Wednesday, October 3, 2018

Youtube daily report Oct 3 2018

"Apple cloud" cake. For full list of ingredients check the description below.

Cut cold butter into little pieces.

Add egg yolks and knead the dough very quickly.

Shape the dough into ball and refrigerate for an hour.

Grease the bottom of your pan and line it with baking paper.

Beat egg whites until stiff.

Add sugar, one spoon at a time.

Add potato starch as you're almost done with mixing.

Spread meringue over the pan bottom. Bake in 140C for 1h or a bit longer until crispy.

Line the bottom of your pan with cold dough.

Poke it with a fork and refrigerate for 15 minutes.

Then bake in 190C for more less 18 minutes. Set aside to cool.

Cook apples with water until softened.

Then blend everything and let boil.

Turn the stove off and add jellies. Mix well and set aside to cool.

As it starts to thicken, spread it over cold bottom.

Mix mascarpone, heavy cream and powdered sugar together. Optionally add lemon juice near the end.

Spread the cream over completely set apple layer.

Cover with meringue.

Thanks for watching! Please like and subscribe! Cheers!

For more infomation >> Ciasto "Jabłkowa chmurka" / "Apple cloud" cake (English subtitles) - Duration: 3:31.

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Dine Out For the Cure - Duration: 5:06.

For more infomation >> Dine Out For the Cure - Duration: 5:06.

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Dine Out For the Cure (Part 3) - Duration: 3:13.

For more infomation >> Dine Out For the Cure (Part 3) - Duration: 3:13.

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Appliquez ceci sur votre tête et tous vos cheveux blancs vont disparaître ! | Santé 24.7 - Duration: 9:44.

For more infomation >> Appliquez ceci sur votre tête et tous vos cheveux blancs vont disparaître ! | Santé 24.7 - Duration: 9:44.

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We Try Sensory Deprivation For The First Time And It Kind of Worked | Inc. - Duration: 7:38.

I'm Chris Beier and I'm Kevin Ryan today we are testing sensory deprivation

what are we gonna do here we are gonna float what does that mean

so there's sensory deprivation tanks and the room is right over there right

there's gonna be nothing to see nothing to hear nothing to smell and we're gonna

touch water but it's gonna feel like we're touching nothing because it's

perfectly body temperature they say can ease anxiety insomnia symptoms of

depression PTSD Wow can help you relax this is quite a place yeah this is

called lift and they had a few tanks here they have a lot of salt this is 1 2

3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 bags of salt epsom salt and this

is for one tank in order to float you gotta have salt in the tank

uh-huh and I guess the idea is you know brilliant minds go into these tanks to

problem-solve yeah and that's why we're going in there yeah

brahmam saw these takes every problem ink has ever had words will be summed 60

minutes gonna bring ourselves into a state of theta yeah

thinking consciousness beta consciousness where we'll be able to see

is this really the Fountain of Youth and maybe it is

let's drink from it

okay that's your neck rest that's the neck rest so you put that under okay

okay the point is to make us or not to fall asleep okay lady come on in your

sessions over thank you okay Mike them toward here

right so here's my tank got my showered supplies about to strip down and jump in

this coffin filled with water I'm now going to get butt-naked and just lie in

a shallow pool of water for an hour and come back with brilliant insights

do you feel relaxed right now I do feel relaxed right now if you're

trying to I'm trying to bring forth energy for the sake of your and your

gain we're done we've got the old breath back again so I tried to bring in things

