Insall & Scott Surgery of the Knee, 2-Volume Set

6th Edition - February 10, 2017
Imprint: Elsevier
Author: W. Norman Scott
Language: English
Hardback ISBN:
9 7 8 - 0 - 3 2 3 - 4 0 0 4 6 - 6

Now offered in 2 full volumes — both in print and online — Insall & Scott Surgery of the Knee by Dr. W. Norman Scott remains the definitive choice for guidance on the most effe… Read more

Insall & Scott Surgery of the Knee, 2-Volume Set

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Now offered in 2 full volumes — both in print and online — Insall & Scott Surgery of the Knee by Dr. W. Norman Scott remains the definitive choice for guidance on the most effective approaches for the diagnosis and management of the entire scope of knee disorders. This edition reflects a complete content overhaul, with more than 50 new chapters and over 400 contributors from around the world. The video program includes 70 new video clips, while new and expanded material covers a range of hot topics, including same-day surgery and hospital management of knee arthroplasty patients and anesthesia specific for knee surgery.

Cover image
Title Page
Table of Contents
Copyright
Section Editors
Dedication
Contributors
Foreword
Foreword
Foreword
Preface
Preface to the Fifth Edition
Preface to the Fourth Edition
Preface to the Third Edition
Preface to the Second Edition
Preface to the First Edition
Acknowledgments
Online Contents
Section I Basic Science
1 Anatomy*
Normal Skeletal Structures
Hyaline and Articular Cartilage
Menisci
Capsule
Synovial Cavity
Bursae
Cruciate Ligaments
Anterior Aspect
Medial Aspect
Lateral Aspect
Posterior Aspect
Nerves
Blood Supply
Motion and Function
References
2 Anatomic Aberrations*
Skeletal Abnormalities
Ligament Abnormalities
Meniscal Abnormalities
Muscle Abnormalities
Arterial Anomalies
Nerve Abnormalities
Cysts
Plicae
Summary
References
3 Clinical Examination of the Knee
History
Observation and Inspection
Palpation
The Patellofemoral Joint
The Tibiofemoral Joint
Ligamentous Examination
References
4 Gene Therapy for the Treatment of Knee Disorders*
Introduction
Overview of Gene Therapy
Gene Therapy for the Treatment of Knee Disorders
Clinical Application
Future Directions
References
Section II Imaging of the Knee
5 Knee Imaging Techniques and Normal Anatomy
Radiography
Computed Tomography
Magnetic Resonance Imaging
Ultrasound
Nuclear Medicine
References
6 Fractures
Diagnosis and Imaging Protocols
Distal Femoral Fractures
Fractures of the Physis
Fractures and Dislocations of the Patella
Femorotibial Knee Dislocations
Tibial Plateau and Proximal Tibia and Fibula Fractures and Dislocations
References
7 Imaging of the Meniscus
Introduction
Normal Anatomy
Biomechanical Properties of the Meniscus
Imaging of the Meniscus
Evaluation of Meniscal Tears
Anatomic Variants and Pitfalls
Related Meniscal Pathology
Postoperative Meniscus
References
8 Cruciate Ligaments
Anterior Cruciate Ligament
Anterior Cruciate Ligament Mechanism of Injury
Bone Marrow Contusion Patterns
Normal Magnetic Resonance Appearance of the Anterior Cruciate Ligament
Radiography
Computed Tomography
Anterior Cruciate Ligament Magnetic Resonance Imaging
Anterior Cruciate Ligament Reconstruction
Normal Anterior Cruciate Ligament Graft Imaging
Magnetic Resonance Imaging of Complications of Anterior Cruciate Ligament Reconstruction
Graft Impingement
Arthrofibrosis
Other Anterior Cruciate Ligament Graft Complications (Ganglion Cyst Formation and Tunnel Widening)
Hardware Failure
Posterior Cruciate Ligament
Other Ligamentous Knee Structures
Conclusion
References
9 Imaging of Synovium and Cartilage of the Knee
Synovium
Cartilage
References
10 Lateral Supporting Structures
Introduction
General ANATOMIC Considerations
General Imaging Considerations
Conclusion
References
11 Medial Supporting Structures
Introduction
Anatomy of the Posteromedial Corner
Function and Biomechanics of the Posteromedial Corner
Posteromedial Compartment Injuries
Clinical Manifestations of Posteromedial Corner Injuries
Treatment of Posteromedial Corner Injuries
Conclusion
References
12 Imaging of the Extensor Mechanism
Imaging of the Extensor Mechanism
Patellar Dislocation
Risk Factors for Lateral Patellar Dislocation
Quadriceps and Patellar Tendinopathy and Tendon Tear
Prepatellar Quadriceps Continuation
Plica
Bipartite Patella
Conclusion
References
13 Imaging of Total Knee Arthroplasty
Imaging
Complications
Radionuclide Imaging
Summary
References
14 Tumors in the Knee
Introduction
Benign Primary Osseous Tumors of the Knee
Malignant Primary Osseous Tumors of the Knee
Benign Primary Soft Tissue Tumors of the Knee
Benign Fibrohistiocytic Soft Tissue Tumors of the Knee
Tumors of the Soft Tissues, Unclassified
Malignant Soft Tissue Tumors of the Knee
Conclusion
References
15 Ultrasound-Guided Procedures
Introduction
Intra-Articular Procedures
Corticosteroid Injections
Viscosupplementation
Contrast
Tendon Procedures
Patella Tendon
Popliteus Tendon
Bursae, Cysts, and Ganglions
Biopsy
Summary
References
Section III Biomechanics
16 Three-Dimensional Morphology of the Knee
Introduction
Materials and Methods
Results
Discussion
Acknowledgments
References
17 Fluoroscopic Analysis of Total Knee Replacement
Analysis Methods
Kinematic Studies Using Fluoroscopy
Sample Results
Summary
References
18 In Vivo Kinematics of the Patellofemoral Joint
Patella Significance and Function
Anatomy and Design Factors
Patellofemoral Kinematics, Tracking, and Contact
Chapter Highlights
References
19 Forward Solution Modeling
What Is Mathematical Modeling?
Why Mathematical Modeling?
Basic Concepts of Knee Modeling
Creating A Theoretical Simulator of the Knee
Chapter Highlights
References
20 Contact Mechanics of the Human Knee
Methods for Studying Knee Contact Mechanics
Normal Knee Motion
Normal Knee Forces
Comparison of Total Knee Arthroplasty and Normal Knee Motion and Forces
Comparison of Total Knee Arthroplasty Contact Kinetics
Conclusion
References
21 In Vivo Mechanics and Vibration of the Knee Joint
Knee Kinematics: Mobile or Fixed, Retaining or Sacrificing, and Personalized or Patient Matched?
