Kevin Park, MD, FAAOS

@orthobullets @jesseoteromdphd @OrthoCarolina @dr_a_s_prasad @Dr_Stambough @LeonardBullerMD @DrJeffPadalecki @schulte_ss @jointdocShields @itius @bethgausdenmd @ChrisGraysonMD1 Great case Jesse!

Here are intraop & postop images of yesterday's case by Dr. Jesse Otero (@jesseoteromdphd) and @OrthoCarolina. DYSPLASTIC HIP IN 20M WITH CEREBRAL PALSY PROCEDURE: 1. Percutaneous adductor tenotomy. 2. Acetabular augmentation with femoral head autograft. 3. Direct Anterior THA. This case will be discussed at the Anterior Hip Foundation @AAHips 2026 "Consensus & Controversy" in Nashville, Tennessee, June 5-6, 2026. Here is the link to the clinical presentation and the pre-op imaging: x.com/orthobullets/s… Do you agree with the treatment? Why or why not? Leave a comment and keep the great conversation going! #orthotwitter Vote on this case for CME: orthobullets.tiny.us/n6pmt8s5

Dr. @KevinParkMD will present at the @AAHKS Annual Meeting on reduced reinfection rate with intraosseous vancomycin at reimplantation in two-stage revision TKA—research that recently was recognized as AAHKS Best Podium Presentation Research award. spr.ly/6019Ah2dT

@orthotraumamd @orthobullets @HMethodistMD @BennerKneeMD @MrSimonTalbot @txsportsdoc @centerofhip @jointdocShields @huddleston_md @generalorthomd @bonesmith_ @drgsreddy I have gone away from using steris. Adhesives on steri seem more stickier than in the past

@orthobullets @HMethodistMD @BennerKneeMD @MrSimonTalbot @txsportsdoc @centerofhip @jointdocShields @huddleston_md @generalorthomd @KevinParkMD @bonesmith_ @drgsreddy Looks like @jointdocShields and possibly others dont like staples. We need some consensus here. How do you close your knees? #orthotwitter

Here is a new case by Dr. Colin McNamara. This case is sponsored by Houston Methodist Orthopedics & Sports Medicine @HMethodistMD. KNEE PAIN IN 69F WITH RHEUMATOID ARTHRITIS How would you manage this #orthotwitter? Vote on this case for CME: orthobullets.tiny.us/yc6wn66j

@BennerKneeMD @orthotraumamd @orthobullets @HMethodistMD @MrSimonTalbot @txsportsdoc @centerofhip @jointdocShields @huddleston_md @generalorthomd @bonesmith_ @drgsreddy Interesting. Good to hear you had good results. I have seen some pretty bad wound complications such as wound dehiscence requiring reoperations

@KevinParkMD @orthotraumamd @orthobullets @HMethodistMD @MrSimonTalbot @txsportsdoc @centerofhip @jointdocShields @huddleston_md @generalorthomd @bonesmith_ @drgsreddy What poor results have you seen with zipline? I have used it exclusively since 2017. Occasional mild blistering, a couple cases of temporary skin discoloration, but other wise no complications in my experience with over 1000 cases.

@BennerKneeMD @orthotraumamd @orthobullets @HMethodistMD @MrSimonTalbot @txsportsdoc @centerofhip @jointdocShields @huddleston_md @generalorthomd @bonesmith_ @drgsreddy What is your closure technique using this product? I have never used this product but have seen some poor results by others

@orthotraumamd @orthobullets @HMethodistMD @MrSimonTalbot @txsportsdoc @centerofhip @jointdocShields @huddleston_md @generalorthomd @KevinParkMD @bonesmith_ @drgsreddy I use zipline skin closures 100% of the time. We did a randomized controlled bilateral TKA trial and showed benefits across the board. pubmed.ncbi.nlm.nih.gov/31288266/

@PeltMD @generalorthomd @ArthroToday @denehy1 @neiltheknee @DrCafferky @ashtongoldmanmd I agree that accurate and reproducible results can be done by manual knee techniques. I simply find that I’m more accurate and reliable with technology and validating cuts.

@KevinParkMD @generalorthomd @ArthroToday @denehy1 @neiltheknee @DrCafferky @ashtongoldmanmd A drop rod and calipers. Measured on preop radiograph and cuts are planned. Both coronal and sagital planes. Plan resections are compared to executed. With standardized planning and technique, manual can provide very accurate and reproducible results as well.

