This article of mine which came out in the Journal of Orthopaedic Case Reports has been converted into a small book entitled `Modified Posterior Approach to the Hip Joint' which should be available world wide and also listed on Flipart, Amazon,infibeam.
e-Book - Rockstand, Scribid, Kobo, Kindle, Google Play store.
Dr.K.Mohan Iyer,Bangalore,India
This video explains Lumbar Disc Replacement in Detail. When degenerative disc disease begins to affect the spine this is called degenerative disc disease. This video highlights the history, epidemiology, and treatment options both conservative and surgical. If you or someone you know needs to be seen in regards to Lumbar Disc Replacement feel free to look us up online www.beverlyspine.com or www.santamonicaspine.com OR call toll free 1-8SPINECAL-1
The evolution of shoulder arthroplasty has progressed through several generations of prosthesis designs from the late 19th century to present day. Early designs in the 1890s-1950s aimed to replicate the native anatomy but had high failure rates due to issues like wear, loosening, and infection. Modular designs in the 1980s improved positioning and sizing but still did not fully restore anatomy. Current third generation prostheses from the 1990s onward are anatomically designed with variable sizes and offsets to more closely mimic the native joint mechanics and center of rotation. Reverse total shoulder arthroplasty, developed in the 1970s-1990s, has also improved through lateralized and inferiorly tilted component designs to maximize deltoid function for patients with rotator c
Dr. Satyendra Bhattacharyya's document discusses the history and procedure of shoulder arthroplasty. It begins with the first documented shoulder replacement in 1894, but focuses on developments starting in 1951 by Dr. Charles Neer, who created the first hemi-arthroplasty and total shoulder replacement. The document then discusses factors that influence arthroplasty outcomes, indications for the procedure for conditions like osteoarthritis and rheumatoid arthritis, and details each step of the surgical procedure. It concludes by describing postoperative rehabilitation protocols.
This document summarizes the evolution and design of total shoulder endoprostheses. It discusses the early attempts at shoulder arthroplasty in the late 19th century. It then covers the development of modern total shoulder replacements through 3 generations of prosthesis design, focusing on improvements to the humeral and glenoid components to better restore anatomy. Key topics include surgical approaches, fixation techniques, outcomes data, and complications and revisions related to total shoulder arthroplasty.
This document summarizes several studies that have evaluated the performance of NexGen knee implants, including the NexGen CR Flex, NexGen LPS-Flex, and comparisons of NexGen standard vs. high flex designs. Several studies found high rates of loosening and failure of the NexGen CR-Flex and LPS-Flex implants, with failure rates reaching 9-38% within 2-5 years. Other studies found no significant differences in range of motion or clinical outcomes between NexGen standard and high flex designs. Overall, the studies identified problems with early loosening and failure of some NexGen knee implants.
Shoulder Replacement is also called Shoulder Arthroplasty, which is an option when the shoulder joint pain deters performing the daily activities and other treatments don’t bring relief. Usually in a Shoulder Replacement surgery, the doctor replaces the ends of the damaged Humerus and scapula bones of the shoulder joint or caps them with plastic or metal and plastic and then the components are held in place with cement.
Dr Banarji B.H is acclaimed as the Best Orthopaedic Surgeon Specialised in the field of Arthroscopy and sports medicine, Offers Shoulder replacements at affordable rates.
Know more about shoulder replacement
@http://orthobangalore.com/shoulder-replacement
Contact Us @ http://orthobangalore.com/contact-us
Correlation between acl injury and involvement of the anterolateral ligament ...Prof. Hesham N. Mustafa
Background:
Clinical testing has demonstrated the role of the anterolateral ligament (ALL) in controlling anterolateral laxity and knee instability at high angles of flexion. Few studies have discussed the association between an anterior cruciate ligament (ACL) injury and ALL injury, specifically after residual internal rotation and a post-ACL reconstruction positive pivot-shift that could be attributed to ALL injury. The goal of this study was to assess the correlation between ALL injury and ALL injury with concomitant ACL injury using MRI.
Material and Methods:
This was a retrospective study of 246 patients with unilateral ACL knee injuries from a database that was reexamined to identify whether ALL injuries occurred in association with ACL injuries. We excluded the postoperative reconstructed cases. The charts were reviewed on the basis of the presence or absence of diagnosed ACL injury with no regard for age or sex.
Results:
Of the 246 patients with ACL injury, there were 165 (67.1%) patients with complete tears, 55 (22.4%) with partial tears, and 26 (10.6%) with sprains. There were 176 (71.5%) patients with ALL and associated ACL injuries, whereas 70 (28.5%) did not have associated ACL injuries. There was a significant statistical relationship between ACL and ALL injuries (P<0.0001).
Conclusions:
There is high incidence of ALL tears associated with ACL injuries. Clinicians should be aware of this injury and consider the possibility of simultaneous ALL and ACL repair to prevent further knee instability.
Level of Evidence:
Level IV.
This article of mine which came out in the Journal of Orthopaedic Case Reports has been converted into a small book entitled `Modified Posterior Approach to the Hip Joint' which should be available world wide and also listed on Flipart, Amazon,infibeam.
e-Book - Rockstand, Scribid, Kobo, Kindle, Google Play store.
Dr.K.Mohan Iyer,Bangalore,India
This video explains Lumbar Disc Replacement in Detail. When degenerative disc disease begins to affect the spine this is called degenerative disc disease. This video highlights the history, epidemiology, and treatment options both conservative and surgical. If you or someone you know needs to be seen in regards to Lumbar Disc Replacement feel free to look us up online www.beverlyspine.com or www.santamonicaspine.com OR call toll free 1-8SPINECAL-1
The evolution of shoulder arthroplasty has progressed through several generations of prosthesis designs from the late 19th century to present day. Early designs in the 1890s-1950s aimed to replicate the native anatomy but had high failure rates due to issues like wear, loosening, and infection. Modular designs in the 1980s improved positioning and sizing but still did not fully restore anatomy. Current third generation prostheses from the 1990s onward are anatomically designed with variable sizes and offsets to more closely mimic the native joint mechanics and center of rotation. Reverse total shoulder arthroplasty, developed in the 1970s-1990s, has also improved through lateralized and inferiorly tilted component designs to maximize deltoid function for patients with rotator c
Dr. Satyendra Bhattacharyya's document discusses the history and procedure of shoulder arthroplasty. It begins with the first documented shoulder replacement in 1894, but focuses on developments starting in 1951 by Dr. Charles Neer, who created the first hemi-arthroplasty and total shoulder replacement. The document then discusses factors that influence arthroplasty outcomes, indications for the procedure for conditions like osteoarthritis and rheumatoid arthritis, and details each step of the surgical procedure. It concludes by describing postoperative rehabilitation protocols.
