Paul M Lichstein, MD,MS

@jointdocShields @JArthroplasty @ArthroToday AT is open access - which arguably provides more exposure for your work. Although I believe for any subsequent manuscripts accepted within the year the publication fee is waived

Has anyone else noticed a trend where @JArthroplasty kicks more submissions to @ArthroToday which has a large fee associated with acceptance?

@jointdocShields @BrianChalmersMD @AAHKS @HSpecialSurgery @HSSProfEd @JennaBernstein7 Yep

@BrianChalmersMD @AAHKS @HSpecialSurgery @HSSProfEd @JennaBernstein7 Is that Paul in the back?

Our @aahks president Dr. Huddleston and the advocacy committee met with Senator Barrasso from Wyoming about health policy and maintaining access for our patients - he is also an orthopedic surgeon! @AAHKS @HSpecialSurgery @HSSProfEd @JennaBernstein7 @jointdocShields #orthotwitter

@Dr_Stambough Clinic deal sleds, nice

I don't often wear dress socks to work, but when I do, I wear socks with my kids faces on them!

@ChrisGraysonMD1 @CenterRotation @EdinburghKnee @generalorthomd @jointdocShields @wesmayes12 @ACR_MD @LindaSuleimanMD Do you have preop films? Do you have spine films? I would want to know more about this situation

Pt from OSH 1 month po from l tha. Large LLD. Pt unhappy. Does not want to consider shoe lift. R Tha 15 yrs out but doing well. What options should I offer her? #orthotwitter @CenterRotation @EdinburghKnee @generalorthomd @jointdocShields @wesmayes12 @ACR_MD @LindaSuleimanMD

@Dr_Stambough @DrMattDeren @CleClinicArthGp @RobertMolloyMD @nspiuzzi @DrLeeRubin Bring an osteotome and rongeur

@DrMattDeren @CleClinicArthGp @RobertMolloyMD @nspiuzzi @DrLeeRubin Whatever approach you want. Pros/cons to both. But triple taper stem w collar and standard cup with Biolox on HXLPE (no DM) for me

Gentleman with this xray. Hip fixed with no motion. Leg length discrepancy. Wants a total hip, what's your approach and implant choice? @CleClinicArthGp @RobertMolloyMD @nspiuzzi @DrLeeRubin

@DeviceNation Genius for the ability to generate a subtroch?

Explanted one of these recently, consider it to be one of the most genius fracture implants ever!!!

@marcusmilderman Same here as well

Autobiographical based on today

@orthofacts The fibula is medial in this image

@DrLeeRubin Did the sensitivities indicate another antibiotic w a better MIC for this organism? Is the addition of Rifampin plausible? I just wonder given the morbidly of 2 stage in this patient to explore all options

@paul_lichstein Aspiration performed with patient on doxy. Same organism as prior PJI. First line test for us remains lab culture. Can send out to CD labs when needed or if culture negative and working on BioFire in house at this time.

Ok #OrthoTwitter, seeking advice for this patient. Had #TKA 2 years ago complicated by drainage, had acute DAIR (Failed) then 2-Stage for #PJI completed 9 mo ago. Presents as shown, swollen, and aspiration with pan-sensitive staph. On doxy. Next: repeat DAIR or 2 stage again?

@drjuanroiz This looks like an incredible opportunity to fix a problem.

Wow the “inverted THA” exist!! An amazing case from a partner. Patient with painfull THA. Wow! #orthotwitter #ortho #trauma #traumatic #hip #injury #surgeon #surgery #medtwitter #medical #medicine #medicina #curiosity #orthopaedic #orthopaedicsurgery #doctor #hospital

@ashtongoldmanmd @EdinburghKnee @jaimelbellamyDO @kate_wynne @AAHKS_YAG @ACR_MD @Dr_Stambough @CenterRotation Continue to cement THA for fem neck

What did everyone learn, or will consider trying in their practice after #AAHKS2022? @EdinburghKnee @jaimelbellamyDO @kate_wynne @AAHKS_YAG @ACR_MD @Dr_Stambough @CenterRotation

Alaska Cancels Snow Crab Season Amid Population Decline - The New York Times nytimes.com/2022/10/14/us/…

@jointdocShields Sorry for your loss, they just don’t live long enough

She was one of the best parts of our life - and today the worst She will never know how much she was loved and will be missed #Pippa

@generalorthomd @EdinburghKnee @ExeterHipUnit @drsebheaven @DominicMarley @CenterRotation @jointdocShields @BoneDocMMD @traumaticum @ojedathies @hugortopedista @schulte_ss I like the Synergy cemented or Summit cemented. Both w collar, maybe pass a cable above the lesser. Can use a troch plate but it can be irritating to patient. I’ve used T plate as well as prox humoral or distal tibial plate for these applications and they are lower profile

What stem design do you use for femoral neck/intertroch combo fracture in the elderly? @EdinburghKnee @ExeterHipUnit @drsebheaven @DominicMarley @CenterRotation @jointdocShields @BoneDocMMD @traumaticum @ojedathies @hugortopedista @schulte_ss #orthotwitter

@ChrisGraysonMD1 This might be well served w a staged fusion

Really challenging case today. 48 yo M. Sinus tract from mid tibia. Last surgery 2018 was 2 stage. Multiple previous 2 stages. How aggressive would u be with bony debridement? What spacer? Any other thoughts?

@ChrisGraysonMD1 Stone

@paul_lichstein He had elevated crp and esr. Incisional erythema. And stated it felt exactly like his previous 3 infections. Gross purulence on fascial incision.

@TGHCares also serves as a referral center for failed TJA. This came in last night with acute pain + fever. H/o prior failed DAIR, 2 STAGE, 2nd DAIR. Suppressive oral Abx since Jan. 6. Plan for removal and spacer today. Any role for resection in multiple failed? Delay for cx?

@PhilWalmsley4 @generalorthomd @ChrisGraysonMD1 @jointdocShields @kneedoclond @stevemchale @TGHCares The snip feels wrong I agree @jointdocShields but I’ve become a bit more liberal w them if there are signs of struggle. TTO created a diamond mine the first few times, but has certainly been a savior for extractions

@generalorthomd @ChrisGraysonMD1 @jointdocShields @kneedoclond @stevemchale @TGHCares Stopped doing quads snip after fellowship. My go to is Tibial crest osteotomy which is simple to do, gives good exposure and seems to heal back well with no functional problems.

Back at it this Friday @TGHCares. 3 revisions. Case 1: 8 months s/p TKA. 20-80 ROM. Concern for flexion instability on xrays. Clinical exam limited by stiffness. No infection. Plan for full revision.

@jointdocShields Tried many. Osteoremedies - no WBAT, can fracture. Functional spacer - hurt bc loose by design. Molded hemi type - painful/erode acetabulum. Stone w Stimulan ball - maintain space and dissolves obviating return. Depends on bug, bone stock, patient

#orthotwitter what are you using for your hip spacers? 🧵 Chronically infected hip referred in with draining sinus… Most hips, especially those with soft tissue concerns get static spacers from me 1/4