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 professional suggestions on every thing from sufferer choice and pre-operative making plans to surgical techniques and methods. transparent, evidence-based insurance info which expertise and technique used for overall knee arthroplasty (TKA), reconstruction or revision is better 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 thoughts. as well as supplying useful, pragmatic suggestion in a concise, readable layout, this professional seek advice name deals the whole textual content of the ebook, in addition to hyperlinks to PubMed and periodic content material updates, on-line at expertconsult.com.Access the complete 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 by way of experts-on the integrated DVD so that you can see tips to practice specific techniques.Covers arthroscopic debridement, patellofemoral maltracking and different sizzling issues to maintain you abreast of the most recent advancements within the specialty.Provides evidence-based, clinically concentrated counsel on sufferer choice, pre-operative making plans, surgical strategy and strategies, bearing surfaces and part fabrics, affliction particular ideas, the administration and avoidance of problems, salvage and revision TKA ideas, and more.Discusses adaptations in approach, bearing ideas and layout parts; together with minimally invasive TKA, mounted as opposed to mobile-bearing TKA, and posterior stabilized (PS) as opposed to cruciate maintaining knee designs so that you can opt for that's most suitable 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 evaluation web page in each bankruptcy for speedy connection with pearls and pitfalls for every topic.Presents pictures and interpretive drawings of surgical options in complete colour to carry out intraoperative information as they seem within the working room.Your buy entitles you to entry the website till the following variation is released, or until eventually the present version isn't any longer provided on the market through Elsevier, whichever happens first. If the following variation is released below twelve months after your buy, you may be entitled to on-line entry for 365 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 info for Arthritis and Arthroplasty: The Knee
12 reported 67% good to excellent results in 48 patients with isolated traumatic chondral defects, with significant improvements in International Knee Documentation Committee (IKDC) scores and physical component of the Short Form (SF)-36. These results, however, declined after 2 years in 69% of patients. In addition, patients with body mass index of greater than 30 kg/m2 were found to have inferior results, as did patients with duration of symptoms longer than 12 months. Several studies have reported on microfracture outcome in the athletic population.
For any lesion greater than 1 cm in diameter, multiple plugs should be used. The harvesting punch can be a useful measurement tool that can also be used to create a template for the filling of the defect. During this process, it is critical that the sizing and harvest devices remain as perpendicular as possible to the area of chondral damage. Graft harvest is performed at one of three sites: the peripheral medial femoral condyle, the lateral femoral condyle superior to the sulcus terminalis, or the superolateral aspect of the intercondylar notch.
4. Incomplete defect coverage 5. Failure to remove debris from within the socket or from the edges of the recipient socket 6. 56 7. 59 POSTOPERATIVE RESTRICTIONS/ REHABILITATION For all of the mentioned procedures, early range of motion and protected weight bearing are crucial to the eventual success of the procedure. The patient is usually placed in a hinged knee brace with motion from 0 to 90 degrees. Therapy is initiated on postoperative day 1 and stresses range-ofmotion exercises and isometric quadriceps strengthening.