This document summarizes the evolution and design of total shoulder endoprostheses. It discusses the early attempts at shoulder arthroplasty in the late 19th century. It then covers the development of modern total shoulder replacements through 3 generations of prosthesis design, focusing on improvements to the humeral and glenoid components to better restore anatomy. Key topics include surgical approaches, fixation techniques, outcomes data, and complications and revisions related to total shoulder arthroplasty.
This document summarizes several studies that have evaluated the performance of NexGen knee implants, including the NexGen CR Flex, NexGen LPS-Flex, and comparisons of NexGen standard vs. high flex designs. Several studies found high rates of loosening and failure of the NexGen CR-Flex and LPS-Flex implants, with failure rates reaching 9-38% within 2-5 years. Other studies found no significant differences in range of motion or clinical outcomes between NexGen standard and high flex designs. Overall, the studies identified problems with early loosening and failure of some NexGen knee implants.
Shoulder Replacement is also called Shoulder Arthroplasty, which is an option when the shoulder joint pain deters performing the daily activities and other treatments don’t bring relief. Usually in a Shoulder Replacement surgery, the doctor replaces the ends of the damaged Humerus and scapula bones of the shoulder joint or caps them with plastic or metal and plastic and then the components are held in place with cement.
Dr Banarji B.H is acclaimed as the Best Orthopaedic Surgeon Specialised in the field of Arthroscopy and sports medicine, Offers Shoulder replacements at affordable rates.
Know more about shoulder replacement
@http://orthobangalore.com/shoulder-replacement
Contact Us @ http://orthobangalore.com/contact-us
Correlation between acl injury and involvement of the anterolateral ligament ...Prof. Hesham N. Mustafa
Background:
Clinical testing has demonstrated the role of the anterolateral ligament (ALL) in controlling anterolateral laxity and knee instability at high angles of flexion. Few studies have discussed the association between an anterior cruciate ligament (ACL) injury and ALL injury, specifically after residual internal rotation and a post-ACL reconstruction positive pivot-shift that could be attributed to ALL injury. The goal of this study was to assess the correlation between ALL injury and ALL injury with concomitant ACL injury using MRI.
Material and Methods:
This was a retrospective study of 246 patients with unilateral ACL knee injuries from a database that was reexamined to identify whether ALL injuries occurred in association with ACL injuries. We excluded the postoperative reconstructed cases. The charts were reviewed on the basis of the presence or absence of diagnosed ACL injury with no regard for age or sex.
Results:
Of the 246 patients with ACL injury, there were 165 (67.1%) patients with complete tears, 55 (22.4%) with partial tears, and 26 (10.6%) with sprains. There were 176 (71.5%) patients with ALL and associated ACL injuries, whereas 70 (28.5%) did not have associated ACL injuries. There was a significant statistical relationship between ACL and ALL injuries (P<0.0001).
Conclusions:
There is high incidence of ALL tears associated with ACL injuries. Clinicians should be aware of this injury and consider the possibility of simultaneous ALL and ACL repair to prevent further knee instability.
Level of Evidence:
Level IV.
Modified Posterior Approach to the Hip Joint, International Journal of Orthop...Krishnamohan Iyer
This document describes a modified posterior approach to the hip joint developed by the author in 1981. The modification involves osteotomizing the posterior overhanging part of the greater trochanter to improve exposure and decrease dislocations. Cadaver tests found the modified approach provided greater stability than conventional posterior approaches. The author then used the approach clinically with no dislocations reported. Several other surgeons found similar success rates with the modified approach. The approach preserves soft tissue attachments and muscle insertions for improved stability and less risk of nerve damage compared to other posterior approaches.
This document discusses the development of the Zimmer Gender Solutions High-Flex Knee implant, which is designed specifically for women's anatomy. Standard knee implants are often a poor fit for women due to anatomical differences compared to men, such as narrower femoral dimensions. The Gender Solutions implant addresses three key differences in women's knees: 1) A narrower medial-lateral dimension to reduce implant overhang, 2) A reduced anterior flange thickness to decrease protrusion, and 3) A laterally positioned sulcus to better accommodate women's greater Q-angle and reduce patellar tracking issues. Early experiences with the Gender Solutions implant indicate it provides a better anatomical fit compared to standard unisex implants.
Biologic Knee Replacement (BKR) is our approach to treating knee injuries, from trauma to arthritis, and is designed to help people delay, or even avoid, artificial knee replacement. BKR is a scientifically-proven collection of our out-patient surgical techniques and procedures and consists of any combination of meniscus transplantation, articular cartilage paste grafting, ligament replacement as explained in further detail below. Being "bone on bone" does not always mean that the joint needs to be artificially replaced, often the "bone on bone" is isolated to a portion of the knee joint and this can be repaired using Biologic Knee Replacement.
Reverse shoulder arthroplasty involves replacing the humeral head and glenoid fossa with prosthetics to alter the center of rotation and increase deltoid tension and function. It is indicated for rotator cuff tear arthropathy, proximal humeral fractures in the elderly, failed shoulder replacements, and other conditions. The procedure involves an deltopectoral approach to expose the joint, removal of the humeral head and shaping of the glenoid, then implantation of the glenosphere and humeral cup components. Outcomes are best for osteoarthritis and worse for trauma or revision cases. Complications can include infection, nerve injury, implant loosening or breakage.
A Comparative Study of the Clinical and Functional Outcome Anterior Cruciate ...TheRightDoctors
A Comparative Study of the Clinical and Functional Outcome Anterior Cruciate Ligament Reconstruction Using Transportal and Transtibial Approach for Femoral Tunnel Drilling-Dr. Adarsh Reddy
This document discusses testing methods for total ankle and shoulder replacement implants. It notes that while testing methods are standardized for knee and hip implants, extremity implants like ankle and shoulder prosthetics have not been as extensively tested. The document outlines current testing procedures for these implants, which typically use modified knee or hip simulators. It discusses adapting simulators to test total ankle replacements, including setting up fixtures and inputting motion profiles. Testing procedures for total shoulder replacements are also described, such as using a hip simulator with custom fixtures to simulate shoulder motion. The document stresses the need for more research on in vivo joint motions and forces to further improve testing methods for these implants.
