<p><P>This text is designed to be a concise guide to the essentials of total knee arthroplasty and revision total knee arthroplasty. Edited by Drs. Giles R. Scuderi and Alfred J. Tria, Jr., the text is ideal for orthopedic residents and surgeons. World-renowned experts cover basic principles and ins
Total Knee Arthroplasty: A Technique Manual
β Scribed by Richard D. Scott
- Publisher
- Elsevier
- Year
- 2019
- Tongue
- English
- Leaves
- 144
- Edition
- 3
- Category
- Library
No coin nor oath required. For personal study only.
β¦ Synopsis
An invaluable guide for orthopaedic surgeons at all levels of experience, Total Knee Arthroplasty, 3rd Edition, takes a practical, authoritative approach to this widely performed procedure. Dr. Richard Scott, co-designer of the Total Knee System, walks you step by step through a wide range of surgical scenarios, offering consistent, readable coverage of the techniques you need to know. A user-friendly index, hundreds of detailed, full-color illustrations and photographs, and bulleted summaries make information easy to find and put to use in practice.
Covers all facets of operative and non-operative knee replacement in depth, from simple varus knees to complex valgus and more.
Features new topics such as posterior-stabilized TKA, measured resection techniques, and gap balancing techniques, as well as new high-quality figures and photographs, practical examples, tips, challenges, and recommendations.
Contains step-by-step coverage of techniques and complex methods, including key tips on what to avoid in every situation.
Shares the knowledge and expertise of Dr. Richard Scott, who highlights personal pearls and pitfalls, answers frequently asked questions, and provides expert guidance in the design and technique of PCL retaining TKA and Unicompartmental knee arthroplasty.
Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.
β¦ Table of Contents
Cover
Total Knee Arthroplasty, A Technique Manual
Copyright
Dedication
Preface
1 - Posterior Cruciate Ligament Retention Versus Substitution
Historical Perspective
Advantages of Posterior Cruciate Ligament Retention
Candidates for Posterior Cruciate Ligament Retention
Balancing the Posterior Cruciate Ligament
Disadvantages of Posterior Cruciate Ligament Retention
Indications for Posterior Stabilized Primary Total Knee Arthroscopy
Disadvantages of Posterior Cruciate Ligament Substitution
2 - Primary Total Knee Arthroplasty Surgical Technique
Positioning of the Patient
Placement of the Footrest
Sterile Preparation of the Leg
The Tourniquet
The Incision
Medial Parapatellar Arthrotomy
Completing the Exposure
Preparation of the Femur
Distal Femoral Resection
The Valgus Angle
Sizing the Femur
Determining the Rotational Alignment of the Femoral Component
Placement of the Anteroposterior Cutting Jig
Completing the Femoral Cuts
Trochlear Resection
Posterior Condylar Resection
Chamfer Cuts
Final Preparation of the Femur
Assessing the Potential for Cementless Femoral Fixation
Preparation of the Patella
Clearing the Quadriceps Tendon
Measuring Patellar Thickness and Applying a Cutting Jig
Cutting the Patella
Preparation of the Tibia
Determining the Amount of Tibial Resection
Intramedullary Versus Extramedullary Alignment
Determining Alignment of the Tibial Resection With Extramedullary Devices
Posterior Tibial Slope
Sizing the Tibia
Determining the Rotational Alignment of the Tibial Component
Adjusting Flexion and Extension Gaps
Assessment of Patellar Tracking
Final Preparation Prior to Cementing of Components
Cementing Components
Draining and Closing the Wound
Perioperative Management
Anticoagulation
Rehabilitation Protocol
Follow-Up Appointments
3 - Total Knee Arthroplasty in Severe Varus Deformity
Medial Release in Extension
Shift and Resect Technique
Formal Medial Collateral Ligament Release From the Tibia
Distal Femoral Resection
Femoral Component Rotation
Options for Restoration of Deficient Tibial Bone Stock
Residual Lateral Laxity
Correcting Significant Residual Lateral Laxity
Internal Tibial Torsion
Summary
4 - Total Knee Arthroplasty in Severe Valgus Deformity
Lateral Femoral Condyle Hypoplasia
Balancing the Extension Gap by a Lateral Release
Inverted Cruciform Release for Severe Valgus
Lateral Collateral Ligament, Popliteal, and Biceps Tendon Release
Summary
5 - Patellofemoral Complications Associated With Total Knee Arthroplasty
Maltracking of the Patella
Residual Valgus Limb Alignment
Excessive Valgus Placement of the Femoral Component
Patella Alta
Component Malrotation
Patellar Thickness
Asymmetric Patellar Preparation
Need for Lateral Release
βRule of No Thumbβ Test
Dynamic Patellar Instability
Patellar Blood Supply
Patella Fracture
Patellar Loosening
Patellar Wear
Patellar Clunk Syndrome
Dysplastic Patella
Summary
6 - Stiffness Before and After Total Knee Arthroplasty
Exposing the Stiff Knee
