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 specialist counsel on every thing from sufferer choice and pre-operative making plans to surgical techniques and methods. transparent, evidence-based assurance info which expertise and method 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 offering useful, pragmatic suggestion in a concise, readable layout, this specialist seek advice name deals the whole textual content of the e-book, 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 end result info, part fabrics, and surgical techniques-online at expertconsult.com.Features procedural videos-narrated by means of experts-on the incorporated DVD so that you can see find out how to 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 method and methods, bearing surfaces and part fabrics, disorder particular concepts, the administration and avoidance of issues, salvage and revision TKA ideas, and more.Discusses adaptations in method, bearing recommendations and layout parts; together with minimally invasive TKA, fastened as opposed to mobile-bearing TKA, and posterior stabilized (PS) as opposed to cruciate keeping knee designs so that you can decide on that is optimum 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 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 is not any longer provided on the market by means of Elsevier, whichever happens first. If the subsequent version is released under 12 months after your buy, you'll be entitled to on-line entry for 12 months out of your date of buy. Elsevier reserves the precise to supply an appropriate alternative 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 resources for Arthritis and Arthroplasty: The Knee
If the cartilage on the harvested plug or the cartilage surrounding the recipient site is oblique, the graft should be oriented within the inserter prior to placement to be the best match to the contour of the surrounding cartilage. Also before insertion, the inflow pump should be turned off to prevent swelling of the graft and a possible size mismatch with the recipient site. This will also prevent the graft from being accidentally expelled from the insertion tool because of fluid pressure. The graft is advanced by manual pressure and with gentle taps on the impactor plunger.
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.
2–20A). At this point, if the lesion is incompletely covered, a “snowman” technique may be used to cover the entire lesion (Fig. 2–20B). Fixation of the plug may be augmented with small bioabsorbable compression screws (Arthrex, Naples, FL) or absorbable polydioxanone pins. , very far posterior condylar lesions), a hand-shaped shell allograft can be used and fixed with standard screw fixation or polydioxanone pins. Care should again be taken to ensure that the articular surface of the graft is flush with the recipient site.