that were making me anxious things that I was stressed about things of work that

I didn't have a solution to I got in got out to get the earplugs got back in

gotta have to get the face towel got back you got the sharpener shut the door

from the tank and then thought it was too hot

open the door then the lights outside came back on I'm gonna to get out and

shut the lights again take some adjusting but then everything either way

you want and that's that's where you were just running around wet and nude

like right make fire mid right I gonna make it lucky in the flash just like

feeling out for the walls on the side of the tank I wouldn't say I solved

anything but I no longer feel stressed about

those things here's what we're gonna do now we're gonna go back to work we're

gonna see if work is easier more pleasant more productive more productive

I guess less stressful and we're gonna see if it's easier or harder to go to

sleep and what kind of sleep that I'm getting

is the next day we went through a whole day having done sensory deprivation in

the morning to see what the benefits were mm-hmm

here's my conclusion yeah sensory deprivation in the tank was pretty

boring in fact there were moments where I was like has it been an hour yet the

naked part is really what gets me what do you mean it just it made me feel

naked I wouldn't say I was like noticeably high-energy or like efficient

no not high-energy yeah yeah it was like I don't know if I was efficient either

uh-huh but there was like a piece yeah how did you sleep I slept like a baby so

does that mean that that sense of calm did it wear off until you woke up this

morning it was definitely a well above average night of sleep I did not wake up

during the night I woke up in the same position I fall asleep in so I guess if

you're an entrepreneur and you're busy founder or just your nine-to-five

whatever does he like yeah I can see this being something where you work it

in maybe once a week or once a month or maybe more how much is it 65 to 95 bucks

okay from it the 60 to 100 range for most places seems like what you do to

get yeah yeah and and pay the 65 70 bucks yeah I think it would be worth it

because I would feel more benefit the second time and then that's I think

where I would know is this really something for me mm-hmm what do you do

it again I would do it again when I knew I needed to be in that so we don't

recommend a lot of things and ink tested this show is usually ink debunked aha

but I would suggest trying this at least once give it a go you don't know until

you try that sense of peace I will I'm just gonna work to get back there every

day yeah oh I pray that you do regardless I think we can now say that

sensory deprivation Ben Inc tested look how peaceful that

very peaceful

For more infomation >> We Try Sensory Deprivation For The First Time And It Kind of Worked | Inc. - Duration: 7:38.

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한국 해군 '수중의 암살자' 확보 속도전 - Duration: 11:36.

For more infomation >> 한국 해군 '수중의 암살자' 확보 속도전 - Duration: 11:36.

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Avenatti: We still haven't heard from the FBI - Duration: 2:05.

For more infomation >> Avenatti: We still haven't heard from the FBI - Duration: 2:05.

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GARY HABERMAS: ¿REALMENTE EXISTIÓ JESÚS? - Duration: 10:04.

For more infomation >> GARY HABERMAS: ¿REALMENTE EXISTIÓ JESÚS? - Duration: 10:04.

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GF Vip, da Barbara D'Urso una stoccata a Signorini: 'Su Silvestrin sarei stata più dura' - Duration: 3:40.

For more infomation >> GF Vip, da Barbara D'Urso una stoccata a Signorini: 'Su Silvestrin sarei stata più dura' - Duration: 3:40.

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Audi A4 1.4 TFSI 150pk S tronic S Line Edition - Duration: 1:07.

For more infomation >> Audi A4 1.4 TFSI 150pk S tronic S Line Edition - Duration: 1:07.

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Opel Astra 1.4 Turbo Edition AUTOMAAT - Duration: 1:08.

For more infomation >> Opel Astra 1.4 Turbo Edition AUTOMAAT - Duration: 1:08.

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Opel Meriva Design Edition 1.4 Turbo 120pk | Navi | Trekhaak - Duration: 1:05.

For more infomation >> Opel Meriva Design Edition 1.4 Turbo 120pk | Navi | Trekhaak - Duration: 1:05.

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Volkswagen Transporter 2.0 TDI KOMBI 62KW 11.950 is ex btw/bpm - Duration: 1:04.

For more infomation >> Volkswagen Transporter 2.0 TDI KOMBI 62KW 11.950 is ex btw/bpm - Duration: 1:04.

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Suzuki Celerio - Duration: 1:11.

For more infomation >> Suzuki Celerio - Duration: 1:11.

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Volkswagen Passat 1.4 TSI 150PK VARIANT COMFORTLINE - DAB - Parkeersensoren - Duration: 1:10.

For more infomation >> Volkswagen Passat 1.4 TSI 150PK VARIANT COMFORTLINE - DAB - Parkeersensoren - Duration: 1:10.

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Temptation Island Vip, ultimo appuntamento: falò finali, Marini pazza per Ivan | Wind Zuiden - Duration: 3:42.

For more infomation >> Temptation Island Vip, ultimo appuntamento: falò finali, Marini pazza per Ivan | Wind Zuiden - Duration: 3:42.

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Grande Fratello Vip, Francesco Monte vittima dei bulli: 'Non so se interessi che ci sono' - Duration: 4:21.

