Additional Information
Book Details
Abstract
Learn the latest innovations and techniques of one of the most performed procedures in the world with Total Knee Arthroplasty. Dr. Richard Scott, co-designer of the Total Knee System, brings his years of experience to each clinical challenge, walking you through myriad scenarios and highlighting the pearls and pitfalls he experienced himself along the way. This single-author format lends a consistent, authoritative voice to this medical reference book.
- Regularly consult this expansive reference with topics of interest to surgeons of all levels of experience.
- Quickly find pertinent information with a user-friendly index and hundreds of detailed, full-color illustrations.
- Explore in-depth topics covering all facets of knee replacement, both operative and nonoperative, to restore function to diseased knee joints.
- Comprehend complex methods through an easy-to-access procedure-based format that includes tips on what surgeons should avoid in every situation.
- Take advantage of Dr. Scott's expert guidance in the design and technique of PCL retaining TKA and Unicompartmental knee arthroplasty.
- Access frequently asked questions concerning total knee arthroplasty.
- Consult this title on your favorite e-reader, conduct rapid searches, and adjust font sizes for optimal readability.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Inside Front Cover | ifc1 | ||
| Total Knee Arthroplasty, 2/e | i | ||
| Copyright Page | iv | ||
| Dedication | v | ||
| Preface | vii | ||
| Table Of Contents | ix | ||
| 1 Posterior Cruciate Ligament Retention Versus Substitution | 1 | ||
| Advantages of Posterior Cruciate Ligament Retention | 1 | ||
| Candidates for Posterior Cruciate Ligament Retention | 2 | ||
| Balancing the Posterior Cruciate Ligament | 2 | ||
| Disadvantages of Posterior Cruciate Ligament Retention | 6 | ||
| Indications for Posterior Stabilized Primary Total Knee Arthroscopy | 7 | ||
| Disadvantages of Posterior Cruciate Ligament Substitution | 7 | ||
| References | 9 | ||
| 2 Mobile Versus Fixed Bearings in Total Knee Arthroplasty | 11 | ||
| Why Consider a Mobile-Bearing Alternative? | 11 | ||
| Avoiding Spinout | 13 | ||
| What To Do If Spinout Occurs | 14 | ||
| References | 15 | ||
| 3 Primary Total Knee Arthroplasty Surgical Technique | 17 | ||
| Positioning of the Patient | 17 | ||
| Placement of the Footrest | 17 | ||
| Sterile Preparation of the Leg | 17 | ||
| The Tourniquet | 18 | ||
| The Incision | 18 | ||
| Medial Parapatellar Arthrotomy | 18 | ||
| Completing the Exposure | 19 | ||
| Preparation of the Femur | 20 | ||
| Distal Femoral Resection | 22 | ||
| The Valgus Angle | 22 | ||
| Sizing the Femur | 23 | ||
| Determining the Rotational Alignment of the Femoral Component | 24 | ||
| Placement of the Anteroposterior Cutting Jig | 26 | ||
| Completing the Femoral Cuts | 26 | ||
| Trochlear Resection | 26 | ||
| Posterior Condylar Resection | 26 | ||
| Chamfer Cuts | 27 | ||
| Final Preparation of the Femur | 27 | ||
| Assessing the Potential for Cementless Femoral Fixation | 29 | ||
| Preparation of the Patella | 30 | ||
| Clearing the Quadriceps Tendon | 30 | ||
| Measuring Patellar Thickness and Applying a Cutting Jig | 30 | ||
| Cutting the Patella | 30 | ||
| Preparation of the Tibia | 31 | ||
| Determining the Amount of Tibial Resection | 31 | ||
| Intramedullary Versus Extramedullary Alignment | 31 | ||
| Determining Alignment of the Tibial Resection with Extramedullary Devices | 31 | ||
| Posterior Tibial Slope | 32 | ||
| Sizing the Tibia | 33 | ||
| Determining the Rotational Alignment of the Tibial Component | 34 | ||
