Sharath KR Robotic Replacement, Arthroscopy Expert

Lateralized Glenoid Baseplate in RSA for Anterior Glenoid Deficiency with Rotator Cuff Arthropathy

Anterior glenoid bone loss poses challenges in achieving stable glenoid fixation and restoring shoulder biomechanics during reverse shoulder arthroplasty. A lateralized glenoid baseplate can be a valuable solution in these cases.

Advantages of Glenoid Lateralization:

• Improved fixation: Enables placement of the baseplate on stronger native glenoid bone while minimizing excessive reaming.

• Enhanced stability: Increases compressive forces across the joint, reducing the risk of instability.

• Reduced scapular notching: Moves the center of rotation away from the scapular neck, decreasing impingement.

• Better range of motion: Provides a greater impingement-free arc of movement, particularly in rotation.

• Optimized deltoid mechanics: Improves deltoid wrapping and efficiency, enhancing shoulder function.

• Facilitates bone preservation: Allows correction of deformity without sacrificing additional glenoid bone stock.

Take-home message:
In anteriorly deficient glenoids, the objective is durable fixation and stable biomechanics rather than complete correction of version. Glenoid lateralization helps achieve both while preserving bone and improving function.


#ReverseShoulderArthroplasty #RSA #ShoulderArthroplasty #RotatorCuffArthropathy #AnteriorGlenoidDeficiency #GlenoidBoneLoss #LateralizedBaseplate #ShoulderReplacement #ShoulderSurgery #Orthopaedics #Arthroplasty #ShoulderReconstruction #OrthopaedicEducation #SurgicalPearls #ComplexShoulderArthroplasty #ShoulderSurgeon #MedicalEducation #ShoulderInstability #ArthroplastyTips #ShoulderConference

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1 month ago | [YT] | 5

Sharath KR Robotic Replacement, Arthroscopy Expert

Mickey Mouse Pelvis Morphology: A Challenging Direct Anterior Approach Total Hip Arthroplasty

A 28-year-old muscular male presented with advanced secondary osteoarthritis of the hip associated with severe pain, restricted range of motion, and significant functional limitation. Clinical examination demonstrated a markedly stiff hip with limited extension, abduction, and external rotation.

Preoperative radiographic assessment revealed a unique pelvic morphology characterized by markedly flared iliac wings and a relatively narrow lower pelvis, producing the appearance of a “Mickey Mouse pelvis” on the AP pelvis radiograph. The patient had an exceptionally high Ilium-to-Ischium (I:I) ratio of 4.57, indicating substantial widening of the iliac wings relative to the ischial width. In addition, the proximal femur demonstrated a short femoral neck, further complicating femoral exposure.

From a Direct Anterior Approach (DAA) perspective, this combination represented a perfect storm of unfavorable anatomy. The broad iliac flare created a deep surgical corridor and limited the working space available for femoral preparation. The short femoral neck reduced the lever arm required for femoral elevation, while the stiff hip and muscular soft-tissue envelope further restricted mobilization of the proximal femur.

During surgery, the acetabular exposure was straightforward; however, femoral exposure proved significantly challenging. Extensive capsular releases, including superior and posterolateral releases, were required to achieve adequate femoral elevation. The prominent iliac wings restricted instrument trajectory, and the deep-seated femur demanded meticulous handling to avoid varus stem insertion, calcar fracture, or cortical perforation.

This case highlights the importance of recognizing Mickey Mouse pelvis morphology as a predictor of difficult femoral exposure during DAA total hip arthroplasty. A markedly elevated I:I ratio, particularly when combined with a short femoral neck, muscular build, and hip stiffness, should alert the surgeon to the potential need for extensive releases, specialized instrumentation, and increased operative complexity.

