The Unhappy Total Knee Replacement

This book addresses the need for improved diagnostic and treatment guidelines for patients in whom total knee arthroplasty (TKA) has had an unsatisfactory outcome. It opens by discussing the basics of TKA and the various causes of failure and pain. Diagnostic aspects are considered in detail, with attention to advances in clinical investigation, laboratory analysis and in particular, imaging techniques. In addition, helpful state of the art diagnostic algorithms are presented. Specific pathology-related treatment options, including conservative approaches and salvage and revision TKA strategies, are then explained, with identification of pitfalls and key points. A series of illustrative cases cover clinical scenarios frequently encountered in daily clinical practice. The evidence-based, clinically focused guidance provided in this book, written by internationally renowned experts, will assist surgeons in achieving the most effective management of these challenging cases.

Each year approximately 250,000 Americans undergo total-knee-replacement surgery (also known as a total knee arthroplasty, or TKA). Every year, a million more consider it. If you are considering or have had a total knee replacement you should read this book. It will tell you everything you need to know to prepare for and recover from the surgery, and to get the most out of your new knee. The success of a total knee replacement depends on rehabilitating the knee after the operation -- in fact, the rehab is as important as the surgery itself. This book maps out the road to recovery with week-by-week exercises for a full year. The authors, a surgeon and physical therapist who have both been orthopedic patients, provide practical tips, success stories and personal insights into the recovery process. Most people, even surgeons, don't realize how dramatically arthritis can change a person's life. Author Jeff Falkel, Ph.D., was one of these people. Over the course of 20 years his knees had gotten progressively worse, and eventually the pain reached the point where it was present in every aspect of his life. He could not stand or walk without crippling pain.

The second edition of Knee Replacement brings clinicians up to date with recent advances in surgical replacement of the knee. Beginning with basic principles and anatomy, the text guides surgeons through preoperative, perioperative and postoperative aspects of patient care, including clinical assessment, radiology, surgical techniques and management of complications. To help understanding of the various procedures, a DVD ROM with colour photographs is included, showing every step of knee replacement surgery.

Physicians, surgeons and scientists look at the major problems encountered in total knee replacement. Key issues addressed include design of prosthetic knee components, wear of articular surfaces, fixation, patellar replacement, surgical technique and revision arthroplasty.

Currently younger and more active patients with arthritis, trauma, and other joint diseases are getting predictable and durable results from total knee arthoplasty. The concise chapters in this manual cover indications, contraindications, complications, results, instrumentation, infection, pre-op planning, prosthetic and revision arthoplasty. These two knee specialists have assembled a group of "giants" in the field to present the best techniques for total knee arthoplasty. 250 illus.

Evidence-Based Orthopedics is an up-to-date review of the best evidence for the diagnosis, management, and treatment of orthopedic conditions. Covering orthopedic surgery as well as pre- and post-operative complications, this comprehensive guide provides recommendations for implementing evidence-based practice in the clinical setting. Chapters written by leading clinicians and researchers in the field are supported by tables of evidence that summarize systematic reviews and randomized controlled trials. In areas where evidence is insufficient to recommend a practice, summaries of the available research are provided to assist in decision-making. This fully revised new edition reflects the most recent evidence using the approved evidence-based medicine (EBM) guidelines and methodology. The text now places greater emphasis on GRADE—a transparent framework for developing and presenting summaries of evidence—to allow readers to easily evaluate the quality of evidence and the strength of recommendations. The second edition offers a streamlined presentation and an improved standardized format emphasizing how evidence in each chapter directly affects clinical decisions. Incorporating a vast amount of new evidence, Evidence-Based Orthopedics: Features thoroughly revised and updated content, including a new chapter on pediatric orthopedics and new X-ray images Provides the evidence base for orthopedic surgery as well as pediatric orthopedics and orthopedic conditions requiring medical treatment Covers the different methods for most orthopedic surgical procedures, such as hip replacements, arthroscopy, and knee replacements Helps surgeons and orthopedic specialists achieve a uniform optimum standard through a condition-based approach Aligns with internationally accepted guidelines and best health economic principles Evidence-Based Orthopedics is an invaluable resource for orthopedic specialists, surgeons, trauma surgeons, trainees, and medical students.

Calipered kinematic alignment was proposed by Dr. Stephen M. Howell to enable the accurate and individualized placement of total knee components coincident within ± 0.5 mm of the patient’s pre-arthritic alignment. The aim was to restore the patient's native joint kinematics and thereby address the well documented 20% dissatisfaction when total knee replacement is performed using traditional, or mechanical alignment techniques. With Dr. Stefano A. Bini and Dr. G. Daxton Steele as co-editors, Dr. Howell has curated an international team of expert surgeons and engineers to discuss various aspects of the calipered knee alignment technique in short, concise, and well-illustrated chapters. Each author provides clear, practical guidance for adopting and implementing calipered kinematic alignment covering manual, patient-specific, navigated, and robotic techniques. Chapters on component design tailored explicitly for kinematic alignment and showing the close relationship between knee biomechanics and the kinematically aligned TKA help the surgeon manage complex challenges associated with deformity and post-operative complications. Following the introduction of the calipered kinematic alignment technique for total knee arthroplasty, many international studies have shown consistently better patient satisfaction than the traditional mechanical alignment technique. Better function and high long-term implant survival have catalyzed a paradigm shift in total knee replacement philosophy that is being embraced by orthopedic surgeons and innovative implant companies around the world with excellent results. Calipered Kinematically Aligned Knee Arthroplasty is the definitive textbook on the subject and features: Thorough explanations of how the calipered kinematic alignment technique for total knee arthroplasty accurately sets total knee components coincident with the patient’s pre-arthritic alignment and coaligned with the three rotational axes of the native knee. A personalized approach to total knee surgery designed to reconstitute the patient’s native biomechanics in contrast with mechanical alignment that place all patients in the same standard alignment regardless of their constitutional anatomy. Detailed and well-illustrated descriptions of manual, navigated, robotic and patient-specific guide techniques that confirm kinematic alignment with a caliper. Clinical photos, radiographs, and line art throughout the book as well as helpful online technique videos. Key focus topics such as managing complex deformities, the expected post-operative recovery, and future trends in kinematic alignment. The shared experience and knowledge of international pioneers in the field. An emphasis on a personalized surgical philosophy which enables same-day discharge, reduces pain and opioid use, and promotes quicker recovery, better function, and a more natural feeling knee.