Hip & Knee Replacement Blog — Dr.
Cory Calendine, MD

The Sterile Barrier You Never Think About in Orthopedic Surgery

Ask most people what keeps an operation sterile and they picture the scrub, the gown, the drapes. They rarely think about the gloves, and almost never about what happens when a glove quietly fails.

In orthopaedic surgery, that failure is more common than you might expect. The saws, drills, sharp bone edges, and heavy sutures we work with make glove perforation one of the highest rates of any surgical specialty. The harder problem is that many of these breaches go undetected during the case, leaving a gap in the sterile barrier that no one on the team can see.

Indicator system gloves are a straightforward answer. A dark-colored inner glove sits beneath a straw-colored outer glove. As long as the barrier is intact, the outer layer hides the color. The instant a puncture lets fluid through, it spreads between the two layers and reveals a bright mark exactly where the breach happened - pairing double gloving with an indicator system is a small, repeatable habit that prompts faster glove changes and supports a lower risk of surgical site infection. It is protection you can actually see.

⬇️ Worth the time & cost?

What Happens When the Operating Room Starts Shaking?

4:27 in the afternoon. Tuesday, July 28. Kumamoto, Japan. Watch the room move. The lights. The ceiling. The carts. Now watch what does not move. The hands.
When a patient is open in front of you, your job is to become the most stable object in that building. Cover the wound. Hold every instrument still. Anything that hits the floor is gone from the sterile field. Count what is left, ride out the shaking, and keep going. Walking away from an open incision can be more dangerous than staying in a shaking room.
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The quake registered magnitude 7.1 on the Japan Meteorological Agency scale and reached 7, the highest level, on Japan’s seismic intensity scale. Water mains failed across the region and tens of thousands of households lost running water. Weeks later, thousands of people were still living in shelters. Inside that hospital, the operations already underway were carried through to a safe finish. Not luck or heroics, the video demonstrates courage, training, dedication - and likely a team that had rehearsed for failures long before the failure arrived.
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🎥 @bbcnews

How Feet on the Dash Can Turn a Minor Crash Into Major Surgery

Feet on the dashboard is an easy and common habit, but can lead to life-altering orthopedic injuries. A passenger airbag and seat belt are engineered around one assumption: you are upright, back against the seat, feet on the floor. Change that position and the systems designed to protect you can become the mechanism of injury.
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Frontal-impact biomechanics research: The most common lower limb injury pattern in these collisions is the knee loading against the dashboard, which drives force up the femur + into your hip. That axial load produces acetabular fractures + posterior hip dislocations. Testing on out-of-position occupants shows that flexion/adduction beyond a neutral seated posture measurably reduce your hip’s tolerance to load - and showing your posterior acetabulum (hip socket) as the weakest link in that chain. With feet up, your hips and knees are already flexed + rotated before impact. The airbag deploys in milliseconds, upward and outward into the back of your legs. There is no time to move - meaning femur fractures, patella + extensor mechanism disruption, pelvic ring injury, and facial fractures as the knees are driven toward your head. Elevating the legs also lifts your pelvis out of position under the lap belt, so restraint loads shift from bone onto soft tissue. Feet on the floor. Back against the seat. Belt low across the pelvis, flat across the chest. Be safe. #femurfracture #orthopedicinjuries
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🎥 @W4STJ, @AlexSmith-pw9vn, @fiatovci

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Bone Anchors Explained: The Unsung Hero of Repair Surgery

Some of the smallest tools in orthopedic surgery do some of the heaviest lifting. Bone anchors are one of them, and most people have never heard of them.

When a tendon or ligament tears away from bone, stitching soft tissue to soft tissue usually isn’t an option. There’s nothing solid to sew into. That’s the problem the bone anchor solves. We drill a small hole in the bone, seat the anchor firmly inside, and thread strong sutures through the torn tendon. The anchor grips the bone from within. The sutures pull the tissue back against its natural footprint and hold it there while the body heals.

The same principle shows up across a huge range of procedures: rotator cuff repairs, shoulder and hip labral tears, ACL repair, ligament reconstruction, and Achilles and ankle work.

Not every anchor is the same. Titanium anchors offer maximum holding strength and stay in place for life. Biocomposite anchors slowly dissolve over several years while new bone grows into the space. Newer all-suture anchors are so small they barely disturb the bone at all, which matters when bone stock is limited or a revision is needed later.

The design keeps evolving toward smaller, stronger, and less disruptive. But the job stays the same: create one reliable point of fixation so healing can happen.

It’s a device that rarely gets credit and quietly makes modern repair surgery possible.

⬇️ Have you had a repair that used bone anchors? What surprised you most about your recovery?