For more infomation >> Grande Fratello Vip, Francesco Monte vittima dei bulli: 'Non so se interessi che ci sono' - Duration: 4:21.

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Bean Beans Beans - Duration: 3:57.

For more infomation >> Bean Beans Beans - Duration: 3:57.

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Ηλίας Βρεττός: Η κίνηση ανθρωπιάς του τραγουδιστή για το πυρόπληκτο Μάτι! | News | fthis.gr - Duration: 1:54.

Το δικό του λιθαράκι στη διαδικασία αποκατάστασης στο Μάτι βάζει ο Ηλίας Βρεττός, συμμετέχοντας στη δράση «Ένα Δέντρο Για Το Μάτι», αυτή την Πέμπτη 4 Οκτωβρίου, στις 18:00, στο εμπορικό κέντρο στο Μαρούσι

Στη δράση, που διοργανώνεται από τον μεγάλο ραδιοφωνικό σταθμό, οι πολίτες καλούνται να παραδίδουν φυτά (χαρουπιές, ακακίες, γαζίες, λεύκες, τούγιες, κυπαρίσσια, λεμονιές, πικροδάφνες, μανταρινιές, πορτοκαλιές και κορομηλιές), τα οποία θα δοθούν σε πυρόπληκτα νοικοκυριά

Θέτοντας για ακόμα μία φορά τον εαυτό του, την μουσική και τα τραγούδια του στη διάθεση ενός καλού σκοπού, ο Ηλίας θα τραγουδήσει αφιλοκερδώς στην εκδήλωση, που θα κορυφωθεί με μια μεγάλη συναυλία του, στις 20:00

Ερμηνεύοντας όλα τα τραγούδια του που έχει αγαπήσει το κοινό, καθώς και την πιο πρόσφατη επιτυχία του «Η Αγάπη Μπορεί», που κυκλοφορεί από την Panik Platinum, ο αγαπημένος καλλιτέχνης θα διασκεδάσει τον κόσμο, αλλά και θα στείλει για άλλη μια φορά ένα μήνυμα ανθρωπιάς

Εξάλλου, όπως δηλώνει ο ίδιος, «αγάπη προπάντων σημαίνει ανθρωπιά, παραμερίζοντας το "εγώ"

Εύχομαι σε αυτόν τον κόσμο, να μπορέσουμε όλοι να δικαιολογήσουμε την ύπαρξη μας ως άνθρωποι»

For more infomation >> Ηλίας Βρεττός: Η κίνηση ανθρωπιάς του τραγουδιστή για το πυρόπληκτο Μάτι! | News | fthis.gr - Duration: 1:54.

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Kataklizm żywiołowy! Rządowe Centrum Bezpieczeństwa ostrzega przed sztormami. - Duration: 3:06.

For more infomation >> Kataklizm żywiołowy! Rządowe Centrum Bezpieczeństwa ostrzega przed sztormami. - Duration: 3:06.

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1610 Forest Ln. Mclean - Duration: 4:14.

For more infomation >> 1610 Forest Ln. Mclean - Duration: 4:14.

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5922 Autumn Dr Mclean - Duration: 8:44.

For more infomation >> 5922 Autumn Dr Mclean - Duration: 8:44.

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오늘의 탐정 15회 16회 - Duration: 57:24.

Subtitles Updating... Please like and subscribe to my channel Thanks for watching!

Like,share and Subscribe NOW!

For more infomation >> 오늘의 탐정 15회 16회 - Duration: 57:24.

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Zulice Night /w Fobia Kid, Mladej Moris - Duration: 7:23.

For more infomation >> Zulice Night /w Fobia Kid, Mladej Moris - Duration: 7:23.

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COMMENT J'AI CRÉÉ LE COSTUME DE COPAIN DU WEB - Duration: 1:25.

Hello, you ! You want to look like Copain du Web but you're not Copain du Web ?!

I got the solution : we will create a cosplay to become just like your idol.

We start with the master piece of our suit : the hood

or the underwear ? The weird stuff he's wearing on his head.

No need to explain you in detail how to sew, what better way to do explain it in a tutorial

made by Copain du Web himself to create this hood.

I wanted to add my personal touch for this mythic piece from Copain :

I've chosen logically a unicorn fabric!