The document discusses anterior cruciate ligament (ACL) reconstruction and graft selection. It describes the anatomy of the ACL and common causes of injury. Diagnosis involves clinical tests and MRI imaging. Three main graft options exist - bone-patellar tendon-bone autograft, hamstring autograft, and allograft. The bone-patellar tendon-bone autograft integrates more quickly but risks anterior knee pain, while the hamstring autograft has less donor site morbidity but slower healing. Rehabilitation begins shortly after surgery, focusing on regaining range of motion and strengthening muscles around the knee. Graft selection depends on factors like activity level and age.
Dr. Goradia with G2 Orthopedics and Sports Medicine in Glen Allen, VA reviews advances in knee replacement surgery that are helping more patients live pain free.
The treatment for sarcoma cancer is done only through the surgical methods in which the bone and soft-tissue of limb of the patient is saved from extremity tumour cases.
Tunnel Enlargement in Single Bundle ACL Reconstruction Using Bio-Interference...TheRightDoctors
Tunnel Enlargement in Single Bundle ACL Reconstruction Using Bio-Interference Screw, Transfix and Tight Rope RT: A Comparitive Study Using Computed Tomography-Dr. Ankit Goyal
This document discusses graft selection considerations for ACL reconstruction surgery. It notes that while ACL surgery outcomes have improved, re-injury rates remain high. The best graft depends on factors like the patient's activity level and surgery goals. Autografts like hamstring tendon and bone-patellar tendon-bone have advantages and risks to consider such as donor site morbidity and graft integration/re-rupture rates. Allografts present issues like higher costs and failure rates. Evidence suggests hamstring autografts may have the best cost-effectiveness profile, though bone-patellar tendon-bone grafts have excellent integration; graft choice requires weighing these various factors.
This document discusses arthroscopic rotator cuff repair. It begins with the anatomy of the rotator cuff and classifications of tears. It then discusses techniques for arthroscopic repair including single versus double row repairs and different types of sutures and anchors. It summarizes studies comparing biomechanical properties and retear rates of different repair methods. The document concludes with long term follow up of repairs showing rerupture rates increase with larger tear size and age.
This document describes a novel surgical technique for primary ACL reconstruction using both autograft and a biomimetic graft. The technique involves a four-stranded anatomical single-bundle reconstruction that places the femoral tunnel low to overlap both the AM and PL bundles. Preliminary results on 18 elite football players showed improved IKDC scores, reduced pivot shift, and allowed return to full athletic performance by 3.5 months. However, long-term follow up is still needed to evaluate the outcomes of this new single-bundle technique.
Reverse Total Shoulder Arthroplasty Research Presentationtylers56
A 50-year-old man underwent reverse total shoulder arthroplasty (rTSA) to repair a failed shoulder hemiarthroplasty. He had a history of traumatic shoulder dislocation and multiple stabilization procedures. Following rTSA, he participated in a home-based rehabilitation program with minimal supervision. At 8 months post-op, he demonstrated significant improvements in range of motion, strength, function, and pain relief. Radiographs also showed the prosthesis was securely in place without issues. This case suggests rTSA may be a viable option for younger, highly active patients to improve outcomes following failed shoulder replacement.
J.R. Rudzki gave a presentation on current concepts in shoulder replacement. He discussed the anatomy of the shoulder joint and causes of shoulder arthritis. Treatment options were reviewed, including arthroplasty when conservative measures fail. Surgical techniques for hemiarthroplasty and total shoulder arthroplasty were outlined. Clinical studies showed that both procedures improve function, though total arthroplasty may provide better outcomes. Complications were noted to occur in about 5% of cases. Emerging concepts around reverse total shoulder arthroplasty for rotator cuff arthropathy were presented.
This document describes a modified posterior approach technique for the hip joint. The key steps of the technique include making a skin incision from just below the posterior superior iliac spine curving toward the greater trochanter. The greater trochanter is then osteotomized to include the insertions of surrounding muscles. This posterior triangular flap is turned down to expose the hip joint capsule. The advantages of this modified approach include decreased risk of dislocation compared to conventional approaches by preserving bone and soft tissue attachments and providing stable exposure of the hip joint and surrounding structures.
This document discusses various types of arthroplasty procedures for different joints. Arthroplasty involves surgically reconstructing a joint by replacing worn or damaged parts with prosthetic implants. It summarizes arthroplasty of the hip, knee, ankle, shoulder, elbow, wrist and hand joints. For each joint, it describes the indications, surgical techniques and postoperative rehabilitation for both partial and total joint replacement arthroplasty. The goal of arthroplasty is to relieve pain and restore function by replacing dysfunctional joint surfaces with prosthetic components.
Modified Posterior Approach to the Hip Joint, International Journal of Orthop...Krishnamohan Iyer
This document describes a modified posterior approach to the hip joint developed by the author in 1981. The modification involves osteotomizing the posterior overhanging part of the greater trochanter to improve exposure and decrease dislocations. Cadaver tests found the modified approach provided greater stability than conventional posterior approaches. The author then used the approach clinically with no dislocations reported. Several other surgeons found similar success rates with the modified approach. The approach preserves soft tissue attachments and muscle insertions for improved stability and less risk of nerve damage compared to other posterior approaches.
This document discusses the development of the Zimmer Gender Solutions High-Flex Knee implant, which is designed specifically for women's anatomy. Standard knee implants are often a poor fit for women due to anatomical differences compared to men, such as narrower femoral dimensions. The Gender Solutions implant addresses three key differences in women's knees: 1) A narrower medial-lateral dimension to reduce implant overhang, 2) A reduced anterior flange thickness to decrease protrusion, and 3) A laterally positioned sulcus to better accommodate women's greater Q-angle and reduce patellar tracking issues. Early experiences with the Gender Solutions implant indicate it provides a better anatomical fit compared to standard unisex implants.
Biologic Knee Replacement (BKR) is our approach to treating knee injuries, from trauma to arthritis, and is designed to help people delay, or even avoid, artificial knee replacement. BKR is a scientifically-proven collection of our out-patient surgical techniques and procedures and consists of any combination of meniscus transplantation, articular cartilage paste grafting, ligament replacement as explained in further detail below. Being "bone on bone" does not always mean that the joint needs to be artificially replaced, often the "bone on bone" is isolated to a portion of the knee joint and this can be repaired using Biologic Knee Replacement.
Reverse shoulder arthroplasty involves replacing the humeral head and glenoid fossa with prosthetics to alter the center of rotation and increase deltoid tension and function. It is indicated for rotator cuff tear arthropathy, proximal humeral fractures in the elderly, failed shoulder replacements, and other conditions. The procedure involves an deltopectoral approach to expose the joint, removal of the humeral head and shaping of the glenoid, then implantation of the glenosphere and humeral cup components. Outcomes are best for osteoarthritis and worse for trauma or revision cases. Complications can include infection, nerve injury, implant loosening or breakage.
