By Arun B. Mullaji, Gautam M. Shetty (auth.)
With fast development in expertise and fabrics in overall knee arthroplasty (TKA), long term survival and serve as of the complete knee is now progressively more depending on restoring exact limb alignment, particular part place and optimal soft-tissue stability. right process is vital to making sure this and is all of the extra the most important and demanding to accomplish in arthritic knees with serious and complicated deformities. Correction of such knee deformities kinds a tremendous a part of TKA for orthopedic surgeons operating in either rising and constructed nations.
Deformity Correction in overall Knee Arthroplasty fills the void that exists in treating serious and intricate knee deformities and using computer-navigation in TKA. It covers the rules of deformity correction and soft-tissue balancing in basic TKA in an illustrative, step-wise and algorithmic model. beginning with the preliminary key step of preoperative making plans, this ebook is going directly to in particular describe the way to take care of varieties of deformities encountered in sufferers who endure TKA - varus, valgus, flexion, high blood pressure, rotational and extra-articular deformities - in addition to the stiff knee, the volatile knee, osteotomies in fundamental TKA and postoperative discomfort administration and rehabilitation. This centred how-to guide comprises abundant photographs and transparent, concise textual content from authors who've played millions of TKAs, making it essential reference for any health care professional surprising or usually faced with this kind of procedure.
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Additional info for Deformity Correction in Total Knee Arthroplasty
Example text
Conventionally, the cut is performed using intramedullary guides which are commonly set at an angle of 5–7° valgus. However, choosing this fixed range for the distal femoral valgus cut is fraught with risks especially in knees with severe deformities. A recent prospective study [15] done by the authors has shown wide variations in this angle among patients with the distal femoral valgus correction angle (VCA) varying from 2° to 11° and almost 45 % of limbs having a VCA outside the conventional 5–7° range [15].
A metalbacked tibia is used when the bone quality is poor, patient is heavy, additional components such as a stem or augment needs to be used and if the balance is suboptimal with lateral laxity. Recently an added dimension to the femoral component design has been the “high-flexion” feature. Although advocates of this design have reported benefits in terms of improved flexion, the reported literature is not very convincing on this. Recent reports have also shown increased incidence of early loosening of the femoral 15 components with these high-flexion designs [30, 31].
Mullaji AB, Marawar SV, Luthra M. Tibial articular cartilage wear in varus osteoarthritic knees: correlation with anterior cruciate ligament integrity and severity of deformity. J Arthroplasty. 2008;23:128–35. 8. Seon JK, Park JK, Shin YJ, Seo HY, Lee KB, Song EK. Comparisons of kinematics and range of motion in high-flexion total knee arthroplasty: cruciate retaining vs. substituting designs. Knee Surg Sports Traumatol Arthrosc. 2011;19:2016–22. 9. Luo SX, Zhao JM, Su W, Li XF, Dong GF. Posterior cruciate substituting versus posterior cruciate retaining total knee arthroplasty prostheses: a meta-analysis.