Knee Kinetics: What Have We Found?
Knee Vibration Data: The Future of Diagnosis?
References
22 Does Strain in the Patella Change After Total Knee Arthroplasty? A Finite Element Investigation of Natural and Implanted Patellae
Materials and Methods
Results
Discussion
Acknowledgments
References
23 Wear Simulation of Knee Implants
Introduction to Wear Simulation
Effect of Input Kinematics on Bearing Wear
Influence of Bearing Design on in Vitro Wear Performance of Knee Replacements
Wear Performance of New Materials
Summary
References
24 Knee Wear*
Wear and Damage
Factors Involved in Knee Wear
Mobile-Bearing Knees
Highly Cross-Linked Polyethylene in Knees
Summary
References
25 The Asian Knee
Introduction
Demographic Differences
Differences in Bone Quality
Cultural Differences
Kinematics
Morphological Differences
Mechanical Axis
Morphology of Femur
Morphology of Tibia
Morphology of Patella
Outcome in Asian Total Knee Arthroplasty
Future
References
26 Mobile Fluoroscopy
Introduction
Mobile Fluoroscopy Concepts
Summary
Acknowledgments
References
Section IV Sports Medicine: Articular Cartilage and Meniscus
27 Articular Cartilage
Biology and Structure
Biomechanics
Damage Pathways and Healing Response
Future Directions
References
28 Articular Cartilage Injury and Adult Osteochondritis Dissecans
Presentation
Imaging
Cause, Natural History, and Prognosis
Nonoperative Treatment
Surgical Treatment
Reparative Procedures
Restorative Procedures
Conclusions
References
29 International Experience With Autologous Chondrocyte Implantation With Periosteum (Autologous Chondrocyte Implantation) Including Scaffold Guided Techniques and Tissue Engineered Matrix Support
Tissue Engineered Matrix Support Using Membranes, Carriers, Scaffolds, and Gels in Autologous Chondrocyte Implantation
Alternatives to Autologous Chondrocyte Implantation. Use of Chondral Tissue for Cartilage Regeneration
References
30 Osteochondral Autograft Transplantation
Introduction
Indications
Technical Considerations
Pearls and Pitfalls
Postoperative Regimen
Results
Gross Morphology and Histology
Imaging
Future Directions
Summary
References
31 Osteochondral Allograft Transplantation
Basic Science
Indications
Procurement, Screening, and Storage
Preoperative Planning
Surgical Technique
Postoperative Management
Results
Complications
Conclusions and Recommendations
References
32 Articular Cartilage Repair With Bioscaffolds
Part I: Scientific Basis for Design Considerations of Bioscaffolds
Part II: Scaffolds in Development
References
33 Management of Failed Cartilage Repair
Introduction
Clinical Evaluation
Treatment Algorithm
Rehabilitation
Results Following Revision Cartilage Surgery
Conclusion
References
34 Osteochondritis Dissecans of the Knee in the Young Patient
History
Epidemiology
Pathophysiology
History and Physical Exam
Diagnostic Imaging
Treatment
Initial Management
Surgical Treatment
Conclusion
References
35 Secondary, Spontaneous, and Postarthroscopy Osteonecrosis of the Knee
Spontaneous Osteonecrosis of the Knee
Osteonecrosis in the Postoperative Knee
Comparison of Spontaneous Osteonecrosis of the Knee, Osteonecrosis in the Postoperative Knee, and Secondary Osteonecrosis of the Knee
Treatment Options
Summary and Conclusions
References
36 Healing of Knee Ligaments and Menisci
Ligaments
Menisci
Acknowledgments
References
37 Arthroscopic Meniscal Resection
Clinical Assessment
Surgical Technique
Postoperative Course and Complications
Conclusion
References
38 Arthroscopy-Assisted Inside-Out and Outside-In Meniscus Repair
Introduction
Indications
Surgical Technique for Meniscal Repair
Biomechanical Testing
Results
Rehabilitation of Meniscal Repair
Conclusions
Acknowledgments
References
39 All-Inside Arthroscopic Meniscal Repair
Indications for All-Inside Meniscal Repair
Techniques
Clinical Results
Complications
Adjuncts to Healing
Postoperative Rehabilitation
Summary
References
40 Meniscal Allograft Transplantation
Meniscal Anatomy and Function
Natural History of the Meniscus-Deficient Knee
Biology of the Transplanted Meniscal Allograft
Graft Preparation AND Disease Transmission
Indications and Contraindications for Meniscal Transplantation
Preoperative Considerations
Surgical Techniques
Combined Techniques
Results
Complications
Postoperative Rehabilitation
Conclusion
References
41 Synthetic Meniscal Substitutes and Collagen Scaffold for Meniscal Regeneration
Overview of Meniscal Scaffolds
Collagen Meniscal Implant
Polyurethane Scaffold (Actifit)
Comparison of Early Clinical Results of Meniscal Scaffolds
Meniscal Substitution
Preclinical Advances in Meniscal Scaffolds and Substitutes
Summary
References
Section V Sports Medicine: Ligament Injuries
42 Classification of Knee Ligament Injuries
Relationship of Capsular and Ligamentous Structures
Kinematics
Classification of Ligament Injuries
Determination of Knee Ligament Instability
Knee Ligament Rating Systems
References
43 Sports Knee Rating Systems and Related Statistics
Patient-Reported Knee Rating Scales and Related Statistics
Selecting Appropriate Self Report Outcome Instrument instruments
global outcomes and Quality of Life Scales
Knee Specific Outcomes Scales
Common Statistical Concepts in Outcomes Research
References
44 Medial Ligamentous Injuries of the Knee
Anatomy and Biomechanics
Diagnosis
Imaging
Treatment
Isolated Medial Collateral Ligament Injury
Combined Injuries
Combined Multiligament Injury and Knee Dislocations
Technique
Authors' Preferred Treatment
Surgical Technique
References
45 Fibular Collateral Ligament and the Posterolateral Corner
Anatomy
Clinically Relevant Biomechanics of the Posterolateral Knee
Injuries to the Fibular Collateral Ligament and Posterolateral Corner
Treatment
References
46 Anterior Cruciate Ligament Injuries and Reconstruction
History of Anterior Cruciate Ligament Reconstruction
Predisposing Factors and Associated Injuries
Indications for Reconstruction
Timing of Surgery
Surgical Technique
Graft Passage
Postoperative Management
Complications
Outcomes
New Directions
Conclusion
Acknowledgments
References
47 Bone-Patellar Tendon-Bone Autograft Anterior Cruciate Ligament Reconstruction
Introduction
Surgical Technique
Postoperative Management and Rehabilitation
References
48 Anterior Cruciate Ligament Reconstruction With Hamstring Tendons
Surgical Technique
Postoperative Management
Common Complications and Their Treatment
Summary
References
49 Anterior Cruciate Ligament Reconstruction With Central Quadriceps Free Tendon Graft
Background
Preoperative Considerations
Positioning
Graft Harvest
Graft Preparation
Tunnel Drilling
Graft Passage and Fixation
Rehabilitation
References
50 Allograft Anterior Cruciate Ligament Reconstruction