A Comparative Study of the Clinical and Functional Outcome Anterior Cruciate ...TheRightDoctors
A Comparative Study of the Clinical and Functional Outcome Anterior Cruciate Ligament Reconstruction Using Transportal and Transtibial Approach for Femoral Tunnel Drilling-Dr. Adarsh Reddy
This document discusses testing methods for total ankle and shoulder replacement implants. It notes that while testing methods are standardized for knee and hip implants, extremity implants like ankle and shoulder prosthetics have not been as extensively tested. The document outlines current testing procedures for these implants, which typically use modified knee or hip simulators. It discusses adapting simulators to test total ankle replacements, including setting up fixtures and inputting motion profiles. Testing procedures for total shoulder replacements are also described, such as using a hip simulator with custom fixtures to simulate shoulder motion. The document stresses the need for more research on in vivo joint motions and forces to further improve testing methods for these implants.
The document discusses anterior cruciate ligament (ACL) reconstruction and graft selection. It describes the anatomy of the ACL and common causes of injury. Diagnosis involves clinical tests and MRI imaging. Three main graft options exist - bone-patellar tendon-bone autograft, hamstring autograft, and allograft. The bone-patellar tendon-bone autograft integrates more quickly but risks anterior knee pain, while the hamstring autograft has less donor site morbidity but slower healing. Rehabilitation begins shortly after surgery, focusing on regaining range of motion and strengthening muscles around the knee. Graft selection depends on factors like activity level and age.
Dr. Goradia with G2 Orthopedics and Sports Medicine in Glen Allen, VA reviews advances in knee replacement surgery that are helping more patients live pain free.
The treatment for sarcoma cancer is done only through the surgical methods in which the bone and soft-tissue of limb of the patient is saved from extremity tumour cases.
Tunnel Enlargement in Single Bundle ACL Reconstruction Using Bio-Interference...TheRightDoctors
Tunnel Enlargement in Single Bundle ACL Reconstruction Using Bio-Interference Screw, Transfix and Tight Rope RT: A Comparitive Study Using Computed Tomography-Dr. Ankit Goyal
This document discusses graft selection considerations for ACL reconstruction surgery. It notes that while ACL surgery outcomes have improved, re-injury rates remain high. The best graft depends on factors like the patient's activity level and surgery goals. Autografts like hamstring tendon and bone-patellar tendon-bone have advantages and risks to consider such as donor site morbidity and graft integration/re-rupture rates. Allografts present issues like higher costs and failure rates. Evidence suggests hamstring autografts may have the best cost-effectiveness profile, though bone-patellar tendon-bone grafts have excellent integration; graft choice requires weighing these various factors.
This document discusses arthroscopic rotator cuff repair. It begins with the anatomy of the rotator cuff and classifications of tears. It then discusses techniques for arthroscopic repair including single versus double row repairs and different types of sutures and anchors. It summarizes studies comparing biomechanical properties and retear rates of different repair methods. The document concludes with long term follow up of repairs showing rerupture rates increase with larger tear size and age.
This document describes a novel surgical technique for primary ACL reconstruction using both autograft and a biomimetic graft. The technique involves a four-stranded anatomical single-bundle reconstruction that places the femoral tunnel low to overlap both the AM and PL bundles. Preliminary results on 18 elite football players showed improved IKDC scores, reduced pivot shift, and allowed return to full athletic performance by 3.5 months. However, long-term follow up is still needed to evaluate the outcomes of this new single-bundle technique.
Reverse Total Shoulder Arthroplasty Research Presentationtylers56
A 50-year-old man underwent reverse total shoulder arthroplasty (rTSA) to repair a failed shoulder hemiarthroplasty. He had a history of traumatic shoulder dislocation and multiple stabilization procedures. Following rTSA, he participated in a home-based rehabilitation program with minimal supervision. At 8 months post-op, he demonstrated significant improvements in range of motion, strength, function, and pain relief. Radiographs also showed the prosthesis was securely in place without issues. This case suggests rTSA may be a viable option for younger, highly active patients to improve outcomes following failed shoulder replacement.
J.R. Rudzki gave a presentation on current concepts in shoulder replacement. He discussed the anatomy of the shoulder joint and causes of shoulder arthritis. Treatment options were reviewed, including arthroplasty when conservative measures fail. Surgical techniques for hemiarthroplasty and total shoulder arthroplasty were outlined. Clinical studies showed that both procedures improve function, though total arthroplasty may provide better outcomes. Complications were noted to occur in about 5% of cases. Emerging concepts around reverse total shoulder arthroplasty for rotator cuff arthropathy were presented.
This document describes a modified posterior approach technique for the hip joint. The key steps of the technique include making a skin incision from just below the posterior superior iliac spine curving toward the greater trochanter. The greater trochanter is then osteotomized to include the insertions of surrounding muscles. This posterior triangular flap is turned down to expose the hip joint capsule. The advantages of this modified approach include decreased risk of dislocation compared to conventional approaches by preserving bone and soft tissue attachments and providing stable exposure of the hip joint and surrounding structures.
This document discusses various types of arthroplasty procedures for different joints. Arthroplasty involves surgically reconstructing a joint by replacing worn or damaged parts with prosthetic implants. It summarizes arthroplasty of the hip, knee, ankle, shoulder, elbow, wrist and hand joints. For each joint, it describes the indications, surgical techniques and postoperative rehabilitation for both partial and total joint replacement arthroplasty. The goal of arthroplasty is to relieve pain and restore function by replacing dysfunctional joint surfaces with prosthetic components.
Current Concepts in High Tibial osteotomy and Unicondylar knee replacementPaudel Sushil
This document discusses current concepts in unicondylar knee arthroplasty and high tibial osteotomy for the management of unicompartmental osteoarthritis of the knee. It provides an overview of the procedures, including types of osteotomies for high tibial osteotomy, indications and contraindications for each procedure, long-term results, and risks of converting between the two procedures. The document also reviews principles and considerations for each technique as well as selected implant designs for unicondylar knee arthroplasty.
The document discusses meniscal injuries of the knee. It describes the anatomy and function of the menisci, types of meniscal tears, symptoms and diagnosis of tears. Treatment options include nonsurgical care, partial meniscectomy to remove torn parts, and meniscal repair surgery which is best for peripheral, vertical tears. While removal addresses pain, it increases risk for osteoarthritis long term. The goal of repair is to preserve as much viable meniscal tissue as possible for cartilage protection.
