. Rao and Reddy [ 15], in their study on the association of frontal plane tibiofemoral alignment with knee pain in 314 knees (195 patients), found a positive correlation between coronal tibiofemoral angles and pain in primary OA. Leena Sharma [ 16] observed that the burden of malalignment of the knees predicts a decline in physical function and that these effects can be detected as early as 18 months. Implications for intraoperative planning of valgus correction angle We wouldn’t be able to discuss abnormal postures without mentioning windswept posture, also known as windswept deformity. This postural description has more to do with abnormalities at the hip joints and lower extremities than describing the pelvis alone. In-soo Song MD, Je-gyun Chon MD, Jun-beom Kim MD (2008) Total knee arthroplasty for treating valgus and varus in the knees of one person. J Korean Knee Soc 20(2):110–116

Mullaji et al. [ 17] studied the variation in femoral valgus correction angle (VCA) between the two limbs in patients with windswept deformity undergoing TKA and found that VCA in varus knees was significantly higher compared to mean VCA in the valgus knees. Shi et al. [ 18], in their large study on the accuracy of using individualized valgus correction angle during TKA for varus and valgus deformities of the knee, concluded that individual correction angles improve the accuracy of postoperative limb alignment after TKA compared with using fixed valgus correction guides. Nam et al. [ 19], in a retrospective review of 320 consecutive patients, found that the use of a variable distal femur resection angle improves femoral component alignment after TKA. Similarly, Zhou K et al. [ 20], in a radiological study, showed that individual VCA for distal femoral resection could achieve better postoperative alignment accuracy and fewer outliers of limb and femoral component malalignment in the coronal plane. Clinical outcomes following bilateral TKA in windswept deformities Shi X, Li H, Zhou Z, Shen B, Yang J, Kang P et al (2015) Individual valgus correction angle improves the accuracy of postoperative limb alignment restoration after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 25(1):277–283 We draw from our review of literature and experience that SBTKA in the medically fit group of patients is advantageous for the following reasons:Bagsby D, Pierson JL (2015) Functional outcomes of simultaneous bilateral versus unilateral total knee arthroplasty. Orthopedics 38:e43–e47. https://doi.org/10.3928/01477447-20150105-59. The abnormal biomechanics and force moment of the knee cause progressive arthritis of the knee. The valgus deformity usually precedes a varus deformity on the contralateral knee in windswept deformities. Correct restoration of mechanical tibiofemoral angles by individualizing valgus correction angles have better outcomes after TKA. Conclusion