Exposing the Knee Ankylosed in Extension
Exposing the Knee Ankylosed in Flexion
Heterotopic Bone Formation
Overzealous Physical Therapy
Manipulation of the Knee
Timing of Knee Manipulation
Technique of Knee Manipulation
Manipulating Into Extension
Summary
7 - Flexion Contracture Associated With Total Knee Arthroplasty
Treatment Options
Preoperative Measures
Intraoperative Measures
Osteophyte Removal
Additional Distal Femoral Resection
Algorithm Based on Personal Experience
Summary of Treatment Guidelines
Other Important Considerations
Contractures Resulting From Bony Deformity
Bilateral Contractures
Patella Baja
Posterior Slope
Capsular Closure
Ancillary Measures
Summary
8 - Total Knee Arthroplasty After Osteotomy
Operative Exposure
Patella Baja
Retained Hardware
Upsloped Joint Line
Nonunion
Malunion
Consequences of Overcorrection of a Varus Tibial Osteotomy
Offset Tibial Shafts
Unicompartmental Replacement After Failed Tibial Osteotomy
Summary
9 - Total Knee Arthroplasty in Rheumatoid Arthritis
Ipsilateral Hip Involvement
Anticoagulation Needs
Flexion Contracture
Rheumatoid Cysts
Patellar Resurfacing
Synovectomy and Recurrent Active Rheumatoid Synovitis
Risk for Infection
Need for Adequate Knee Flexion
Osteopenia
Anesthetic Considerations
Posterior Cruciate Ligament Preservation Versus Substitution
Summary
10 - Bone Stock Deficiency in Total Knee Arthroplasty
Femoral Deficiency
Bone Grafting
Cement Alone
Cement Plus Screw Augmentation
Augmented Components
Trabecular Metal Augments and Metaphyseal Sleeves
Tibial Deficiency
Bone Grafting
Bulk Allograft
Cement Alone
Cement Plus Screw Augmentation
Modular Augmentation Wedges
Trabecular Metal Augments and Metaphyseal Sleeves
Custom Components
Summary
11 - Bilateral Simultaneous Total Knee Arthroplasty
The Decision
Anesthetic Considerations
Anticoagulation
Weight-Bearing Status
Surgical Technique
Length of the Incisions
Preemptive Advice to Patients
Patient Satisfaction
Bilateral Revisions
Bilateral Primary and Revision Surgery
Summary
12 - Sepsis and Total Knee Arthroplasty
Perioperative Prophylactic Measures
Preoperative Germicidal Skin Scrub
Surgical Preparation and Draping
Laminar Air Flow Versus Ultraviolet Lights
Intravenous Antibiotics
Proper Skin Incision
Wound Care
Skin Necrosis
Postoperative Prophylactic Measures
Classification of Infections
Treatment Options
Closed Treatment
Open Synovectomy, DΓ©bridement, and Insert Exchange
Primary Prosthetic Exchange
Delayed Prosthetic Exchange
Delayed Exchange Protocol
Resection Arthroplasty
Knee Arthrodesis
Amputation
Summary
13 - Staying Out and Getting Out of Trouble During Total Knee Arthroplasty
Choosing the Correct Incision
Dealing With Skin Necrosis
A Draining Wound
Dealing With Excessive Suction Drainage
Treating a Large Hematoma
Treating Patellar Tendon Avulsion
Avoiding Medial Collateral Ligament Injury
Addressing Medial Collateral Ligament Injury
Avoiding and Resolving Popliteus Tendon Impingement
Choosing between Femoral Sizes
Summary
14 - Frequently Asked Questions Concerning Total Knee Arthroplasty
Categories of Questions
The Answers
Preoperative Questions
Perioperative Questions (in Hospital)
Perioperative Questions (Out of the Hospital)
Postoperative Concerns
Postoperative Concerns (Long Term)
15 - Mobile Versus Fixed Bearings in Total Knee Arthroplasty
Why Consider a Mobile-Bearing Alternative
Avoiding Spinout
What To Do If Spinout Occurs
16 - Unicompartmental Knee Arthroplasty
Classic Selection Criteria
Minimally Invasive Unicompartmental Knee Arthroplasty
Metallic Unicompartmental Hemiarthroplasty
Summary
17 - Unicompartmental Knee Arthroplasty Technique
Basic Principles
Preoperative Planning
Operative Exposure
Other Elements of Medial Exposure
Preparation of the Tibia
Distal Femoral Resection
Intramedullary Femoral Alignment Technique
Extramedullary Femoral Alignment Technique
Sizing of the Femur
Rotational Alignment of the Femoral Component
Mediolateral Positioning of the Femoral Component
Final Preparation of the Femur
Final Preparation of the Tibial Component
Technical Nuances in Lateral Compartment Arthroplasty
Cementing Components
Closure
β¦ Subjects
Knee Arthroplasty; Orthopedics; Surgery; Orthopedic Surgery; Physical Medicine & Rehabilitation
π SIMILAR VOLUMES
here, two well-known knee experts have assembled a group of leaders in the field to present a book encompassing the best techniques for total knee arthroplasty. Concise chapters cover indications, contraindications, complications, results, instrumentation, infection, preop planning, prosthetic choic
<p>Currently, younger and more active patients with arthritis, trauma and other joint diseases are getting predictable and durable results from total knee arthroplasty. Studies show that this procedure maintains a high level of performance, longevity and patient satisfaction for all age groups. Two