The Stone Clinic is a sports medicine clinic in San Francisco, California, offering orthopaedic surgery and medical care, physical therapy and rehabilitation, and radiology imaging services. The Stone Clinic was founded by Kevin R. Stone, M.D., an orthopaedic surgeon, combining himself with a team of nurses, physical therapists, imaging specialists, and patient coordinators, in 1988 to focus on caring for injured athletes and people experiencing arthritis pain.
The Stone Clinic is founded on the goal of rehabilitating all patients to an operating level higher than before they were injured. The Stone Clinic specializes in sports medicine and injury treatment of knee, shoulder, and ankle joints. Stone has lectured and is recognized internationally as an authority on cartilage and meniscal growth, replacement, and repair. Stone and the Stone Clinic are known for the development of the paste grafting surgical technique in 1991, combined with meniscus replacement, which are biologic joint replacement procedures for the regeneration of the knee joint. Surgical procedures were subjected to rigorous outcomes analysis with the results reported in peer reviewed journals. The surgical techniques have been taught to surgeons in the US and worldwide, through lectures and videos.
Nursing students, medical students, residents, fellows, and other physicians from various institutions around the world, rotate through The Stone Clinic and mentor with Stone. The Stone Clinic hosts the annual Meniscus Transplantation Study Group Meeting as well as the annual Professional Women Athlete's Career Conference.
McKinley Court Care Centre's Dr Jones presented the topic "Knee Joint Replacement" on July 9, 2011. The topics that were discussed covered normal/abnormal join function, symptoms of joint disorders, and treatments.
Contact us for more information on knee joint replacement or to attend the next seminar!
info@mckinleycourtcarecentre.com
www.mckinleycourtcare.com
The medial and lateral menisci are C-shaped pieces of fibrocartilage in the knee that help distribute weight and improve joint congruity. The medial meniscus is less mobile and more commonly injured, usually via a twisting motion. Injuries are evaluated clinically and via imaging like MRI, with arthroscopy used to confirm tears. Treatment involves rest, bracing, and exercises for minor tears, while surgery like partial or total meniscectomy or repair is used for more severe tears. Complications are rare but include infection, nerve injury, and arthrofibrosis. Recovery focuses on regaining motion and strength.
The knee joint is composed of three joints within a synovial cavity. It includes the medial and lateral condylar joints between the femur and tibia, and the patellofemoral joint between the femur and patella. The knee joint is supported by ligaments including the ACL, PCL, medial collateral ligament, lateral collateral ligament, and menisci. The knee allows for flexion and extension through the actions of various muscles and is an important weight-bearing joint that can be subject to injuries and osteoarthritis.
High tibial osteotomies are a surgical procedure used to treat unicompartmental osteoarthritis of the knee caused by malalignment. There are several types of high tibial osteotomies including medial opening wedge, lateral closing wedge, medial opening hemicallotasis, and dome osteotomies. Complications can include recurrence of deformity, irritation or failure of implants, nerve palsy, nonunion, infection, or stiffness. Outcomes of high tibial osteotomies are generally good, though some patients may eventually require total knee arthroplasty. High tibial osteotomies can be combined with cartilage restoration procedures, though long-term outcomes of graft survival are mixed.
The document discusses the history and future of total knee replacement (TKR). It describes the two main approaches in TKR design - the anatomical approach which preserves soft tissues and the functional approach which simplifies knee mechanics. While the anatomical approach aims to maintain knee function, issues with component alignment and fixation led to the functional approach. However, this resulted in high contact stresses due to incongruent surfaces. More recent mobile-bearing designs aim to allow motion while reducing stresses, but surgery is more complex. The document questions whether newer techniques like computer navigation can improve outcomes long-term.
1) The document describes an endoscopic technique for gastrocnemius recession to treat ankle equinus contracture as an alternative to open gastrocnemius release.
2) Key steps of the endoscopic procedure include making a small medial incision, using an endoscope to visualize and transect the medial and lateral heads of the gastrocnemius tendon while avoiding surrounding nerves and vessels, and confirming a gain of at least 10-15 degrees of ankle dorsiflexion.
3) Potential advantages over open release include smaller incisions and faster recovery, though the endoscopic technique has a learning curve and risks of poor visualization if surrounding anatomy cannot be safely defined and protected.
Patella in total knee arthroplasty to resurface or not is the questionBipulBorthakur
This document discusses different perspectives and techniques regarding patellar resurfacing during primary total knee arthroplasty. It notes that while resurfacing was routinely performed in North America, Asian surgeons often do not due to patient characteristics. Three main approaches are described: always resurfacing, never resurfacing, and selective resurfacing based on factors like cartilage quality and arthritis. Complications of both resurfacing and non-resurfacing are presented. Multiple studies are reviewed that compare outcomes between the two techniques, with many finding reduced reoperation rates but similar pain levels with resurfacing. The conclusion is that the best approach remains controversial, though resurfacing is often recommended for inflammatory arthritis or severe patellar deformity.
1. The document discusses treatment modalities for patients with varus medial knee osteoarthritis.
2. It focuses on non-operative treatments like bracing and insoles, as well as surgical treatments including closing-wedge and opening-wedge high tibial osteotomy and total knee arthroplasty.
3. The goal is to evaluate the effectiveness of these interventions using patient-reported outcomes, imaging, biomechanics, and long-term follow-up studies.
This document provides an overview of anterior cruciate ligament (ACL) injuries, including the functions of the ACL, typical mechanisms of injury, symptoms, signs, diagnostic imaging, natural history if untreated, and treatment options. It discusses the goals of ACL reconstruction surgery, including proper graft selection, placement, tensioning, and fixation. Post-operative rehabilitation is also summarized, with the goal of regaining motion and strength while protecting the graft.
Computer Navigated Medial Opening Wedge High Tibial Osteotomy- Review of Lite...CrimsonPublishersOPROJ
Computer Navigated Medial Opening Wedge High Tibial Osteotomy- Review of Literature by Kunal Dhurve* in Crimson Publishers: Orthopedic Research and Reviews Journal
The document discusses considerations for correcting varus deformity during total knee arthroplasty for osteoarthritis. It analyzed 20 patients with over 15 degrees of varus deformity who underwent TKA. The goal of TKA is to restore the mechanical axis of the knee to distribute load evenly and reduce wear. This involves correcting alignment through distal femoral and proximal tibial cuts while balancing the extension and flexion gaps. Restoring proper alignment through the joint line and balancing the soft tissues is important for implant longevity and stability.