Allograft Considerations
Results of Allograft Anterior Cruciate Ligament Reconstruction
Operative Considerations
Procedure
Postoperative Management
References
51 Double-Bundle Anterior Cruciate Ligament Reconstruction
Anatomy and Biomechanics
Preoperative Considerations
Technique
Postoperative Rehabilitation
Potential Pitfalls and Recommendations
Results
Conclusion
References
52 Anterior Cruciate Ligament Reconstruction via the Anteromedial Portal and Single-Tunnel, Double-Bundle Techniques
Anterior Cruciate Ligament Reconstruction via the Anteromedial Portal
Anterior Cruciate Ligament Reconstruction via Single-Tunnel, Double-Bundle Technique
References
53 Complications of Anterior Cruciate Ligament Reconstruction
Intraoperative Complications
Postoperative Complications
Graft-Specific Complications
Medical Complications
References
54 Revision Anterior Cruciate Ligament Reconstruction
Introduction
Etiology
Patient Evaluation
Surgical Techniques
Conclusion
References
55 Revision Anterior Cruciate Ligament Surgery
Preoperative Workup
Treatment Options
Surgical Procedures
Case Examples
Outcomes
Conclusion
References
56 Osteotomy and the Cruciate-Deficient Knee
Cruciate Injury and Arthrosis
Indications for Osteotomy
Treatment of Cruciate Deficiency and Arthrosis
Preoperative Evaluation
Surgical Procedure
Postoperative Protocol
Outcomes
Complications
References
57 Rehabilitation of the Surgically Reconstructed and Nonsurgical Anterior Cruciate Ligament
Introduction
Nonoperative Rehabilitation of Anterior Cruciate Ligament Injuries
Rehabilitation After Anterior Cruciate Ligament Reconstructive Surgery
Summary
References
58 Knee Bracing for Athletic Injuries
Rehabilitative Braces
Prophylactic Knee Braces
Functional Knee Braces
Biomechanical Findings
Summary
References
59 Decision Making and Surgical Treatment of Posterior Cruciate Ligament Ruptures
Introduction
Posterior Cruciate Ligament Anatomy
Posterior Cruciate Ligament Fiber Function
Diagnosis of Posterior Cruciate Ligament Function and Knee Joint Subluxations
Clinical Evaluation
Management Considerations
Operative Techniques: Current Concepts
Intraoperative Evaluation
Posterior Cruciate Ligament Graft Harvest Options
Surgical Procedures
Alternative Posterior Cruciate Ligament All-Inside Techniques
Posterior Cruciate Ligament Avulsion Fractures
Posterior Cruciate Ligament Augmentation Approaches and Techniques
Postoperative Rehabilitation
Clinical Studies
Posterolateral Surgical Technique Options
Posterolateral Postoperative Rehabilitation
References
60 Posterior Cruciate Ligament Reconstruction
Anatomy
History and Physical Examination
Tibial Inlay Technique in Detail
Summary
References
61 Posterior Cruciate Ligament Reconstruction
Introduction
Surgical Indications
Surgical Timing
Graft Selection
Posterior Cruciate Ligament Reconstruction Surgical Technique
Anterior Cruciate Ligament Reconstruction
Overview of Graft Tensioning and Fixation
Postoperative Rehabilitation
Authors' Results of Posterior Cruciate Ligament Reconstruction
Summary
References
62 Posterior Cruciate Ligament Reconstruction
Scientific Rationale
Surgical Indications
Surgical Technique
Additional Surgery
Postoperative Rehabilitation
Clinical Results
Conclusions
Acknowledgments
References
63 The Dislocated Knee
Introduction
Vascular Injuries
Neurologic Injuries
Classification
Evaluation
Treatment
Complications
Authors' Approach
Conclusion
References
64 Dislocation of the Proximal Tibiofibular Joint
Introduction
Anatomy
Classification
Clinical Evaluation
Treatment
Conclusion
References
Section VI Sports Medicine: Patellar and Extensor Mechanism Disorders
65 Disorders of the Patellofemoral Joint
Basic Anatomy and Biomechanics
Imaging
Patellofemoral Instability and Osteoarthritis
Patellofemoral Pain Syndrome/Anterior Knee Pain
Patellofemoral Osteoarthritis
References
66 Distal Realignment of the Patellofemoral Joint
Pathophysiology of Patellofemoral Pain and Instability: Implications for Treatment
A Rational Approach to Distal Realignment
Our Recommended Treatment Approach
Summary
References
67 Surgery of the Patellofemoral Joint
Introduction
Acknowledgments
References
68 Repair and Reconstruction of the Medial Patellofemoral Ligament for Treatment of Lateral Patellar Dislocations
Lateral Patella Dislocations: Surgical Indications
Anatomy of the Medial Side of the Knee: Surgical Implications
Medial Patellofemoral Ligament Repair
Medial Patellofemoral Ligament Reconstruction
Rehabilitation After Medial Patellofemoral Ligament Repair Reconstruction
Skeletally Immature Patients
Complications
Concomitant Surgical Procedures
Clinical Results
Conclusions
References
69 Sulcus-Deepening Trochleoplasty
Normal and Pathologic Anatomy
Function and Biomechanics
Indications
Procedures and Options
Postoperative Care
Results
Complications
Conclusion
References
70 Quadriceps and Patellar Tendon Disruption*
Anatomy
Causes of Quadriceps Tendon Disruption
Quadriceps Tendon Rupture
Patellar Tendon Rupture
References
Section VII Knee Arthritis
71 Gout and Other Crystalline Arthropathies
Crystalline Arthropathies
References
72 Knee Osteoarthritis
Introduction
References
73 Overview of Psoriatic Arthritis
General Considerations
Unique Management Issues
References
74 Systemic Allergic Dermatitis in Total Knee Arthroplasty
Systemic Allergic Dermatitis
Sensitivity to Implants
Work-Up Prior to Implantation
Post Knee Arthroplasty
Conclusions
References
75 Rheumatoid Arthritis of the Knee
References
76 Hemophilia and Pigmented Villonodular Synovitis Hemophilia and the Knee
Pigmented Villonodular Synovitis
References
76B Human Immunodeficiency Virus Infection and Its Relationship to Knee Disorders
Epidemiology of Human Immunodeficiency Virus Infection
Human Immunodeficiency Virus Virology
Transmission of Human Immunodeficiency Virus
Human Immunodeficiency Virus–Infected Health Care Workers: Risk of Transmission to Patients
Diagnosis of Human Immunodeficient Virus Infection
Clinical Manifestations of Human Immunodeficient Virus Infection
Treatment of Human Immunodeficiency Virus Infection
Specific Issues Related to Perioperative Management of Human Immunodeficiency Virus-Infected Patients
Management of Occupational Exposure to Human Immunodeficiency Virus
Human Immunodeficiency Virus Infection and Musculoskeletal Disease
Summary
References
Section VIII Anesthesia for Knee Surgery
Part I Preoperative Evaluation
77 Basics, Preoperative Assessment, and Medical Optimization
References
78 Patients With Stents
Coronary Artery Stents and Management
In-Stent Thrombosis and Restenosis: Aspirin and Clopidogel Resistance and the Diabetic Dilemma
