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 counsel on every little thing from sufferer choice and pre-operative making plans to surgical techniques and strategies. transparent, evidence-based insurance information which expertise 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 possible choices to TKA in more youthful arthritic sufferers and look at expertly narrated video demonstrations of surgical options. as well as offering sensible, pragmatic recommendation in a concise, readable structure, this professional seek advice name bargains the entire textual content of the e-book, in addition to hyperlinks to PubMed and periodic content material updates, on-line at expertconsult.com.Access the total textual content of the book-as good as hyperlinks to PubMed and periodic content material updates on final result info, part fabrics, and surgical techniques-online at expertconsult.com.Features procedural videos-narrated through experts-on the integrated DVD so that you can see find out how to practice specific techniques.Covers arthroscopic debridement, patellofemoral maltracking and different scorching issues to maintain you abreast of the most recent advancements within the specialty.Provides evidence-based, clinically concentrated assistance on sufferer choice, pre-operative making plans, surgical procedure and strategies, bearing surfaces and part fabrics, sickness particular suggestions, the administration and avoidance of problems, salvage and revision TKA suggestions, and more.Discusses adaptations in procedure, bearing concepts and layout elements; together with minimally invasive TKA, mounted as opposed to mobile-bearing TKA, and posterior stabilized (PS) as opposed to cruciate protecting knee designs so that you can select that's most excellent for every patient.Explores possible choices to TKA in more youthful arthritic sufferers, together with arthroscopy, cartilage fix and replacement,, distal femoral arthroplasty and unicompartmental arthroplasty.Includes a assessment web page in each bankruptcy for fast connection with pearls and pitfalls for every topic.Presents images and interpretive drawings of surgical ideas in complete colour to deliver out intraoperative info as they seem within the working room.Your buy entitles you to entry the website until eventually the following variation is released, or till the present variation is not any longer provided on the market through Elsevier, whichever happens first. If the following variation is released under 365 days after your buy, you can be entitled to on-line entry for three hundred and sixty five days out of your date of buy. Elsevier reserves the perfect to provide an appropriate substitute 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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Extra resources for Arthritis and Arthroplasty: The Knee
To ensure stable plug implantation, at least half of the plug must be buried in bone. Therefore, to reconstruct a 15-mm defect, a 30-mm plug is required. Each system has its recommended technique for graft extraction, but in all cases, avoiding excessive toggling is paramount. After graft removal, either measuring the graft directly or using a plunger device in the harvest site determines length. The grafts are placed in moist gauze on the back table and are carefully labeled with length and diameter.
Several autografts may be placed in a “snowman” technique to achieve coverage of a larger defect. FIGURE 2–13. Arthroscopic view of the final autograft implantation. restore the native radius of curvature. 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.
2–17). Purely chondral lesions and those without an 6/10/2010 9:05:13 AM 20 SURGICAL TREATMENT OF THE ARTHRITIC KNEE: ALTERNATIVES TO TKA adequate osseous base cause difficulty in fixation and may be better treated with debridement. The harvest of the graft should be performed as previously described. The plugs are then strategically placed to stabilize the fragment. Several peripheral plugs should be placed with a single central plug. The central plug must be of sufficient length to cross the entire length of the OCD lesion and anchor solidly into the cancellous bone deep to the lesion.
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