It's comfty because it's stretch and it's very soft.

And we, we are crazy about softness.

To be more accurate, you can also wear blue contact lenses.

Well, if you're like me and you have a lack of facial hair to look like Copain du Web,

there is a solution to avoid surgical implants : make-up.

You only need to delimit the beard surface with the help of a make-up sponge,

and eyebrow eyeshadow of the color of your hairs.

And voilà how to create a real hypster beard !

For more infomation >> COMMENT J'AI CRÉÉ LE COSTUME DE COPAIN DU WEB - Duration: 1:25.

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Génération Type 1 : À FOND LA FORME - #5 - Duration: 3:39.

For more infomation >> Génération Type 1 : À FOND LA FORME - #5 - Duration: 3:39.

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Dr. John Burch and Dr. Kirk Fee Discuss Hip Replacements - Duration: 6:17.

I'm John Burch and I'm an orthopaedic surgeon, I do general orthopaedics here at WKONA.

My name is Kirk Fee and I'm an orthopaedic surgeon here at Western Kentucky Orthopaedics

and Graves Gilbert Clinic.

Well myself and my partners together combine to provide everything that can be required

of orthopaedic surgeons.

We see a wide variety of patients here.

We see children, we see elderly patients, we see weekend warriors.

We see a lot of patients with hip and knee arthritis.

The incidents are increasing in our population.

People are getting older; people are trying to stay active longer.

If you look at patients, I see people all the time at the restaurant, grocery, my wife

says, "Someone must have a bad hip or a bad knee because you're looking at them funny"

and I say, "Yeah" and I'm thinking yeah I could fix that.

It's very very common and a lot of people don't realize they've got the issue they just

know that they've got difficulty walking, but 9 times out of 10 it's a problem with

their hip or their knee.

Hip arthritis itself is something that often times is mistaken for having come from the

knee itself when it's really coming from the hip.

It's interesting that people say, "My hip hurts" and that can mean a lot of different

things to a lot of people.

Sometimes it means their buttock; sometimes it's around the top of the thigh.

A very classic finding is pain in the groin sort of in the front of the hip and people

point to that spot, it's a pretty clear indication there's a problem with the hip joint, but

they may complain of things like, "I can't climb the stairs anymore", "I have trouble

getting my shoes and socks on because I can't pull my foot up to reach it", "I have difficulty

climbing the stairs", "Difficulty getting up out of the chair".

Those are all things which are common to patients that have bad hips.

Physical therapy can help in the early stages of hip arthritis.

We tell people to really make sure that they're stretching as much as possible.

Weight loss can help, anti-inflammatory drugs can help and you certainly want to try all

of those things first.

If we have objective evidence of arthritis in the hip, if we have objective evidence

of necrosis of the hip or other diseases of the hip and we've failed conservative management,

then that's when we start thinking about hip replacements.

Traditionally whenever hip replacements were started in orthopaedics, the surgical approaches

went from the back of the hip.

It's a traditional approach; it is still used in many many centers across the country.

As with any surgery there are advantages and disadvantages of that.

One of the disadvantages of the posterior approach is that it splits muscle and so we

think that they do have a tendency, slightly higher tendency, to come out of socket.

So what some very forward thinking surgeons started thinking about, actually in California,

was is there a way to get into the hip from the front and leave all of the muscles intact

and actually they came up with a beautiful approach that's used very very commonly now

and it's something that we started looking at about 6-7 years ago where we basically

come in from the front and it leaves all the muscles intact around the hip.

The red line indicates the typical incision for the posterior approach and there's not

many people making one too much smaller than that, but when you do that you've got to cut

all these muscles away from the back of the pelvis.

The anterior approach is this dotted blue line and that's even longer than most of us

do.

It's about 3/4 of that size typically and the difference though is like we said; the

muscles are split from the front side.

We can get right to the hip by going through this interval and not have to cut anything,

just kind of opened up like this and there's the hip joint.

It's so good because you're not cutting any muscles.

You're going between muscle layers and because of that all those nice posterior elements

that are there to stabilize the hip, they're all kept preserved, intact, and normal and

so the chance of popping it out is extremely small.

In my now 12 years of doing it, I've had 0 dislocations.