Guidelines
Regional Anesthesia
Summary
References
79 Diabetes Mellitus and the Knee
Treatment of Diabetes
Complications of Diabetes
Surgical Complications
Functional Outcomes
References
80 Rheumatoid Arthritis
Background
Preoperative
Anatomical Abnormalities and Difficult Airways
Regional Anesthesia
Pharmacological Management
Postoperative Care
References
81 Bilateral Total Knee Replacement
Patient Selection
Economic Cost
Procedure
Outcomes
Summary
References
Part II Perioperative Management of Inpatient Procedures
82 Monitoring During Total Knee Arthroplasty
References
83 Spinal or General Anesthesia?
Introduction
Arthroscopic Knee Surgery
Knee Arthroplasty
Considerations for an Aging Population
Conclusions
References
84 Revision Total Knee Arthroplasties
References
85 The Pneumatic Tourniquet
Introduction
Mechanical Effects
Ischemia-Reperfusion Effects
Systemic Effects
Treatment of Ischemia-Reperfusion Injury
Economic Impact
Conclusion
References
86 Cement Embolism
Introduction
Mechanisms
Diagnostic
The Treatment
Conclusion
References
87 Tranexamic Acid
Background
Tranexamic Acid (Chemistry, Mechanism of Action, Clinical Use)
Tranexamic Acid in Surgery
Tranexamic Acid in Trauma Surgery
Tranexamic Acid in Total Knee Arthroplasty
Dosing and Timing
Toward a Protocol
References
88 Blood Loss and Fluid Management
Blood and Fluid Loss
Blood and Fluid Management
Summary
References
89 Anesthesia for Knee Surgery
References
90 Specific Considerations for Fractures and Dislocations
Introduction
Anesthetic Considerations
Anesthetic Technique
Compartment Syndrome
Fat Embolism Syndrome
Deep Venous Thrombosis and Thromboembolism
References
Part III Preoperative Analgesia: Nerve Blocks
91 Femoral Nerve Block
Introduction
Femoral Nerve Block Levels
Anatomy (Figs. 91.1 and 91.2)
Indications and Benefits
Contraindications and Risks
Alternatives
Conclusion
Key References
92 Adductor Canal Block
Anatomy
Technique
Total Knee Arthroplasties
Minor Knee Surgery
Complications
Conclusion
References
93 Fascia Iliaca Compartment Block
References
94 Psoas Compartment Block
Psoas Compartment Block
Technique
Complications
Clinical Efficacy
Conclusion
References
95 Sciatic Nerve Block
Introduction
Functional Anatomy
Approaches to the Sciatic Nerve
Indications
Functional Outcomes
Conclusion
References
96 Obturator Nerve Block
References
97 Continuous Perineural Analgesia for Knee Surgery
Posterior Lumbar Plexus Block
Femoral Catheter
Adductor Canal Catheters
Sciatic Catheters
Infection and Perineural Catheters for Knee Surgery
Obturator Nerve Block
Conclusion
References
98 Local Anesthetic Infiltration
Periarticular Injection
Formulations
Preoperative Considerations
Periarticular Injection Technique
Complications
References
99 Epidural Analgesia
Indications and Contraindications
Anatomy
Mechanism of Action
Postoperative Analgesia
Side Effects and Complications
Epidural Anesthesia and Thromboprophylaxis
References
100 Neuraxial Opioids
Mechanism of Action
Intrathecal and Epidural Opioids
Postoperative Analgesia
Side Effects
References
101 Systemic Opioids and Postoperative Nausea and Vomiting
Systemic Opioids
Postoperative Nausea and Vomiting
References
102 Multimodal Pharmacologic Analgesia
Acute Pain Medicine Service
Acetaminophen
Nonsteroidal Anti-Inflammatory Drugs
Ketamine
Gabapentinoids
Opioids
Interventional Techniques
Conclusion
References
103 Chronic Pain After Total Knee Arthroplasty
Etiology and Risk Factors
Pathophysiology
Assessment and Diagnostic Testing Modalities
Prevention
Treatment
References
Part IV Ambulatory Procedures
104 Knee Arthroscopy
Ambulatory Surgery
Knee Arthroscopy
Ligament Reconstruction
References
Part V Thromboprophylaxis
105 Thromboprophylaxis and Neuraxial Anesthesia
References
Section IX Plastic Surgery
106 Soft Tissue Healing
History
Phases of Wound Healing
Cellular Elements of Healing
Factors Affecting Soft Tissue Healing
Healing the Incision
Influence of Growth Factors
References
107 The Problem Wound
Introduction
Preoperative Soft Tissue Manipulation
The Problem Wound
Muscle and Myocutaneous Flaps
Conclusion
References
Section X Fractures About the Knee
108 Distal Femur Fractures
Anatomy
Incidence and Etiology
Classification
Diagnosis
Management
Implants: Design and Function
Treatment
Complications
Summary and Future Directions
References
109 Tibial Plateau Fractures
Surgical Anatomy
Mechanism of Injury
Classification
Clinical Evaluation
Treatment
Complications
Conclusion
References
110 Fractures of the Patella
Introduction
Anatomy
Biomechanics
Diagnosis
Classification
Nonoperative Treatment
Operative Treatment
Complications
Patella Fractures in Total Knee Arthroplasty
Summary
References
111 Treatment of Periprosthetic Fractures Around a Total Knee Arthroplasty
Patient Evaluation
Open Reduction and Internal Fixation
Role of Revision Arthroplasty
Conclusions
References
Section XI Pediatric Knee
112 Normal Knee Embryology and Development
Overview of Embryology
Timing and Staging of Development
Normal Sequential Embryologic Development of the Knee*
Embryologic Development of Variants and Specific Abnormalities
References
113 Congenital Deformities of the Knee
Congenital Dislocation of the Knee