Study finds 1◦-2◦ difference between planned and postoperative radiographic sagittal alignment in robotic-assisted TKA. Is that still a perfect cut? @generalorthomd @denehy1 @neiltheknee @DrCafferky VA: @ashtongoldmanmd arthroplastytoday.org/article/S2352-…

@generalorthomd @ArthroToday @denehy1 @neiltheknee @DrCafferky @ashtongoldmanmd @Dr_Stambough Hope you are not using persona…. I agree there are many ways to do a TKA. I guess I just like to validate my cuts to make sure I have dialed in enough slope. I started with 5 deg of slope now I do 7-8 deg. My patients seem to do better.

@KevinParkMD @ArthroToday @denehy1 @neiltheknee @DrCafferky @ashtongoldmanmd I also use MC. I'm not sure fine tuning sagittal slope makes a difference with MC/UC/CS. I aim to cut the tibia flat to 3 degrees. I believe @Dr_Stambough does something similar. Some leave PCL, some believe it creates kinematic conflict. There are so many ways to do a TKA.

@generalorthomd @ArthroToday @denehy1 @neiltheknee @DrCafferky @ashtongoldmanmd As MC/CS surgeon, I agree that my target for sagittal slope varies depending on the patient. But I use technology to check my cuts. How do you guys check your cuts?

@generalorthomd @ArthroToday @denehy1 @neiltheknee @DrCafferky @ashtongoldmanmd I disagree with your statement of those angles are much different than with manual. Manual cuts vary widely. How do you assess your sagital slope?

@Dr_Stambough @ArthroToday @GHaidukewychMD @JewettOrtho @generalorthomd @Bloch_ortho @aschwartz45 I sometimes had to on difficult primaries - bad avn, acetabular protrusio and conversions. Haven’t seen much instability from releasing OE.

@ArthroToday @GHaidukewychMD @JewettOrtho @generalorthomd @Bloch_ortho @aschwartz45 I would absolutely try NOT to release the externus. Can do another postional reset or leading edge Tensor release first

Indecent exposure in DAA THA? What releases help you achieve decent exposure? @GHaidukewychMD @JewettOrtho @generalorthomd @bloch_ortho Visual Abstract: @aschwartz45 arthroplastytoday.org/article/S2352-…

Our orthopedic surgeons Dr. @KevinParkMD and @TimBrownMD will present at #MAOA on how intraosseous vancomycin reduces the rate of periprosthetic joint infection following aseptic revision total knee arthroplasty. spr.ly/6019FUB1T

Great week at AAOS2025! Presented a few talks of accepted research projects @HMethodistMD met up with my colleagues and hung out with Methodist residents! #AAOS2025 @MethodistHosp #orthopedics #orthotwitter #orthoX

@tdd340 🥶

Hmmm🤔

@wesmayes12 @ArthroToday @Ian_Kennedy13 @morga050 @AAHKS Yup

@ArthroToday @Ian_Kennedy13 @morga050 @AAHKS Is there a followup study on whether this increases word of mouth referrals as well? I like this idea, some people are just gonna go to the ED without calling regardless.

Who you gonna call? Patients wore an orange wristband with on-call phone number on it. This was effective in encouraging patient calls but did not reduce ED visits. @ian_kennedy13 @wesmayes12 @morga050 @aahks arthroplastytoday.org/article/S2352-…

@AleksiReito @orthotraumamd @orthobullets @StephenJIncavo @HMethodistMD @ChrisGraysonMD1 @tdd340 @jointdocShields @yoon_rs @schulte_ss @DrFraneNicholas @stevemchale @itius pubmed.ncbi.nlm.nih.gov/35227534/ This is another paper by our group on abductor tear repair using bone trough technique. We saw significant improvement in gait pain and function. How big of a patient series do we need?

@orthotraumamd @orthobullets @StephenJIncavo @HMethodistMD @ChrisGraysonMD1 @tdd340 @jointdocShields @yoon_rs @schulte_ss @DrFraneNicholas @stevemchale @itius @KevinParkMD I'm happy for the patient. But what does our field look like in 20 years? We endorse small patient series and have panel discussions on double vs single row fixation still in 2044? Is that really a progress in our field? Currently we ignore the most relevant questions in ortho.