Key Learning Point

While acetabular preparation is usually reproducible in DAA, femoral exposure remains the critical step. A high Ilium-to-Ischium ratio (4.57), short femoral neck, and stiff muscular hip represent important preoperative warning signs for a technically demanding Direct Anterior Approach hip replacement.
#DirectAnteriorApproach
#DAAHipReplacement
#AnteriorHipReplacement
#TotalHipArthroplasty
#HipReplacementSurgery
#DifficultDAA
#MickeyMousePelvis
#IliumToIschiumRatio
#ShortFemoralNeck
#StiffHip
#ComplexHipArthroplasty
#HipSurgery
#Orthopaedics
#OrthopaedicSurgery
#Arthroplasty
#HipArthroplasty
#JointReplacement
#YoungArthritis
#SurgicalPearls
#TipsAndTricks
#FemoralExposure
#PrimaryTHA
#MusculoskeletalSurgery
#OrthopaedicEducation
#HipSurgeon
#AnteriorApproachTHA
#BangaloreHipSurgeon
#OrthopaedicTeaching
#CaseOfTheWeek

1 month ago | [YT] | 0

Sharath KR Robotic Replacement, Arthroscopy Expert

For a Stage 1 Revision Total Knee Replacement (infected TKR), a cement mould/spacer is used after explantation of the prosthesis to deliver high local antibiotic concentration, maintain joint space, preserve soft tissue tension, and allow some mobility until Stage 2 reimplantation.

Key Points for Cement Mould (Articulating Spacer)

Indications

* Chronic periprosthetic joint infection (PJI)
* Planned two-stage revision knee arthroplasty

Advantages

* High local antibiotic delivery
* Maintains knee motion
* Prevents soft tissue contracture
* Easier exposure during second-stage surgery
* Better patient comfort and mobility compared to static spacers

Technique

1. Remove all implants and cement.
2. Thorough synovectomy and debridement.
3. Multiple tissue samples for culture.
4. Prepare antibiotic-loaded PMMA cement (commonly Vancomycin + Tobramycin/Gentamicin).
5. Use a silicone mould or handmade mould to create femoral and tibial components.
6. Insert articulating spacer and check stability, alignment, and ROM.
7. Close over drains as required.

Common Antibiotic Cement Mix

* 40 g PMMA cement
* Vancomycin 2–4 g
* Tobramycin/Gentamicin 2.4–3.6 g

(Adjust according to organism sensitivity and cement handling characteristics.)

Tips & Tricks

* Avoid excessive cement interdigitation to facilitate removal at Stage 2.
* Maintain balanced flexion-extension gaps.
* Reinforce spacer with Steinmann pins or K-wires if needed.
* Aim for 0–90° ROM intraoperatively.
* Ensure adequate thickness to prevent spacer fracture.

Possible Complications

* Spacer fracture
* Dislocation/subluxation
* Bone loss
* Persistent infection
* Extensor mechanism problems

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1 month ago | [YT] | 0

Sharath KR Robotic Replacement, Arthroscopy Expert

My article in today’s times of India on robotic knee replacement

3 months ago | [YT] | 5

Sharath KR Robotic Replacement, Arthroscopy Expert

Honoured to be part of the 1st IAHF (Indian Anterior Hip Foundation) as faculty.

Had the privilege of interacting with some of the finest and most experienced surgeons in Direct Anterior Approach (DAA) hip replacement. It was wonderful to meet respected senior experts, reconnect with old friends, and build new professional friendships.

Delivered a lecture on “Tips and Tricks of Femoral Stem in DAA”, sharing practical insights and surgical nuances from my experience.

An enriching and inspiring experience that reinforces the commitment to keep learning, sharing, and advancing patient care.

Grateful for the opportunity.

#IAHF #DAAHip #HipReplacement #Orthopaedics #MedicalEducation #SurgeonLife #LearningNeverStops

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3 months ago | [YT] | 5

Sharath KR Robotic Replacement, Arthroscopy Expert

Hi everyone, welcome to my new YouTube Community. Now you can post on my channel too. To get started, tell me in a post what you'd like to see next on my channel.
Visit my Community: youtube.com/@drsharathkr80/community

4 months ago | [YT] | 0

Sharath KR Robotic Replacement, Arthroscopy Expert

Conducted a Hip Replacement Cadaver Course and demonstrated hip replacement surgery for delegates.