Ordinarily it's about 1 out of 50 and I've done hundreds and hundreds since then and

have not had one and that's just a testament to the approach.

It's a very good procedure.

Doesn't mean I'm a great surgeon; it means it's just a good approach to the problem.

Secondarily because you're not cutting all those muscles it just doesn't hurt as much.

With a lower rate of dislocation; with shorter hospital stays and quicker recovery; we think

all of those things combined have what let us to embrace the anterior approach of the

hip.

I think the biggest compliment that I can say about my partners is that if my father

broke his hip, if my mother needed a knee replacement, that there's unequivocally I

would bring them in here for their care and that's how much I trust my friends and my

partners.

Our hospitals do a very good job and I think pride is taken here in Warren County to try

to provide state of the art care.

I can't begin to list all of the positives about what I do for a living.

It's things like seeing the fella who came back at 2 weeks and was working in his garage

after hip replacement and the family saying, "Thank you so much.

You've changed his life".

That's priceless.

That does so much for me on a daily basis.

My real goal is to get to where they don't think about their hip at all and that's my

question.

I'll see them back usually at 6 months and then a year and that's one of the first questions

I ask, "How's it doing?" and if they say, "Fine", I'll say, "Do you think about your

hip?" and it's a success in my mind if they say, "No I don't think about it too much".

For more infomation >> Dr. John Burch and Dr. Kirk Fee Discuss Hip Replacements - Duration: 6:17.

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Kayini Wura d'Oumou Sangaré / Bass+Tabs (3/69) - Duration: 3:28.

For more infomation >> Kayini Wura d'Oumou Sangaré / Bass+Tabs (3/69) - Duration: 3:28.

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COMMENT COMMENCER VALIANT ?! - Duration: 6:43.

For more infomation >> COMMENT COMMENCER VALIANT ?! - Duration: 6:43.

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Part 2 The Secret. For the little ones. Funny. That's cool. Only for toddlers. [Moustached Nanny] - Duration: 2:32.

Tatiana Shatskikh

For the smallest part 2

Toys

How many toys are there on Earth? -

More than in ponds of frogs!

If we collect everything together,

Oceans will be five!

Constructor

Pick up a car, cross-country vehicle, The palace, the rocket, the ship

And even the whole town The designer of "Lego" helped us.

That's just true friends You will not build of bricks!

Horse

On a rubber horse I jump, I jump, I jump.

I'm a neighbor Natashka On the horse I'll take it!

The horse could not stand the two, Blown away, poor, and quiet.

I must reinforce my friend ... Feed the sausage!

A bike

Velkibid three-wheeled, fast, The steering wheel is elegant, silvery.

If you do not sleep while driving, You can overtake the pope!

For more infomation >> Part 2 The Secret. For the little ones. Funny. That's cool. Only for toddlers. [Moustached Nanny] - Duration: 2:32.

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E-girls、映画『パーフェクトワールド 君といる奇跡』主題歌を配信開始! - Duration: 2:48.

For more infomation >> E-girls、映画『パーフェクトワールド 君といる奇跡』主題歌を配信開始! - Duration: 2:48.

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Opel Astra 1.4 TURBO 140 PK COSMO NAVI, PDC, ECC, LMV, etc... - Duration: 1:02.

For more infomation >> Opel Astra 1.4 TURBO 140 PK COSMO NAVI, PDC, ECC, LMV, etc... - Duration: 1:02.

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Dungeons & Dragons Neverwinter (GUERRIER DEFENSIF) FARME DIAMANT - Duration: 29:10.

For more infomation >> Dungeons & Dragons Neverwinter (GUERRIER DEFENSIF) FARME DIAMANT - Duration: 29:10.

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One in a Million | Kansas State University - Duration: 2:48.

Once you step foot on this campus or in this community, no matter where you come from,

the color of your skin or your religious background, together we make a family.

We often talk about the K-State family

and believe me when I say it is truly special.

Follow a passion even if that passion is not the norm.

You got to figure out what feels right for you.

We have not even scratched the surface as to what we can become as human beings.

Never give up and you can succeed. If you have willpower and determination,

I'm telling you right now you can't be stopped!

(Announcer) He will try to throw the ball into the endzone, Touchdown! No time left on the clock...