Congenital Dislocation of the Patella
Flexion Deformity of the Knee
Pterygium Syndromes
References
114 Meniscal Disorders
Meniscal Tears
Discoid Meniscus
References
115 Osteochondritis Dissecans
Introduction
History and Causes of Osteochondritis Dissecans
Diagnosis
Nonoperative Management
Operative Management
Summary
References
116 Reconstruction of the Anterior Cruciate Ligament in Pediatric Patients
Surgical Techniques and Postoperative Rehabilitation Procedures
References
117 Tibial Spine Fractures
Introduction
Mechanism of Injury
Physical Examination
Imaging
Associated Injuries
Classification
Surgical and Applied Anatomy
Current Treatment Options
Author's Preferred Treatment
Arthroscopic Reduction and Internal Fixation With Epiphyseal Cannulated Screws
Arthroscopic Reduction and Suture Fixation
Pearls and Pitfalls
Prognosis and Complications
References
118 Physeal Fractures About the Knee
Background
Distal Femur
Proximal Tibia
Focal Periphyseal Edema
References
119 Patellar Instability
Embryology
Anatomy and Biomechanics
Risk Factors
Classification
Natural History
Physical Examination
Imaging
Treatment
Other Medial Patellofemoral Ligament Reconstruction Options
Surgical Complications
Outcomes and Return to Activity
Complex Patellofemoral Instability
Summary
References
Section XIIA Joint Replacement and Its Alternatives
120 Nonoperative Treatment of Knee Arthritis
Patient Education
Physical Therapy, Weight Loss, and Other Modalities
Pharmacologic Measures
Other Treatments
American Academy of Orthopaedic Surgeons Guidelines Summary
References
121 Osteotomies About the Knee
High Tibial Osteotomy for Varus Knee
Distal Femoral Osteotomy for Valgus Knee
Tibial Tubercle Osteotomy for Patellofemoral Joint Arthritis
Conclusion
References
122 Osteotomy for the Arthritic Knee
Osteotomy: General Concepts and Indications
High Valgus Tibial Osteotomy
High Tibial Varus Osteotomy
Distal Femoral Osteotomy for the Treatment of a Valgus Deformity
Double Osteotomy
Conclusions
References
123 Scoring Systems and Their Validation for the Arthritic Knee
Background and Rationale
Scoring System Structure
Statistical Requirements
Classifications of Outcome Measures
Patient Factors Affecting Outcome
References
124 Historic Development, Classification, and Characteristics of Knee Prostheses
Early Prosthetic Models
Evolution of Prosthetic Design
Types of Prostheses
Anatomic Functions of the Cruciate Ligaments
Current Prosthesis Design
General Prosthetic Features
Acknowledgments
References
125 Unicompartmental, Bicompartmental, or Tricompartmental Arthritis of the Knee
Definitions
Introduction
Surgical Options
Factors Affecting Decision Making
Long-Term Clinical Results of Surgical Options
Conclusion
References
126 Patellofemoral Arthroplasty
Introduction
Epidemiology
Nonsurgical Treatment
Surgical Alternatives
Patient Selection for Patellofemoral Arthroplasty
Clinical Evaluation
Surgical Technique
Postoperative Management
Design Features That Impact Patellar Tracking
Clinical Results
Complications
Summary
References
127 Unicompartmental Knee Arthroplasty
Unicompartmental Knee Arthroplasty: the European Experience
Patient Selection
Surgical Technique
Results
Summary
References
128 Unicomparmental Knee Replacement With ACL Reconstruction
Etiology
Diagnosis and Preoperative Evaluation
Review of Relevant Literature
Surgical Technique
Intra- and Postoperative Treatment
Conclusion
References
129 Fixed-Bearing Medial Unicompartmental Knee Arthroplasty
Introduction
Indications
Surgical Technique
Reported Outcomes
References
130 Medial Unicompartmental Knee Arthroplasty Mobile Bearing
Introduction and History
Design Rationale
Why Use a Spherical and Not a Polyradial Femoral Condyle?
Operative Technique
Comparison of Unicompartmental Knee Arthroplasty and Total Knee Arthroplasty
Pain
Conclusions
References
131 Bicompartmental Knee Arthroplasty
Historical Perspective
Surgical Technique
Materials, Methods, and Results
Summary
References
132 Bicondylar Knee Replacement
Implant Design
Patient Selection
Physical Examination
Imaging
Indications and Contraindications
Biomechanics
Surgical Techniques
Clinical Results
Complications
Newer Technology
Conclusion
References
133 Bicruciate Total Knee Arthroplasty
Introduction
History
Kinematics
Clinical Outcomes
Technique
Challenges
Conclusion
References
134 Bicruciate Total Knee Arthroplasty
Introduction
Benefits
Indications
Conclusions
Conflicts of Interest
References
135 European Analysis and Results of Partial Knee Replacement
Unicompartmental Knee Arthroplasty Versus Total Knee Arthroplasty: Function and Survival
Failure Analysis in Unicompartmental Knee Arthroplasty
References
136 Posterior Cruciate Ligament Retention in Total Knee Arthroplasty
Results of Posterior Cruciate Ligament-Retaining Total Knee Arthroplasty
Functional Comparisons
Kinematics
Posterior Cruciate Ligament-Retaining Versus Posterior Cruciate Ligament-Substituting Designs
Potential Advantages of Posterior Cruciate Retention
Surgical Technique and Implant Design
Conclusion
References
137 Preserving the Posterior Cruciate Ligament
Introduction
Basics
Key Factors for Posterior Cruciate Ligament Balancing