| Adjusting Flexion and Extension Gaps | 35 | ||
| Assessment of Patellar Tracking | 36 | ||
| Final Preparation Prior to Cementing of Components | 36 | ||
| Cementing Components | 36 | ||
| Draining and Closing the Wound | 37 | ||
| Perioperative Management | 37 | ||
| Anticoagulation | 37 | ||
| Rehabilitation Protocol | 38 | ||
| Follow-Up Appointments | 38 | ||
| References | 38 | ||
| 4 Total Knee Arthroplasty in Severe Varus Deformity | 41 | ||
| Medial Release in Extension | 41 | ||
| Shift and Resect Technique | 41 | ||
| Formal Medial Collateral Ligament Release From the Tibia | 43 | ||
| Distal Femoral Resection | 43 | ||
| Femoral Component Rotation | 44 | ||
| Options for Restoration of Deficient Tibial Bone Stock | 45 | ||
| Residual Lateral Laxity | 45 | ||
| Correcting Significant Residual Lateral Laxity | 46 | ||
| Internal Tibial Torsion | 47 | ||
| Summary | 47 | ||
| References | 48 | ||
| 5 Total Knee Arthroplasty in Severe Valgus Deformity | 49 | ||
| Lateral Femoral Condyle Hypoplasia | 50 | ||
| Balancing the Extension Gap by a Lateral Release | 54 | ||
| Inverted Cruciform Release for Severe Valgus | 54 | ||
| Lateral Collateral Ligament, Popliteal, and Biceps Tendon Release | 55 | ||
| Summary | 58 | ||
| References | 58 | ||
| 6 Patellofemoral Complications Associated with Total Knee Arthroplasty | 59 | ||
| Residual Valgus Limb Alignment | 61 | ||
| Excessive Valgus Placement of the Femoral Component | 61 | ||
| Patella Alta | 61 | ||
| Component Malrotation | 61 | ||
| Patellar Thickness | 62 | ||
| Asymmetric Patellar Preparation | 62 | ||
| Need for Lateral Release | 62 | ||
| “Rule of No Thumb” Test | 63 | ||
| Dynamic Patellar Instability | 63 | ||
| Testing for Dynamic Instability | 63 | ||
| Patella Fracture | 64 | ||
| References | 68 | ||
| 7 Stiffness Before and After Total Knee Arthroplasty | 69 | ||
| Exposing the Stiff Knee | 69 | ||
| Exposing the Knee Ankylosed in Extension | 70 | ||
| Exposing the Knee Ankylosed in Flexion | 70 | ||
| Heterotopic Bone Formation | 72 | ||
| Overzealous Physical Therapy | 72 | ||
| Manipulation of the Knee | 72 | ||
| Timing of Knee Manipulation | 73 | ||
| Technique of Knee Manipulation | 73 | ||
| Manipulating Into Extension | 74 | ||
| Summary | 74 | ||
| References | 74 | ||
| 8 Flexion Contracture Associated with Total Knee Arthroplasty | 75 | ||
| Treatment Options | 75 | ||
| Preoperative Measures | 76 | ||
| Intraoperative Measures | 76 | ||
| Osteophyte Removal | 76 | ||
| Additional Distal Femoral Resection | 77 | ||
| Algorithm Based on Personal Experience | 78 | ||
| Summary of Treatment Guidelines | 78 | ||
| Other Important Considerations | 78 | ||
| Contractures Resulting From Bony Deformity | 78 | ||
| Bilateral Contractures | 78 | ||
| Patella Baja | 79 | ||
| Posterior Slope | 79 | ||
| Capsular Closure | 79 | ||
| Ancillary Measures | 79 | ||
| Summary | 80 | ||
| References | 80 | ||
| 9 Total Knee Arthroplasty After Osteotomy | 81 | ||
| Operative Exposure | 81 | ||
| Patella Baja | 81 | ||
| Retained Hardware | 82 | ||
| Up-Sloped Joint Line | 83 | ||
| Nonunion | 83 | ||
| Malunion | 85 | ||
| Consequences of Overcorrection of a Varus Tibial Osteotomy | 85 | ||
| Offset Tibial Shafts | 88 | ||
| Unicompartmental Replacement after Failed Tibial Osteotomy | 88 | ||
| Summary | 88 | ||
| References | 90 | ||
| 10 Total Knee Arthroplasty in Rheumatoid Arthritis | 91 | ||
| Ipsilateral Hip Involvement | 91 | ||
| Anticoagulation Needs | 92 | ||
| Flexion Contracture | 92 | ||
| Rheumatoid Cysts | 93 | ||
| Patellar Resurfacing | 93 | ||
| Synovectomy and Recurrent Active Rheumatoid Synovitis | 94 | ||