High tibial osteotomy (HTO) is a surgical procedure that involves correcting angular deformities of the tibia. It has been used to treat conditions like osteoarthritis, osteochondritis dissecans, and malalignment. There are several techniques for HTO including lateral closing wedge osteotomy, medial opening wedge osteotomy, and dome osteotomy. HTO can help relieve pain from unicompartmental osteoarthritis and delay the need for knee replacement in young, active patients. Potential complications include fracture, nonunion, nerve palsy, and issues that can make later knee replacement more difficult. Precise surgical planning and fixation are important for achieving good outcomes from HTO.
Osteoarthritis is a degenerative joint disease that commonly affects weight-bearing joints like the knee and hip. It has multiple causes but is generally attributed to normal wear and tear over time. Knee osteoarthritis symptoms include pain, swelling, stiffness, and reduced mobility. Treatments include medications, physical therapy, bracing, and knee replacement surgery for severe cases. Knee replacement surgery involves removing damaged bone and cartilage and replacing them with artificial implants. Extensive physical therapy is then needed for rehabilitation and recovery of strength and mobility.
Revision Total Ankle Arthroplasty to Tibial Stemmed Implant: A Case Reportskisnfeet
This case report describes the revision of a failed total ankle replacement (TAR) using two different methods. Initially, the failed TAR was revised using a tibial stemmed implant. However, this revision failed due to infection, requiring a second revision involving removal of the implant and tibiotalocalcaneal arthrodesis with a retrograde nail. While the tibial stemmed implant revision had short term success in other patients, this case demonstrates the difficulty and risk of infection in revision surgeries.
Total hip arthroplasty has been an important surgical operation in orthopaedics in the 20th century. After many trails, major advancement in Total Hip Arthroplasty was made by Sir John Charnley in 1962, who introduced low friction arthroplasty. This consists of a polyethylene cup and 22.2 mm head, both components being fixed with methacrylate cement. In the following years there were many changes to this basic principle (model) of total hip arthroplasty. Patient education has become an important factor in improvement of function following total hip replacement.
Total knee arthroplasty by dr..ammar m.sheetAmmar Sheet
This document provides information on total knee arthroplasty (TKA). It discusses knee anatomy and biomechanics. It describes the different designs of knee prostheses including unconstrained, constrained, and mobile bearing. It outlines surgical techniques for TKA including approaches, alignment, and balancing ligaments. It discusses indications and contraindications for TKA as well as techniques to ensure proper patellar tracking and joint line restoration. The goal of TKA is to relieve pain, correct alignment and restore function of the knee joint.
Retrograde Intramedullary Nail with Femoral Head Allograft for Large Deficit ...skisnfeet
The document summarizes a study that evaluated the outcomes of using a retrograde intramedullary nail with femoral head allograft for large defect tibiotalocalcaneal arthrodesis. Eleven patients were included who had this procedure for conditions such as Charcot neuroarthropathy, avascular necrosis, or revision fusion. While complications occurred in six patients, eight patients were considered successes based on clinical and radiographic criteria, such as stability and union. The technique provides a powerful one-stage method to address large bony deficits but also carries risk, as only partial unions were observed in some cases. Overall, it was deemed a useful technique for this difficult patient population.
This document summarizes a study on using proximal fibular osteotomy (PFO) to treat medial compartment osteoarthritis of the knee. PFO is presented as a simpler, less expensive alternative to procedures like high tibial osteotomy (HTO). The study included one patient who underwent PFO and was followed for 6 months, showing decreased pain scores and improved knee joint space. While PFO provided good short-term outcomes, more research is needed to establish its role compared to procedures like HTO and unicompartmental knee arthroplasty. PFO may be particularly suitable for resource-limited settings due to its low cost and technical simplicity.
Reversing the Trend- Newer Types of Shoulder Replacementcoreinstitute
Recently, there has been much discussion about a relatively new type of shoulder replacement, which offers patients the prospects of pain relief and better shoulder function. View this presentation to learn more about this shoulder replacement surgery.
Effect of a_knee_ankle_foot_orthosis_on_knee.10huda alfatafta
The KAFO significantly reduced knee varus angle and the first peak of the external knee adduction moment during walking compared to no orthosis. It also reduced the knee adduction angular impulse during stair ascent compared to no orthosis. No significant differences were found between the custom and off-the-shelf knee valgus braces for any measures. The KAFO showed greater improvements in knee alignment and loading than the knee valgus braces for this individual with varus knee alignment.
Total joint replacement is a common orthopedic procedure that replaces damaged bone and cartilage in a joint with prosthetic implants. The document discusses several types of total joint replacements including hip, knee, finger, elbow, and ankle replacements. It provides details on the surgical procedures, materials used in implants, rehabilitation process, and common causes for failure or reoperation. Total joint replacement is an effective procedure that can relieve pain and restore mobility for conditions like osteoarthritis and rheumatoid arthritis.
The first knee replacement was performed in 1968. Since then, improvements in material selection and techniques have greatly increased its effectiveness.
The study of biomaterials by biomedical engineers has led to advancements in more accurate sizing, the option of patella femoral replacement, better instrumentation as well as components that allow an increased range of motion and a lower wear rate have since been developed and implemented. During this period the collaboration between surgeons and engineers produced many developments in the design of the prosthesis. Today this procedure is safe and established even if in continuous development. The progress in technologies and the use of new materials let researches try again old-fashioned techniques from the past in order to be improved.The most common reason for knee replacement is that other treatments (weight loss, exercise/physical therapy, medicines, injections, and bracing) have failed to relieve arthritis-associated knee pain. The goal of knee replacement is to relieve pain, improve quality of life, and maintain or improve knee function
Scope
Possible disadvantages of knee replacement surgery include replacement joints wearing out over time, difficulties with some movements and numbness. A replacement knee can never be quite as good as a natural knee – most people rate the artificial joint about three-quarters average (Marian et al.,2021)
Most knee replacements aren’t designed to bend as far as your natural knee. Although it’s usually possible to kneel, some people find it uncomfortable to put weight on the scar at the front of the knee. There may be some numbness at the outer edge of the spot. This usually improves over about two years, but it’s unlikely that the feeling will ultimately return to normal. A replacement knee joint may wear out after a time or may become loose.