Our Preferred Surgical Steps in Cruciate-Retaining Total Knee Arthroplasty With Extension Gap Balancing First and Spacer Technique (Surgeons Can Use Other Sequences as They Prefer)
References
138 Custom-Made Knee Replacements
Author's Surgical Pearls
References
139 Posterior Cruciate Sacrificing Total Knee Arthroplasty
Sparing the Posterior Cruciate Ligament
Sacrificing the Posterior Cruciate Ligament
Conclusion
References
140 Posterior Cruciate Ligament—Substituting Total Knee Arthroplasty
Evolution of Posterior Cruciate Ligament—Substituting Knee Arthroplasty
Surgical Technique
Clinical Results of Posterior Cruciate Ligament—Substituting Designs
Complications of Posterior Cruciate Ligament Substitution
Conclusion
References
141 Posterior Cruciate Ligament Substituting Total Knee Arthroplasty
Introduction
Features of the Middle Eastern Knee
Features of Advanced Disease
Activities of Daily Living
Preoperative Assessment
Intraoperative Considerations
Postoperative Care
Conclusion
References
142 Mobile-Bearing Total Knee Arthroplasty
Introduction
Design Rationale of Mobile-Bearing Total Knee Arthroplasty
Proposed Biomechanical Advantages of a Mobile-Bearing Total Knee Arthroplasty
Surgical Technique for Mobile-Bearing Total Knee Arthroplasty
Clinical Results of Mobile-Bearing Total Knee Arthroplasty
Mobile-Bearing Use in Revision Total Knee Arthroplasty
Conclusion
References
143 Cemented Total Knee Arthroplasty
Introduction
Evolution of Cementless Fixation
Rationale for the Use of Cementless Total Knee Arthroplasty
Results of Cemented Total Knee Arthroplasty
Cemented Total Knee Arthroplasty in Young Patients
Comparative Literature: Cement Versus Cementless
Hybrid Fixaton Techniques
Failures Modes in Total Knee Arthroplasty
Diagnosis of Failed Cementless Knees
Conclusion
References
144 Cementless Total Knee Arthroplasty
Introduction
Early Cementless Designs: a Mixed Bag
Early Cementless Designs: Success Stories
Modern Cementless Total Knee Replacement Designs: Improved Biomaterials and Technology
Modern Cementless Total Knee Replacement: Early Clinical Performance
Surgical Considerations and Preferred Technique
Clinical and Perioperative Considerations
Conclusions
References
145 Patellar Resurfacing in Total Knee Arthroplasty
Introduction
History of Patellar Resurfacing
Basic Science
Surgical Technique
Pros and Cons of Patella Resurfacing
Patella-Related Complications in Total Knee Arthroplasty
Anterior Knee Pain and Causes Thereof
Predictors of Anterior Knee Pain
Secondary Resurfacing
Patellar Scoring Systems
Prospective and Randomized Controlled Trials
Regional and National Arthroplasty Registries
Conclusion
Acknowledgments
References
146 Patella Resurfacing—Never
Introduction
National Arthroplasty Registers
Prospective and Randomized Controlled Trials
Cases Needing Patellar Resurfacing
Complications Associated With Patellar Resurfacing
Surgical Approach: Reshaping the Patella
Conclusion
References
147 Patella Resurfacing—Always
Historical Trends of Patella Resurfacing
Implant Choice and Design
Biomechanics of a Resurfaced Patella
Technical Pearls for Patella Resurfacing
Specific Surgical Techniques
Addressing the Complications of Patella Resurfacing
Outcomes of Patella Resurfacing
Economics of Patella Resurfacing
Selective Resurfacing
Conclusion
References
148 Alignment in Total Knee Arthroplasty
Traditional Alignment Principles
Newer Insights
Constitutional Alignment
Modern Outcome Studies
Summary
References
149 Surgical Approaches in Total Knee Arthroplasty
Approaches
Arthrotomy
Medial Parapatellar Arthrotomy
Subvastus Approach
Midvastus Approach
Trivector-Retaining Arthrotomy
Anterolateral Approach
Lateral Parapatellar Approach
Extended Approaches
Limited Subvastus Approach
Limited Midvastus Approach
Quadriceps-Sparing Surgical Approach
Conclusion
References
150 Surgical Techniques and Instrumentation in Total Knee Arthroplasty
Relevant Knee Anatomy and Alignment
Objectives of Prosthetic Replacement
Theories of Surgical Technique
Preoperative Planning
Exposure
Techniques and Instrumentation
Fitting of Trial Components
Cemented Versus Uncemented Fixation
Management of Instability or Deformity
Management of Varus Deformity
Asymmetrical Valgus Instability
Flexion Contracture
Extension Contracture (“Stiff Knee”)
Correction of Genu Recurvatum
Management of Bone Defects
Intraoperative Problems and Their Solutions (Insall)
Aftercare of Total Knee Arthroplasty
References
151 Gap-Balancing Techniques in Total Knee Arthroplasty
Introduction
Surgical Technique
Gap-Balancing Advantages and Disadvantages
Measured Resection Advantages and Disadvantages
Conclusions
References
152 Modern Measured Resection Technique
Introduction
Rationale of the Gap-Balancing Technique
Advantages of the Gap Balancing Technique
Disadvantages of the Gap Balancing Technique
Rationale of the Measured Resection Technique
Advantages of the Measured Resection Technique
Disadvantages of the Measured Resection Technique
Author's Preferred Technique: Extension Gap First With Hybrid (Combined Measured Resection and Gap Balancing) Technique
References
153 Is the Understanding of Gap Balancing and Measured Resection Techniques Necessary to Understand Image-Guided Surgical Techniques for Knee Arthroplasty?