So one thing about K-State and our family is we don't rest on our laurels

and we don't shy away from challenges and hard work

The University is a community of many people. It is all of us together who must carry this University forward.

Do not forget who you are, do not forget your history and where you come from.

Do not forget what you have sacrificed to be where you are right now.

(Crowd roars loudly)

(Announcer) It's good! Kansas State is headed to the Elite 8!

My father often said, "sometimes we must take positions that are neither safe,

nor politic, nor popular, but he must take it because conscience tells him it is right.

We're talking about the Kansas State way.

Kansas State people are unique, the university is unique

and I know the people of Kansas State are truly special.

I get to talk with many of the young people

and I must honestly say to you that my hope is always renewed.

I think... that you who sit today under the sound of my voice...

may well have the answer.

For more infomation >> One in a Million | Kansas State University - Duration: 2:48.

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మంగళవారం రోజున ఈ విధంగాచేస్తే మీ శత్రువులు మిమ్మల్ని ఏమిచేయలేరు | Astrology | Secrets of Satru Badha - Duration: 1:23.

For more infomation >> మంగళవారం రోజున ఈ విధంగాచేస్తే మీ శత్రువులు మిమ్మల్ని ఏమిచేయలేరు | Astrology | Secrets of Satru Badha - Duration: 1:23.

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రాహు, కేతువులు మీకు అనుకూలంగా మారి సకల దోషాలు తొలగిపోవాలంటే | Astrology | Secrets of Study Tips - Duration: 3:03.

For more infomation >> రాహు, కేతువులు మీకు అనుకూలంగా మారి సకల దోషాలు తొలగిపోవాలంటే | Astrology | Secrets of Study Tips - Duration: 3:03.

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Pirate Roulette ~ Pirate Barrel Game & Ngepung???... - Duration: 3:05.

A: Why do you have to do it on me?

Y: Hi, guys... I'm Yenny...

A: I'm Princess of Fan... ^^

L : I'm Leo

Y; Okay, today we are going to play Pirate Barrel Game

Y: But to make it more fun, there will be a penalty for those who pops the pirate out from the barrel

A: Right...

Y: Any suggestion for the penalty?

A: He (Leo) knows

L: To make it more fun, the penalty will be blowing flour

L: Nowadays, blowing flour is a big hits

L: "Breath-in" the flour :P

L: Whoever lost, will be blowing the flour

Y: Okay then, let's play

Y: Whose turn?

A: From the winner first (from previous game, Dog Dentist, check my desc.)

L: Okay from the winner (from previous game)

A: Okay, let's see... can we peek on the hole?

A: The winner of the previous game is me

Y: Hey, you lost in the previous game

A: Let's start with the winner

Y: Insert the dagger properly

L: Do it properly

L: That's how you do it

Y: It's my turn now

Y: I have a bad feeling

L: It's my turn, this way...

Y: Oh, okay then

A: Clockwise, English

Y: What is the meaning of clockwise?

A: Clock is the clock... clock... (noise)

Y: How about "wise"?

L: Wise is also a noise

L: wise... wise... (noise)

Y: wise... so cool... wise...

Y: so the meaning of clockwise is noises :P

Y: Let's stop it, I have a headache

Y: I have a felling, it's gonna be me

L: Not yet..

A: I'm the winner

Y: Done

A: So, I win, right?

L: Not yet...

Y: It's your turn now

A: I will insert the dagger here

A: It's so nerve-wrecking, guys...

A: Hey, do it properly

Y: This game is actually a good exercise for your heart :P

L: Shocking...

A: The winner is me

Y: I'm not lucky today

L: So, we will see Yenny blow the flour

For more infomation >> Pirate Roulette ~ Pirate Barrel Game & Ngepung???... - Duration: 3:05.

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Dr. John Burch and Dr. Kirk Fee Discuss Hip Replacements - Duration: 6:17.

I'm John Burch and I'm an orthopaedic surgeon, I do general orthopaedics here at WKONA.

My name is Kirk Fee and I'm an orthopaedic surgeon here at Western Kentucky Orthopaedics

and Graves Gilbert Clinic.

Well myself and my partners together combine to provide everything that can be required

of orthopaedic surgeons.

We see a wide variety of patients here.

We see children, we see elderly patients, we see weekend warriors.