, total knee replacement can help relieve pain that emanates from arthritis restoring the normal mobility of an individual. The procedure involves removing the damaged bone and cartilage from the thigh bone, shin bone, and kneecap and replacing it with an artificial joint made of metal alloys, high-grade plastics and polymers. However, despite having its advantages, total knee replacement surgery carries several risks such as infection, blood clots in the leg veins or lungs, heart attack, stroke and nerve damage. The artificial knee can also wear out due to excessive use. Excess glue is squeezed out to the side as the element is pressed into place and removed. The cement hardens quickly, the incision is closed using several layers of sutures, and a bandage is applied
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British Columbia Medical Journal - November 2010: Knee replacement
1. BC MEDICAL JOURNAL VOL. 52 NO. 9, NOVEMBER 2010 www.bcmj.org442
ABSTRACT: Partial knee replace-
ments have come into and out of
favor over the past 60 years. There
has been renewed interest in partial
knee replacements in the armamen-
tarium for arthritic knees due to
increasingly good results. Partial
knee replacements include the uni-
condylar knee replacement and the
patellofemoral arthroplasty. These
partial knee replacements are indicat-
ed for specific, isolated arthritic por-
tions of the knee joint—specifically
the medial, lateral, or patellofemoral
portion of the joint. In carefully
selected patients outcomes are com-
parable to the results of total knee
replacements. Patient selection and
meticulous surgical technique are
likely the key to a good result in a par-
tial knee replacement.
P
artial knee replacements
are a form of knee arthro-
plasty that doesn’t replace
the entire knee (the femoral
condyles, tibial plateau, and patella).
These surgical interventions include
the patellofemoral arthroplasty and
the more common unicondylar knee
arthroplasty. Both procedures have
been available since the 1950s and
may be options for patients who have
osteoarthritis in one compartment of
the knee, do not have specific con-
traindications for these more conser-
vative procedures, and who have
failed to benefit from nonoperative
management of their osteoarthritis.
Unicondylar knee
arthroplasty
In the past, unicondylar knee replace-
ments fell out of favor primarily be-
cause of the surgical technique of the
time, which made conversion to a full
knee replacement difficult. However,
with the advent of minimally invasive
approaches for unicondylar knee
replacement, there has been renewed
interest in this procedure over the past
decade.
A unicondylar knee replacement
( ) consists of a metal compo-Figure 1
nent that goes on the femoral condyle,
and another component that goes on
the tibial side. The tibial component
can be metal-backed with a fixed-
bearing or mobile-bearing polyethyl-
ene bearing surface, or it can be an all-
polyethylene fixed-bearing cemented
component. There is no evidence that
one approach is better than another.
The rationale for considering a
unicondylar knee arthroplasty is that
it is a more conservative operation
with faster recovery, less resection of
bone, conservation of the cruciate lig-
aments, and potentially better func-
tion. In addition, conversion to a total
knee replacement down the road is
simple using modern techniques, with
outcomes similar to a primary knee
replacement. When appropriate, par-
tial knee arthroplasty can be thought
of as a time-buying operation.
In addition, a unicondylar knee
replacement is an alternative to other
invasive procedures such as a high
tibial osteotomy or a total knee
replacement.
Partial knee replacement
The last decade has seen renewed interest in unicondylar knee
arthroplasty and patellafemoral arthroplasty for patients with
osteoarthritis affecting one compartment of the knee.
Robert C. Schweigel, MD, FRCSC
Dr Schweigel is a clinical instructor in the
Department of Orthopaedics at the Univer-
sity of British Columbia.
2. www.bcmj.org VOL. 52 NO. 9, NOVEMBER 2010 BC MEDICAL JOURNAL 443
Patient selection
Careful patient selection is needed to
get the best possible results. This re-
quires a thorough history and physical
examination.
The history should include specif-
ic questions about the knee to deter-
mine whether there was a gradual
onset of pain or whether there was a
specific incident (i.e., trauma) that
caused the problem. This is particu-
larly important because anterior cru-
ciate ligament deficiency is a con-
traindication for a unicondylar knee
replacement. When considering a uni-
condylar knee replacement, the loca-
tion of the pain is very important. It
must be localized to only one com-
partmentoftheknee.Foramedialuni-
condylar knee replacement, the pain
has to be medial and the patient has to
be able to point to the medial side of
the knee as the site of the pain. For a
lateral unicondylar knee replacement,
which is much less common as the
results are less predictable than a
medialunicondylarkneereplacement,
the pain has to be lateral. For either a
lateral or medial unicondylar knee
replacement, the presence of substan-
tial patellofemoral pain is a con-
traindication. In addition, the pain has
to be of sufficient magnitude and to
interfere with activities of daily living
to warrant surgical intervention. It is
important to ensure that all reasonable
attempts at medical management have
been exhausted before considering
any surgical procedure.
Indications
Kozinn and Scott have outlined several
classic indications and contraindica-
tions for unicondylar knee replace-
ment.1 Indications include the diagno-
sis of unicondylar osteoarthritis or
osteonecrosis in either the medial or
lateral compartment of the knee. Ini-
tially, Kozinn and Scott stipulated that
patient age had to be greater than 60
years and weight had to be less than
82 kg. There had to be minimal pain at
rest and low demand of activity. The
ideal range of motion was an arc of
flexion of 90 degrees with a contrac-
ture of less than 5 degrees. The angu-
lar deformity had to be less than 15
degrees and be passively correctible
to neutral at the time of operation.
Specific contraindications to a uni-
condylar knee arthroplasty identified
by Kozinn and Scott included the
diagnosis of an inflammatory arthri-
tis, age younger than 60 years, high
patientactivitylevel,painatrest(which
may indicate an inflammatory com-
ponent), and patellofemoral pain or
exposed bone in the patellofemoral or
opposite compartment at the time of
the surgery. Asymptomatic chondro-
malacia in the patellofemoral joint
was not necessarily a contraindication.
More recently, some of these indi-
cations have been expanded. Various
authors have reported good results in
patients younger than 60 years2 and in
obese patients with BMIs over 30.3
Generally it is felt that both of the
cruciate ligaments have to be intact to
perform a unicondylar knee arthro-
plasty. Again however, studies have
suggested that a medial compartment
unicondylar arthroplasty is possible
in an ACL-deficient knee in certain
Partial knee replacement
Figure 1. (A) Anteroposterior radiograph showing a medial unicondylar knee replacement. (B) Lateral radiograph showing a medial
unicondylar knee replacement. Radiographs courtesy of Dr Bas Masri.
A B
3. BC MEDICAL JOURNAL VOL. 52 NO. 9, NOVEMBER 2010 www.bcmj.org444
circumstances;4 still, most surgeons
will not perform a unicondylar knee
replacement on a patient with a histo-
ry of torn ACL, and the presence of
a torn ACL should be considered a
contraindicationtoaunicondylarknee
replacement.