Introduction
Gap Balancing Technique
Measured Resection Technique
References
154 Mid-Flexion Instability After Total Knee Arthroplasty
Introduction
Surgical Technique of TKA Induces Joint Line Elevation
Experimental Evidence: Joint Line Elevation Causes Mid-Flexion Instability
Geometrical Explanation of the Relation Between Raising the Joint Line and Mid-Flexion Instability
Discussion
Conclusion
References
155 Correction of Fixed Deformities With Total Knee Arthroplasty
Preoperative Planning
Fixed Varus Deformity
Fixed Valgus Deformity
Conclusions
References
156 Correction of Deformities With Total Knee Arthroplasty
Outline
Coronal Alignment
Sagittal Alignment
Rotational Alignment
Femoral and Tibial Morphology
Ligament Balancing
References
157 Pressure Sensors and Soft Tissue Balancing
Background
Classical Soft Tissue Balancing
Pressure Sensors: an Introduction
Balancing With Sensors
Clinical Evidence
Discussion
Future Developments
References
158 The Clinical Effectiveness of Custom-Made Guides for Total Knee Arthroplasty
Limb Alignment and Component Positioning Accuracy
Functional Outcome
Blood Loss
Tourniquet and Surgical Time
Cost Effectiveness of Custom-Made Guide
Computed Tomography–Versus Magnetic Resonance Imaging–Based Custom-Made Guide
Discussion and Conclusion
References
159 Computer Navigation in Primary Total Knee Arthroplasty
Introduction
Literature Review
Contemporary Navigation System Features
Metrology and Clinical Evaluation of the eGPS
Future Evolution of Digital Imaging and Computer Navigation
References
160 Kinematically Aligned Total Knee Arthroplasty
Overview
Goal One: Restore the Native Tibial-Femoral Articular Surfaces
Goal Two: Restore the Native Knee and Limb Alignments
Goal Three: Restore the Native Laxities of the Knee
Technique and Quality Assurance Steps for Minimizing Flexion and Kinematically Aligning the Femoral Component to the Native Articular Surface
Technique and Quality Assurance Steps for Aligning the Tibial Component to the Native Articular Surface
Managing the Knee With an Insufficient Posterior Ligament or Severe Fixed Valgus Deformity
Alignment and 3- and 6-Year Survivorship of Kinematically Aligned Total Knee Arthroplasty
Summary
References
161 Computer-Assisted Navigation
Choices in Systems
Surgical Technique: Tracker Mounting Options
Sequence Changes in Computer-Assisted Surgery
Conjoint Cutting Jig Technique
Patient-Specific Instrumentation and Computer-Assisted Surgery
Procedural Notes in Detail
Balancing Gap
Acknowledgments
References
162 Robotics in Total Knee Arthroplasty
Introduction
History
Surgical Technique
Published Results
The Future
References
163 Robotic Unicompartmental Knee Arthroplasty
Introduction
Acrobot
Mako
Blue Belt Technologies
Operative Technique for Medial Unicompartmental Knee Arthroplasty
Literature Review
Conclusion
References
164 Management of Extra-Articular Deformity in Total Knee Arthroplasty With Navigation
Extra-Articular Deformities: Intra-Articular Versus Extra-Articular Correction
Rationale for Total Knee Arthroplasty With Navigation in the Management of Extra-Articular Deformities About the Knee
Surgical Technique: Navigation for Extra-Articular Deformities Not Requiring Osteotomy
Surgical Technique: Navigation for Extra-Articular Deformities Requiring Osteotomy
Results of Navigation for Extra-Articular Deformity
Conclusions
References
165 Computer-Assisted Total Knee Arthroplasty for Extramedullary Deformity
Introduction
Literature Review
Case Presentation and Surgical Technique
Preoperative Planning
Technique
Pearls and Pitfalls
Conclusion
References
166 Impact of the Cavus Foot and Ankle on the Painful Knee
Introduction
Pathomechanics of the Cavus Foot and Ankle
Clinical Evaluation
Radiographic Evaluation
Treatment
Conclusions
References
167 Flat Foot and Its Effect on the Knee
What Is a Flat Foot?
The Painless Low-Arched Foot and the Painful Knee
The Collapsed Arch and Its Effect on the Knee
References
168 The Impact of the Foot and Ankle on Total Knee Replacement
Physical Examination
Foot and Ankle Deformity and Knee Alignment
Treatment of Foot and Ankle Deformity
Posterior Tibial Tendon Dysfunction
Cavovarus Deformity
Posttraumatic Deformity
Neuroarthropathy
Ankle Arthritis
Knee Arthroplasty With Foot Deformity
Which Deformity Should Be Corrected First?
Conclusions
References
Section XIIB Revision and Complex Knee Arthroplasty
169 Complications of Total Knee Arthroplasty
General Complications
Systemic Complications
Local Complications
Vascular Complications
Nerve Palsy and Neurologic Complications
Mechanical Complications
Patellar Complications
Unexplained Pain
References
170 Extensile Exposures for Revision Total Knee Replacement
Introduction
Objectives of Surgical Exposure in Revision Total Knee Replacement
Regional Anatomy
Patient Assessment
Extensile Exposures
Proximal Techniques
V-Y Quadricepsplasty/Quadriceps Turndown
Summary
References
171 Revision of Aseptic Failed Total Knee Arthroplasty
Indications for Revision
Preoperative Assessment
Surgical Technique
Management of the Patella
Results of Revision Surgery
Custom Components
Summary
References
172 The Infected Total Knee Replacement
Introduction
Incidence, Risk Factors, and Prevention
Microbiology and Diagnosis
Treatment
Conclusion
References
173 Instability in Total Knee Arthroplasty
Extension Instability: Symmetrical
Extension Instability: Asymmetrical
Flexion Instability: Symmetrical
Flexion Instability: Asymmetrical
Midflexion Instability
Recurvatum or Hyperextension Deformity
References
174 Management of Bone Defects in Revision Total Knee Arthroplasty
Background
Preoperative Planning
Bone Loss Assessment and Classification
Reconstruction With Cement and Screws
Reconstruction With Morselized Allograft
Reconstruction With Bulk Allograft
Reconstruction With Modular Blocks or Wedges
Reconstruction With Porous Metal Metaphyseal Cones
Reconstruction With Novel Porous Titanium Cones
Reconstruction With Metaphyseal Titanium Tapered Sleeves
References
175 Patellar Revision
The Well-Fixed Patella
Patellar Component Removal
Patellar Component Revision
Severe Bone Loss
Conclusion
References
176 Patellar Fractures in Total Knee Arthroplasty
Prevalence and Risk Factors for Patellar Fracture
Classification
Results
References
177 Extensor Mechanism Disruption After Total Knee Arthroplasty
Introduction
Anatomy
Preoperative Assessment and Planning
Quadriceps Tendon Ruptures
Patellar Tendon Ruptures and Avulsions
Surgical Management of Extensor Mechanism Dysfunction
Synthetic Mesh Reconstruction
Summary
References
Section XIII Total Knee Arthroplasty Perioperative Management Issues
178 Obesity
Epidemiology
References
179 Pain Catastrophizers
Introduction
Pain and Total Knee Arthroplasty
Defining the Construct of Pain Catastrophizing
Pain Catastrophizing and Total Knee Arthroplasty
Conclusion
References
180 Medical Optimization of Patients With Atherosclerotic Cardiovascular Disease and Cardiovascular Risk Factors
Perioperative Cardiovascular Events
Cardiovascular Risk Stratification and Coronary Artery Disease
Medical Therapy for Cardiovascular Risk Factor Optimization
Challenging Patient Populations
Conclusions
References
181 Decreasing the Risk of Surgical Site Infections Following Total Knee Arthroplasty
Epidemiology and Financial Implications
Identification and Modification of Risk Factors Prior to Total Knee Arthroplasty
Conclusion
References
182 Effects of Prehabilitation, Falls, and Musculoskeletal Comorbidity on Total Knee Arthroplasty Outcomes
Evidence of the Impact of Prehabilitation on Total Knee Arthroplasty Recovery and Outcome
Fall Risk and Risk Prevention for Total Knee Arthroplasty
Are Persons Who Plan to Undergo Total Knee Arthroplasty at Increased Risk for Falls?