We see a lot of patients with hip and knee arthritis.

The incidents are increasing in our population.

People are getting older; people are trying to stay active longer.

If you look at patients, I see people all the time at the restaurant, grocery, my wife

says, "Someone must have a bad hip or a bad knee because you're looking at them funny"

and I say, "Yeah" and I'm thinking yeah I could fix that.

It's very very common and a lot of people don't realize they've got the issue they just

know that they've got difficulty walking, but 9 times out of 10 it's a problem with

their hip or their knee.

Hip arthritis itself is something that often times is mistaken for having come from the

knee itself when it's really coming from the hip.

It's interesting that people say, "My hip hurts" and that can mean a lot of different

things to a lot of people.

Sometimes it means their buttock; sometimes it's around the top of the thigh.

A very classic finding is pain in the groin sort of in the front of the hip and people

point to that spot, it's a pretty clear indication there's a problem with the hip joint, but

they may complain of things like, "I can't climb the stairs anymore", "I have trouble

getting my shoes and socks on because I can't pull my foot up to reach it", "I have difficulty

climbing the stairs", "Difficulty getting up out of the chair".

Those are all things which are common to patients that have bad hips.

Physical therapy can help in the early stages of hip arthritis.

We tell people to really make sure that they're stretching as much as possible.

Weight loss can help, anti-inflammatory drugs can help and you certainly want to try all

of those things first.

If we have objective evidence of arthritis in the hip, if we have objective evidence

of necrosis of the hip or other diseases of the hip and we've failed conservative management,

then that's when we start thinking about hip replacements.

Traditionally whenever hip replacements were started in orthopaedics, the surgical approaches

went from the back of the hip.

It's a traditional approach; it is still used in many many centers across the country.

As with any surgery there are advantages and disadvantages of that.

One of the disadvantages of the posterior approach is that it splits muscle and so we

think that they do have a tendency, slightly higher tendency, to come out of socket.

So what some very forward thinking surgeons started thinking about, actually in California,

was is there a way to get into the hip from the front and leave all of the muscles intact

and actually they came up with a beautiful approach that's used very very commonly now

and it's something that we started looking at about 6-7 years ago where we basically

come in from the front and it leaves all the muscles intact around the hip.

The red line indicates the typical incision for the posterior approach and there's not

many people making one too much smaller than that, but when you do that you've got to cut

all these muscles away from the back of the pelvis.

The anterior approach is this dotted blue line and that's even longer than most of us

do.

It's about 3/4 of that size typically and the difference though is like we said; the

muscles are split from the front side.

We can get right to the hip by going through this interval and not have to cut anything,

just kind of opened up like this and there's the hip joint.

It's so good because you're not cutting any muscles.

You're going between muscle layers and because of that all those nice posterior elements

that are there to stabilize the hip, they're all kept preserved, intact, and normal and

so the chance of popping it out is extremely small.

In my now 12 years of doing it, I've had 0 dislocations.

Ordinarily it's about 1 out of 50 and I've done hundreds and hundreds since then and

have not had one and that's just a testament to the approach.

It's a very good procedure.

Doesn't mean I'm a great surgeon; it means it's just a good approach to the problem.

Secondarily because you're not cutting all those muscles it just doesn't hurt as much.

With a lower rate of dislocation; with shorter hospital stays and quicker recovery; we think

all of those things combined have what let us to embrace the anterior approach of the

hip.

I think the biggest compliment that I can say about my partners is that if my father

broke his hip, if my mother needed a knee replacement, that there's unequivocally I

would bring them in here for their care and that's how much I trust my friends and my

partners.

Our hospitals do a very good job and I think pride is taken here in Warren County to try

to provide state of the art care.

I can't begin to list all of the positives about what I do for a living.

It's things like seeing the fella who came back at 2 weeks and was working in his garage

after hip replacement and the family saying, "Thank you so much.

You've changed his life".

That's priceless.

That does so much for me on a daily basis.

My real goal is to get to where they don't think about their hip at all and that's my

question.

I'll see them back usually at 6 months and then a year and that's one of the first questions

I ask, "How's it doing?" and if they say, "Fine", I'll say, "Do you think about your

hip?" and it's a success in my mind if they say, "No I don't think about it too much".

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