| Risk for Infection | 94 | ||
| Need for Adequate Knee Flexion | 95 | ||
| Osteopenia | 95 | ||
| Anesthetic Considerations | 96 | ||
| Posterior Cruciate Ligament Preservation Versus Substitution | 96 | ||
| Summary | 97 | ||
| References | 97 | ||
| 11 Bone Stock Deficiency in Total Knee Arthroplasty | 99 | ||
| Femoral Deficiency | 99 | ||
| Bone Grafting | 99 | ||
| Cement Alone | 99 | ||
| Cement Plus Screw Augmentation | 99 | ||
| Augmented Components | 102 | ||
| Tibial Deficiency | 103 | ||
| Bone Grafting | 103 | ||
| Cement Alone | 106 | ||
| Cement Plus Screw Augmentation | 106 | ||
| Bulk Allograft | 106 | ||
| Modular Augmentation Wedges | 108 | ||
| Trabecular Metal Cones and Metaphyseal Sleeves | 109 | ||
| Custom Components | 109 | ||
| Summary | 111 | ||
| References | 111 | ||
| 12 Bilateral Simultaneous Total Knee Arthroplasty | 113 | ||
| The Decision | 113 | ||
| Anesthetic Considerations | 113 | ||
| Anticoagulation | 113 | ||
| Weight-Bearing Status | 114 | ||
| Surgical Technique | 114 | ||
| Length of the Incisions | 114 | ||
| Preemptive Advice to Patients | 114 | ||
| Patient Satisfaction | 115 | ||
| Bilateral Revisions | 115 | ||
| Bilateral Primary and Revision Surgery | 115 | ||
| Summary | 115 | ||
| Reference | 115 | ||
| 13 Sepsis and Total Knee Arthroplasty | 117 | ||
| Perioperative Prophylactic Measures | 117 | ||
| Preoperative Germicidal Skin Scrub | 117 | ||
| Surgical Preparation and Draping | 117 | ||
| Laminar Air Flow Versus Ultraviolet Lights | 118 | ||
| Intravenous Antibiotics | 118 | ||
| Proper Skin Incision | 118 | ||
| Wound Care | 118 | ||
| Skin Necrosis | 120 | ||
| Postoperative Prophylactic Measures | 120 | ||
| Classification of Infections | 120 | ||
| Treatment Options | 121 | ||
| Closed Treatment | 121 | ||
| Open Synovectomy, Débridement, and Insert Exchange | 121 | ||
| Primary Prosthetic Exchange | 122 | ||
| Delayed Prosthetic Exchange | 122 | ||
| Delayed Exchange Protocol | 122 | ||
| Resection Arthroplasty | 124 | ||
| Knee Arthrodesis | 124 | ||
| Amputation | 124 | ||
| Summary | 124 | ||
| Reference | 124 | ||
| 14 Staying Out and Getting Out of Trouble During Total Knee Arthroplasty | 125 | ||
| Choosing the Correct Incision | 125 | ||
| Dealing with Skin Necrosis | 126 | ||
| A Draining Wound | 126 | ||
| Dealing with Excessive Suction Drainage | 128 | ||
| Treating a Large Hematoma | 128 | ||
| Treating Patellar Tendon Avulsion | 129 | ||
| Avoiding Medial Collateral Ligament Injury | 129 | ||
| Addressing Medial Collateral Ligament Injury | 130 | ||
| Avoiding and Resolving Popliteus Tendon Impingement | 130 | ||
| Choosing between Femoral Sizes | 131 | ||
| Summary | 133 | ||
| References | 133 | ||
| 15 Repeat Operation After Total Knee Arthroplasty | 135 | ||
| Femoral Component Loosening | 135 | ||
| Tibial Component Loosening | 135 | ||
| Patellar Complications | 136 | ||
| Metal-Backed Patella | 136 | ||
| All-Polyethylene Patella | 136 | ||
| Unresurfaced Patella | 136 | ||
| Polyethylene Wear | 137 | ||
| Prosthetic Infection | 137 | ||
| Traumatic and Atraumatic Late Laxity | 137 | ||
| Miscellaneous Causes for Re-Operation | 138 | ||
| Recurrent Hemarthrosis | 139 | ||
| Recurrent Rheumatoid Synovitis | 139 | ||
| Stiffness Refractory to Manipulation | 140 | ||
| Ganglion Cysts | 140 | ||
| Summary | 140 | ||
| References | 140 | ||
| 16 Unicompartmental Knee Arthroplasty | 141 | ||
| Classic Selection Criteria | 144 | ||
| Minimally Invasive Unicompartmental Knee Arthroplasty | 145 | ||
| Metallic Unicompartmental Hemiarthroplasty | 145 | ||
| Summary | 146 | ||
| References | 146 | ||