This was my 27th Arthroplasty Cadaver Course, and it has been a privilege to contribute to orthopaedic surgical training for more than a decade.

Forever grateful to MSR ALC for supporting and helping us continue to conduct orthopaedic courses. Thanks to Meyer for their academic initiative.

#HipReplacement #Arthroplasty #CadaverCourse #OrthopaedicEducation #JointReplacement #SurgicalTraining #Orthopaedics #DAAHipReplacement

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4 months ago (edited) | [YT] | 10

Sharath KR Robotic Replacement, Arthroscopy Expert

Honored to be invited as Guest Faculty at Sridevi Medical College for the Clinical Society Meeting.

It was a privilege addressing the enthusiastic postgraduates and respected faculty from all departments. Speaking on “Knee Pain Through the Ages”, we journeyed across the spectrum:
• 🔹 Ligament injuries in the young and athletic
• 🔹 Cartilage damage and meniscal pathology
• 🔹 Malalignment and early degeneration
• 🔹 Advances in robotic partial knee replacement
• 🔹 Robotic total knee replacement for advanced arthritis

The interactive discussions, insightful questions, and academic spirit made the session truly meaningful.

Grateful for the warm hospitality and vibrant academic environment. Looking forward to many more such knowledge-sharing platforms.

#GuestFaculty
#ClinicalSocietyMeeting
#SrideviMedicalCollege
#KneePain
#LigamentInjury
#CartilageDamage
#RoboticKneeReplacement
#PartialKneeReplacement
#TotalKneeReplacement
#Orthopaedics
#MedicalEducation
#AcademicExchange

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4 months ago | [YT] | 6

Sharath KR Robotic Replacement, Arthroscopy Expert

Honoured to be invited to AIIMS as faculty for the Direct Anterior Approach (DAA) Hip Replacement course.

Had the opportunity to demonstrate DAA hip replacement on a cadaver at one of the hands-on stations and also moderated a scientific session—a truly enriching academic experience.

Standing in the same corridors of AIIMS brought back memories. I stood here years ago as a PG aspirant and appeared for the AIIMS entrance examination three times in 2004.
After many years, to return to the same institution—this time as a hip specialist and invited faculty—was deeply humbling and emotional. Life truly comes full circle.

It was wonderful to meet old friends and make new ones, and to have long, meaningful conversations about life, orthopaedics, evolving surgical philosophies, the growth of DAA in India, and global trends in hip arthroplasty.

Icing on the cake was meeting the Director of AIIMS in his chamber and having a very pleasant interaction—a simple, humble, and gracious gentleman.

My sincere thanks to Dr Vikrant and the Department of Orthopaedics, AIIMS, for organizing such a wonderful program and for the kind invitation and opportunity.

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5 months ago | [YT] | 6

Sharath KR Robotic Replacement, Arthroscopy Expert

Honoured to have moderated the Complex Hip Replacement session at ROC 2026 (Ranawat Orthopaedic Conference).

The session featured stimulating discussions on challenging primary and revision hip arthroplasty cases, surgical decision-making, implant choices, and complication management. Thought-provoking case presentations and active audience interaction truly reflected the academic depth and collaborative spirit that ROC is known for.

Grateful to the faculty and participants for sharing their expertise and insights, making it a highly engaging and enriching experience. Looking forward to translating these discussions into better outcomes for our patients.

#ROC2026 #RanawatOrthopaedicConference #HipReplacement #ComplexArthroplasty #Orthopaedics #HipArthroplasty #AcademicOrthopaedics #ContinuousLearning

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6 months ago | [YT] | 2