Here are postop images and a clinical video of yesterday's case by Dr. Stephen Incavo (@StephenJIncavo) and Houston Methodist Orthopedics & Sports Medicine (@HMethodistMD). HIP PAIN AND LIMP IN 78F PROCEDURE: GLUTEUS MEDIUS/MINIMUS REPAIR + GLUTEUS MAXIMUS TRANSFER Here is the link to the clinical presentation and the pre-op imaging: orthobullets.tiny.us/0020924 Click here to view an intraoperative video showing the steps of the gluteus medius repair: orthobullets.tiny.us/incavo-intraop Do you agree with the treatment? Why or why not? Leave a comment and keep the great conversation going! #orthotwitter Vote on this case for CME: orthobullets.tiny.us/2p98hpy4

@AleksiReito @orthotraumamd @orthobullets @StephenJIncavo @HMethodistMD @ChrisGraysonMD1 @tdd340 @jointdocShields @yoon_rs @schulte_ss @DrFraneNicholas @stevemchale @itius journals.lww.com/jaaos/fulltext… This is our review paper on JAAOS regarding abductor tears. Please feel free to go through some of the refs in this paper

@orthotraumamd @orthobullets @StephenJIncavo @HMethodistMD @ChrisGraysonMD1 @tdd340 @jointdocShields @yoon_rs @schulte_ss @DrFraneNicholas @stevemchale @itius @KevinParkMD If you go through those refs in the intro, there is no support for that claim. It's a made-up statement. We lack studies supporting causality between tears and pain. In that study, patients received brace and restricted WB for 6 weeks. What would be the outcome simply with that?

@orthotraumamd @Derekwmooremd @orthobullets Do it!!

I have been trying to convince @Derekwmooremd that @orthobullets needed to run a Super Bowl ad but we missed the deadline. Maybe next year, we’ll sponsor the “Orthobullets Halftime Report: The Official Source for Game-Time Ortho Questions.” From turf toe to tendinopathies, from shoulder dislocations to meniscus tears—whether you’re a pro athlete or a weekend warrior, Orthobullets has the playbook for you. Check it out for expert insights, treatment strategies, and everything in between. #SuperBowl #Orthobullets #SportsMedicine #GameTimeDecision #OrthoPlaybook

@Derekwmooremd @jointdocShields @orthotraumamd @orthobullets @StephenJIncavo @HMethodistMD @drsebheaven @ChrisGraysonMD1 @tdd340 @yoon_rs @schulte_ss @DrFraneNicholas @stevemchale @itius @shaunpat1 If the patient has abductor weakness, I would skip the injection and recommend mri. If the patient has trochanteric pain and has good abductor strength, I would recommend a steroid injection. However I wouldn’t give more than one in a year.

@KevinParkMD are you at a point where you think steroid injections for the presumed diagnosis of trochanteric bursitis should be avoided until after an MRI is done and confirms that there is not an underlying abductor tendon tear and that the pathology is in the trochanteric bursa?

Here is a new case by Dr. Stephen Incavo (@StephenJIncavo) and Houston Methodist Orthopedics & Sports Medicine (@HMethodistMD). HIP PAIN AND LIMP IN 78F How would you manage this #orthotwitter? Vote on this case for CME: orthobullets.tiny.us/2p98hpy4

@orthotraumamd @orthobullets @StephenJIncavo @HMethodistMD @drsebheaven @ChrisGraysonMD1 @tdd340 @jointdocShields @yoon_rs @schulte_ss @DrFraneNicholas @stevemchale @itius @shaunpat1 Not very often. They usually have host of other problems such as further fragility fractures, leg length discrepancy from the fracture, etc. symptomatic abductor tendon tears are usually low on the list

@orthobullets @StephenJIncavo @HMethodistMD @drsebheaven @ChrisGraysonMD1 @tdd340 @jointdocShields @yoon_rs @schulte_ss @DrFraneNicholas @stevemchale @itius @KevinParkMD Speaking of hip fractures though how often are surgeons seeing symptomatic abductor tears after antegrade femoral nailing? @jointdocShields @shaunpat1 @KevinParkMD pmc.ncbi.nlm.nih.gov/articles/PMC24…