Arthritis and Arthroplasty: The Knee by Thomas E. Brown MD, Quanjun Cui, William M. Mihalko MD PhD,

By Thomas E. Brown MD, Quanjun Cui, William M. Mihalko MD PhD, Khaled Saleh

The Knee-a quantity within the new Arthritis and Arthroplasty series-offers specialist information on every thing from sufferer choice and pre-operative making plans to surgical techniques and strategies. transparent, evidence-based assurance info which know-how and method used for overall knee arthroplasty (TKA), reconstruction or revision is healthier for every sufferer. entry discussions of debates on sizing and balancing, minimally invasive surgical procedure, part removing, administration of bone loss and ligament insufficiency in revision TKA, an infection, peirprosthetic fractures and extra. discover choices to TKA in more youthful arthritic sufferers and examine expertly narrated video demonstrations of surgical concepts. as well as supplying functional, pragmatic suggestion in a concise, readable layout, this specialist seek advice identify bargains the entire textual content of the publication, in addition to hyperlinks to PubMed and periodic content material updates, on-line at expertconsult.com.Access the entire textual content of the book-as good as hyperlinks to PubMed and periodic content material updates on end result facts, part fabrics, and surgical techniques-online at expertconsult.com.Features procedural videos-narrated via experts-on the incorporated DVD so that you can see how one can practice specific techniques.Covers arthroscopic debridement, patellofemoral maltracking and different scorching subject matters to maintain you abreast of the most recent advancements within the specialty.Provides evidence-based, clinically targeted assistance on sufferer choice, pre-operative making plans, surgical strategy and methods, bearing surfaces and part fabrics, affliction particular techniques, the administration and avoidance of issues, salvage and revision TKA suggestions, and more.Discusses adaptations in strategy, bearing recommendations and layout parts; together with minimally invasive TKA, fastened as opposed to mobile-bearing TKA, and posterior stabilized (PS) as opposed to cruciate preserving knee designs so that you can pick out that's prime for every patient.Explores choices to TKA in more youthful arthritic sufferers, together with arthroscopy, cartilage fix and replacement,, distal femoral arthroplasty and unicompartmental arthroplasty.Includes a evaluation web page in each bankruptcy for fast connection with pearls and pitfalls for every topic.Presents pictures and interpretive drawings of surgical innovations in complete colour to convey out intraoperative info as they seem within the working room.Your buy entitles you to entry the website till the subsequent variation is released, or until eventually the present version is not any longer provided on the market via Elsevier, whichever happens first. If the subsequent variation is released lower than 12 months after your buy, you can be entitled to on-line entry for 12 months out of your date of buy. Elsevier reserves the best to provide an appropriate alternative product (such as a downloadable or CD-ROM-based digital model) may still on-line entry to the website be discontinued.

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Phase I of therapy is the protection phase and lasts for 6 weeks. The patients are placed in a range-of-motion brace locked in 0 degrees extension during upright activity. A total of 2 weeks of non–weight bearing is followed by 4 more weeks of toetouch weight bearing and full weight bearing by 6 weeks. CPM is instituted 8 to 12 hours per day, up to 90 degrees for the first 2 weeks, then up to 120 degrees by 6 weeks. Hamstring and calf stretching is instituted early, with isometric contraction of the quadriceps and hamstrings, including straight-leg raises.

20 Some advise proceeding in a stepwise fashion, with harvest, reaming, and implantation for each planned recipient hole, one at a time. There are commercially available back-filler plugs composed of a variety of osteoconductive materials that can be used to fill the donor sites if desired (Fig. 2–16). An open procedure should be used when attempting to resurface patellar lesions as this cannot be performed arthroscopically. indd 39 FIGURE 2–15. Postoperative magnetic resonance image of a patient who underwent mosaicplasty for a femoral condyle defect.

As a result, these should be addressed either concurrently or in a prior procedure. Most will agree that greater than 5 degrees of varus or valgus malalignment is unacceptable. Sterett and Steadman44 demonstrated good results with combined high tibial osteotomy and microfracture in patients with both significant malalignment and chondral lesions. indd 33 Lesions of the femoral condyles, tibial plateau, trochlea, or patella Lesions less than 4 cm2 Lesions of the femoral condyles, trochlea, or patella Lesions greater than 1 cm2 and up to 16 cm2 36 Lesions of the femoral condyles Lesions less than 4 cm2 Bone defects of up to 10 to 15 mm34 Unstable osteochondritis dissecans lesions37 Lesions of the femoral condyles or tibial plateau Lesions greater than 2 cm2 29,38–40 Well-contained bipolar lesions Lesions associated with cavitary defects and bone loss Revision chondral surgery Bony defects of greater than 1 cm Symptomatic osteochondritis dissecans lesions that have failed prior attempts at native fragment fixation41–43 13 compliance, infection, inflammatory arthropathy, tumor, and the presence of systemic cartilage disorders.

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