Sports Medicine

Complex Primary and Revision Total Knee Arthroplasty: A by Bryan D. Springer, Brian M. Curtin

By Bryan D. Springer, Brian M. Curtin

Comprised completely of medical situations masking complicated fundamental and revision overall knee arthroplasty, this concise, useful casebook will supply orthopedic surgeons with the easiest real-world options to correctly deal with the extra advanced varieties of knee alternative they might come across. each one bankruptcy is a case that opens with a distinct scientific presentation, by means of an outline of the prognosis, evaluate and administration strategies used to regard it, in addition to the case consequence and medical pearls and pitfalls. situations incorporated illustrate assorted administration innovations for fundamental knee arthroplasty, together with the varus and valgus knee, flexion contracture and extra-articular deformity, in addition to periprosthetic an infection and revision overall knee arthroplasty, together with poor extensor mechanism, periprosthetic femur fracture and ligamentous instability. Pragmatic and reader-friendly, Complex basic and Revision overall Knee Arthroplasty: A medical Casebook can be an outstanding source for orthopedic surgeons faced with a tough knee joint replacement.

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Extra info for Complex Primary and Revision Total Knee Arthroplasty: A Clinical Casebook

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In a more extreme example of this, Easley et al. showed that in an elderly population, using a more constrained implant, the constrained condylar knee, without addressing medial tissue laxity nor even performing any lateral soft tissue release, gave reasonable results while avoiding longer surgeries and the possible complications associated with both lateral release and medial tightening [11]. 2. 4 25 Complications in the Valgus Knee Certain complications have been shown to be more common in patients with valgus knees undergoing TKA when compared to TKA patients with varus knees, several of which deserve specific mention: • Patellar osteonecrosis—As mentioned above, this is particularly a problem when extensive lateral release is done in conjunction with a medial surgical approach.

3. 6 41 Clinical Pearls/Pitfalls • The key to the management of the total knee with a preoperative flexion contracture is not to initially resect too much distal femoral bone without first evaluating the posterior osteophytes/capsule and the steps that may be necessary to balance the knee in the coronal plane. • Excessive distal femoral resection (>4 mm beyond the minimum for a given implant system) is not recommended, as raising the joint line to that extent affects collateral ligament balance and can lead to mid-flexion instability.

J Orthop Trauma. 1995;9:273–7. 2. Suzuki G, et al. Previous fracture surgery is a major risk factor of infection after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2011;19(12):2040–4. 3. Klatte TO, Schneider MM, Citak M. Infection rates in patients undergoing primary knee arthroplasty with pre-existing proposed if fixation-devices. Knee. 2013;20(3):177–80. 4. Brooks PJ, Walker PS, Scott RD. Tibial component fixation in deficient tibial bone stock. Clin Orthop Relat Res. 1984;184: 302–8.

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