Fall Risk and Risk Prevention Strategies for Patients With Total Knee Arthroplasty While in the Hospital
Are Persons Who Underwent Total Knee Arthroplasty at Risk for Falls Following Postsurgical Recovery?
Musculoskeletal Comorbidity and Total Knee Arthroplasty Outcomes
Back Pain Comorbidity and Associations With Outcome
Painful Joint Counts and Associations With Outcome
Inflammatory Arthritis Versus Osteoarthritis and Outcome
Summary
References
183 Intra-articular and Periarticular Injections
Background
Techniques
Steroids
Hyaluronic Acid
Platelet-Rich Plasma
Comparisons
A Note on Stem Cells, Cytokines, and Growth Hormone
Author Remarks
References
184 Techniques and Eligibility for Same Day/Next Day Discharge of Total Knee Arthroplasty
Introduction
Surgical Setting
Patient Selection
Preoperative Education
Perioperative Pain Management
Surgical Approach
Blood Management
Immediate Postoperative Care
Postoperative Management
Outcomes
Conclusion
References
185 Pain Management After Total Knee Arthroplasty Patients Leave the Hospital
Introduction
Medical Management of Acute Pain
Nonsteroidal AntiInflammatory Drugs and Acetaminophen
Anticonvulsants (Gabapentinoids)
Local Anesthetics
N-Methyl D-Aspartate Receptor Antagonists
Opioids
Cryotherapy
Extended Regional Anesthesia
The Importance of Adequate Analgesia and the Transition From Acute to Chronic Pain
Conclusion
References
Part I Hospital Management of TKA Patients
186 Continuous Passive Motion
Introduction
Early Knee Motion
Summary
References
187 Cryotherapy After Total Knee Arthroplasty
Introduction
Early Trials
Ice or Device?
Putting the Evidence Together
Conclusion
References
188 Immediate Motion versus Splinting After Total Knee Arthroplasty
Early Knee Splinting
Early Knee Motion
Summary
References
189 Internet-Based versus In-Person Physical Therapy After Total Knee Arthroplasty
Examples of Internet-Based Physical Therapy
Advantages of Internet-Based Physical Therapy
Disadvantages of Internet-Based Physical Therapy
Conclusion and Future Directions
References
190 Venous Thromboembolic Disease
Etiology and Pathophysiology of Venous Thromboembolism
Risk Factors for Venous Thromboembolism and Their Modification
References
191 ACCP, SCIP, and AAOS Guidelines for Venous Thromboembolism Prophylaxis After Total Knee Arthroplasty
Background
Current ACCP Guidelines
SCIP Guidelines
AAOS Guidelines
References
192 Aspirin and Sequential Pneumatic Compression Devices
Aspirin
Mechanical Prophylaxis
Conclusion
References
193 Venous Thromboembolic Disease Stratification of Risk
Options for Thromboprophylaxis in Knee Surgery
Thromboprophylaxis in Knee Arthroscopy
Thromboprophylaxis in Trauma Surgery Below the Knee
Venous Thromboembolism Stratification of Risk and Who Needs Aggressive Anticoagulation
Conclusion
References
194 Bleeding and Infection Risk With Aggressive Anticoagulation
Long-Term Anticoagulation
Preoperative Factors
Intraoperative Factors
Postoperative Factors
Postoperative Thrombotic Events Requiring Aggressive Anticoagulation
Conclusion
References
Part II Economics, Quality, and Payment Paradigms for Total Knee Arthroplasty
195 Total Joint Arthroplasty—Historical Perspective
Epidemiology
Hospital Reimbursements
Physician Reimbursements
Implant Costs
Hospital Cost Containment
Utilization Review and Cost Control
Implant Cost Control
Conclusion
References
196 Payment Paradigms
Historical Perspective and the “Value” Proposition
Fee for Service
Capitation
Global Provider Budgets
Bundled Payment
Contrarian Viewpoint and Alternative Patient-Based Financial Mechanisms
Conclusion
References
197 Physician-Hospital Partnerships
Traditional Partnership
Medical Directorship
Service Line Prioritization
Management Service Organization
Management Service Agreement
Joint Payer Contracting Relationship
Joint Venture
Professional Services Agreement
Physician Employment
Conclusion
Bibliography
198 Value-Based Purchasing
Value in Health care
Pay for Performance
Centers for Medicare and Medicaid Services Value-Based Programs
Controlling Costs and Quality of Care
Quality and Metrics
Percentile Breakdown of Quality Measures and Fee Structure
Domain Weights
Medicare Spending Models
How Hospitals Fared on the First Round
Publicly Available Data
Future Changes and Implications
References
199 Quality Measures and Payment for Total Knee Replacement
Introduction
Examples of Pay-for-Performance Models
Surgical Data Currently Being Evaluated
Proposed Comprehensive Care for Joint Replacement
Total Knee Performance Measure Set
Success
Summary
References
Appendix 199.1.
Appendix 199.2.
Section XIV Tumors About the Knee
200 Evaluation of the Patient With a Bone Lesion About the Knee
History
Physical Examination
Imaging
Laboratory Evaluation
Differential Diagnosis
Biopsy
Staging of Bone Tumors
Conclusion
References
201 Surgical Treatment of Benign Bone Lesions
Staging of Benign Bone Tumors
Treatment of Specific Benign Conditions
Conclusion
References
202 Surgical Management of Malignant Bone Tumors Around the Knee
Tumor Biology
Principles of Surgical Management
Principles of Reconstruction
Common Malignant Bone Tumors of the Knee
Conclusion
References
203 Allograft Prosthetic Composite Reconstruction of the Knee
Basic Principles of Allograft Prosthetic Reconstruction
Extensor Mechanism Repair
Allograft Prosthetic Composite Reconstruction of the Distal Femur
Allograft Extensor Mechanism Transplantation
References
204 Megaprostheses for Reconstruction Following Tumor Resection About the Knee
Introduction
Rationale for Use of Megaprostheses
Indications
Methods of Fixation of Megaprostheses
Surgical Technique
Clinical Results
Complications
Revision of Failed Hinge Megaprostheses
Summary
References
205 Metastatic Disease About the Knee
Treatment Principles
Evaluation
Prediction of Impending Fracture
Orthopedic Management
References
206 Soft Tissue Tumors of the Knee
Clinical Features
Evaluation
Differential Diagnosis
Summary
References
207 Common Pitfalls in Tumors About the Knee
History and Physical Examination
Imaging
Making the Diagnosis
Sports Tumors Around the Knee
Summary Pearls and Pitfalls
References
Index

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