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 assistance on every thing from sufferer choice and pre-operative making plans to surgical techniques and methods. transparent, evidence-based assurance info which know-how 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 choices to TKA in more youthful arthritic sufferers and examine expertly narrated video demonstrations of surgical ideas. as well as offering sensible, pragmatic recommendation in a concise, readable structure, this professional seek advice identify bargains the complete textual content of the publication, in addition to hyperlinks to PubMed and periodic content material updates, on-line at expertconsult.com.Access the entire textual content of the book-as good as hyperlinks to PubMed and periodic content material updates on consequence information, part fabrics, and surgical techniques-online at expertconsult.com.Features procedural videos-narrated by means of experts-on the integrated DVD so that you can see how one can practice specific techniques.Covers arthroscopic debridement, patellofemoral maltracking and different sizzling subject matters to maintain you abreast of the newest advancements within the specialty.Provides evidence-based, clinically centred counsel on sufferer choice, pre-operative making plans, surgical process and methods, bearing surfaces and part fabrics, affliction particular recommendations, the administration and avoidance of problems, salvage and revision TKA innovations, and more.Discusses diversifications in method, bearing techniques and layout parts; together with minimally invasive TKA, fastened as opposed to mobile-bearing TKA, and posterior stabilized (PS) as opposed to cruciate maintaining knee designs so that you can select that's foremost for every patient.Explores 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 fast connection with pearls and pitfalls for every topic.Presents pictures and interpretive drawings of surgical options in complete colour to carry out intraoperative info as they seem within the working room.Your buy entitles you to entry the website until eventually the subsequent version is released, or until eventually the present variation is not any longer provided on the market via Elsevier, whichever happens first. If the following variation is released under 12 months after your buy, you can be entitled to on-line entry for twelve months out of your date of buy. Elsevier reserves the suitable to provide an appropriate substitute product (such as a downloadable or CD-ROM-based digital model) should still on-line entry to the website be discontinued.
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Additional resources for Arthritis and Arthroplasty: The Knee
Microfracture holes are created at the periphery of the lesion at 3- to 4-mm intervals and then continued in a spiral pattern to the B cm FIGURE 2–5. Microfracture awls penetrate the subchondral plate to stimulate the marrow elements and to allow access of the marrow elements to the bony surface. center. The distance of 3 to 4 mm allows for adequate penetration and coverage of the defect while limiting the possibility of fracture of the bone between the holes. The shaver is again introduced and run over the newly created defects to debride any loose bone fragments that were created from the microfracture.
A spinal needle may be useful to ensure proper placement of the portals. The portals should be made through vertical incisions so as to facilitate maneuvering of the harvesting chisel and to provide an extensile approach should an arthrotomy be necessary. The defect is sized with a probe or commercially available measuring device to determine the number, diameter, and position of the graft cylinders that will be required. For any lesion greater than 1 cm in diameter, multiple plugs should be used.
Pulse lavage of the donor plug after harvest will decrease marrow elements in the subchondral bone. 7. Additional donor plugs may be placed in a variety of configurations. 8. If the press-fit is not secure, the plug should be fixed with a screw (bioabsorbable compression screw) advanced to a level just beneath the subchondral plate. 9. Copious amounts of saline irrigation should be provided during any drilling or cutting. 6/10/2010 9:05:15 AM C H A P T E R 2 Cartilage Repair and Replacement: From Osteochondral Autograft Transfer to Allograft 23 12 m 8m m 9m 3 9 6 20 mm 12 9 3 6 A B FIGURE 2–19.
Arthritis and Arthroplasty: The Knee by Thomas E. Brown MD, Quanjun Cui, William M. Mihalko MD PhD, Khaled Saleh