| 17 Unicompartmental Knee Arthroplasty Technique | 149 | ||
| Basic Principles | 149 | ||
| Preoperative Planning | 149 | ||
| Operative Exposure | 150 | ||
| Other Elements of Medial Exposure | 151 | ||
| Preparation of the Tibia | 152 | ||
| Distal Femoral Resection | 154 | ||
| Intramedullary Femoral Alignment Technique | 155 | ||
| Extramedullary Femoral Alignment Technique | 155 | ||
| Sizing of the Femur | 155 | ||
| Rotational Alignment of the Femoral Component | 156 | ||
| Mediolateral Positioning of the Femoral Component | 156 | ||
| Final Preparation of the Femur | 157 | ||
| Final Preparation of the Tibial Component | 159 | ||
| Technical Nuances in Lateral Compartment Arthroplasty | 159 | ||
| Cementing Components | 160 | ||
| Closure | 161 | ||
| References | 161 | ||
| 18 Frequently Asked Questions Concerning Total Knee Arthroplasty | 163 | ||
| Categories of Questions | 163 | ||
| The Answers | 163 | ||
| Preoperative Questions | 164 | ||
| Q: What is the chance for success? | 164 | ||
| Q: What is the recovery time? | 164 | ||
| Q: Will I go to a rehabilitation facility or home? | 164 | ||
| Q: When can I drive? | 164 | ||
| Q: When can I travel? | 164 | ||
| Q: When can I return to work? | 164 | ||
| Q: What activities are permitted after surgery? | 164 | ||
| Q: How long will my knee surgery last? | 164 | ||
| Perioperative Questions (in Hospital) | 164 | ||
| Q: When can I shower or get the incision wet? | 164 | ||
| Q: When can I immerse my knee totally, such as in a bathtub or swimming pool? | 164 | ||
| Q: When should I wear the knee immobilizer? When can I discontinue it? | 165 | ||
| Q: How often should I use the continuous passive motion (CPM) machine? | 165 | ||
| Q: How long do I need a bandage on my incision? | 165 | ||
| Q: When will my sutures (or staples) be removed? | 165 | ||
| Perioperative Questions (Out of the Hospital) | 165 | ||
| Q: How long will I be on pain medication? | 165 | ||
| Q: How long will I be on a blood thinner? | 165 | ||
| Q: Can I drink alcohol during my recovery? | 165 | ||
| Q: How long should I take iron supplements? | 165 | ||
| Q: What are good and bad positions for my knee during recovery? | 165 | ||
| Q: Should I apply ice or heat? | 165 | ||
| Q: How long should I wear compression stockings? | 165 | ||
| Q: Can I go up and down stairs? | 165 | ||
| Q: Will I need physical therapy? | 166 | ||
| Q: When can I resume sexual intercourse? | 166 | ||
| Postoperative Concerns | 166 | ||
| Q: I feel depressed. Is this normal? | 166 | ||
| Q: I have insomnia. Is this normal? What can I do about it? | 166 | ||
| Q: I am constipated. What should I do? | 166 | ||
| Postoperative Concerns (Long Term) | 166 | ||
| Q: How much range of motion do I need? | 166 | ||
| Q: What range of motion should I expect from my knee after 6 weeks? After 1 year? | 166 | ||
| Q: I think my leg feels longer now. Is this possible? | 166 | ||
| Q: Can I use weights when I exercise? | 166 | ||
| Q: Will I set off the security monitors at the airport? Do I need a doctor’s letter? | 166 | ||
| Q: Do I need antibiotics before having dental work or an invasive medical procedure? | 167 | ||
| Q: Can I kneel? | 167 | ||
| Q: When do I need to follow up with my surgeon? | 167 | ||
| Reference | 167 | ||
| Index | 169 | ||
| A | 169 | ||
| B | 169 | ||
| C | 169 | ||
| D | 170 | ||
| E | 170 | ||
| F | 170 | ||
| G | 170 | ||
| H | 170 | ||
| I | 171 | ||
| J | 171 | ||
| K | 171 | ||
| L | 171 | ||
| M | 171 | ||
| N | 172 | ||
| O | 172 | ||
| P | 172 | ||
| Q | 173 | ||
| R | 173 | ||
| S | 174 | ||
| T | 174 | ||
| U | 175 | ||
| V | 175 | ||
| W | 175 | ||
| Inside Back Cover | ibc1 |