In summary, in addition to well-
localized pain with no patellofemoral
involvement, the indications for a uni-
condylar knee replacement include
the following:
• Range of motion of no less than
110 degrees with no more than a 5-
degree flexion deformity.
• Acorrectable varus on valgus defor-
mityofnomorethan5degreesofvar-
us or 15 degrees of valgus, with the
correctability of the deformity to be
determined on physical examination.
• An intact anterior cruciate ligament.
• Osteoarthritis localized to either the
lateralormedialcompartment,keep-
ing in mind that the vast majority of
unicondylar knee replacements are
medial.
• For some fixed-bearing tibial compo-
nentdesigns,aweightlimitof114kg.
Based on the above, it is clear that
not every patient with knee osteo-
arthritis is a candidate for a unicondy-
lar knee replacement, and the final
decision is up to the orthopaedic sur-
geon. Typically, only 10% to 20% of
patients undergoing knee replacement
are candidates for unicondylar knee
arthroplasty.
Results
It is difficult to sort out the results for
unicondylar knee arthroplasty, as
there are different types of unicondy-
lar knee arthroplasties. Additionally,
it is difficult to distinguish between
medial side versus lateral side proce-
dures with respect to outcomes. Fur-
thermore, one has to compare the
results of a unicondylar knee replace-
ment with other options such as a high
tibial osteotomy and a standard total
knee replacement. Again, various au-
thors have reported varying degrees
of success with unicondylar knee
arthroplasty. Recently authors have
reported 96% survival of the implant
at a 10-year follow-up and excellent
or good outcome in 92% of patients.5
Most recently Newman and col-
leagues6 compared unicondylar knee
replacement with total knee replace-
ment in a prospective randomized
control trial. This report stated that the
15-year survivorship for a unicondy-
larkneereplacementwascloseto90%
compared with 80% for a total knee
replacement. Additionally, the report
stated that the unicondylar knee
replacements had more “excellent”
results and a better range of motion
compared with the total knee replace-
ment. Registry data, however, such as
the Swedish Knee Replacement Reg-
istry, have shown a higher reoperation
rate for unicondylar knee replace-
ment, with the main reason for revi-
sion being progression of the arthritis.
The results for revision of a unicondy-
lar knee replacement to a full knee
replacement are similar to the results
for a primary total knee replacement,
and even though unicondylar knee
replacements may not last as long, the
outcome of revision is better than that
of a revision of total knee replacement.
Partial knee replacement
Figure 2: (A) Anteroposterior radiograph showing a patellofemoral replacement. (B) Lateral radiograph showing a patellofemoral replacement.
Radiographs courtesy of Dr Bas Masri.
A B
4. www.bcmj.org VOL. 52 NO. 9, NOVEMBER 2010 BC MEDICAL JOURNAL 445
Complications
The complications after a unicondylar
knee replacement are similar to a total
knee replacement. These complica-
tions include inadequate pain relief,
deep venous thrombosis in 1% to 5%
of patients, infection in less than 1%
of patients, and unexplained pain
about the knee.
Late complications include loos-
ening of a component, subsidence of
the component, degeneration of the
other compartment resulting in pain,
infection, polyethylene wear, and pos-
sible dislocation of the polyethylene
component in a mobile-bearing knee
replacement.
Patellofemoral
arthroplasty
A patellofemoral replacement
( ) is indicated for the man-
agement of isolated osteoarthritis of
the patellofemoral joint. It has to be
clear that this form of partial knee
replacement is not indicated for pat-
ellofemoral pain in the absence of rad-
iographically proven osteoarthritis.
Patient selection
Patellofemoral arthritis occurs in up
to 9% of patients over the age of 40
and 15% of patients over 60.7 Most
patellofemoral pain or arthritis can be
treated with nonoperative measures
such as activity modification, physi-
cal therapy, analgesics, braces, and/or
injections. Patellofemoral arthroplas-
ty may be an option for patellofemoral
arthritis when other treatment modal-
ities have failed.
Patients with chondromalacia of
the patella have been treated with
arthroscopic debridement with limit-
ed success.8 A patellectomy has been
used in the past as well. Unfortunate-
ly, a patellectomy has its own set of
problems,whichincludelossofexten-
sion power and increased risk of arth-
ritis in the tibiofemoral compartment.
Figure 2
Indications
According to Lonner9 the indications
and contraindications for a patello-
femoral arthroplasty are isolated
patellofemoral osteoarthritis, post-
traumatic arthritis, or advanced chon-
dromalacia with eburnation on either
or both of the trochlear and patellar
surfaces. It is contraindicated in pa-
tients with medial or lateral joint line
pain or tibiofemoral arthritis or chon-
dromalacia. It is not felt to be appro-
priate for inflammatory arthritis or
crystalline arthropathy. It should be
used with extreme caution in a patient
who has a highly malaligned patello-
femoral articulation with a high Q
angle and is thus at risk for dislocation.
Results
The component for patellofemoral
arthroplasty consists of a metal troch-
lear component and a polyethylene
button that replaces the articular sur-
face of the patella. Good to excellent
results have been reported in short,
mid-term, and medium follow-up.
The results are reported as being 80%
to 90% good to excellent.9
Complications
The complications after a patello-
femoral arthroplasty include patellar
snapping and instability. Additionally
the standard complications for uni-
condylar knee arthroplasty can be
included. There can be ongoing res-
idual anterior knee pain and dys-
function. There can be subsidence,
polyethylenewear,orloosening.Long-
term arthritis in the tibiaofemoral
joint can also occur.
Conclusions
Partial knee replacements may be an
option for a select group of patients.
There is renewed interest in partial
knee replacements with recently re-
ported good long-term outcomes,
complications similar to total knee
replacement, and the fall-back option
of a conversion to a total knee replace-
ment. For the unicondylar knee, it is a
more conservative option with a fast
recovery, good functional outcome,
and is a possible good option to a high
tibial osteotomy or total knee replace-
ment. The unicondylar knee is most
commonly done for isolated medial
compartment osteoarthritis and has
very specific indications. The patello-
femoral arthroplasty is possibly indi-
cated in patients with isolated patello-
femoral arthritic pain. The limited
reports on the patellofemoral arthro-
plasty suggest very good results.
Partial knee replacement
There is renewed interest in partial
knee replacements with recently reported
good long-term outcomes, complications
similar to total knee replacement, and the
fall-back option of a conversion to a
total knee replacement.
5. BC MEDICAL JOURNAL VOL. 52 NO. 9, NOVEMBER 2010 www.bcmj.org446
Partial knee replacement
Competing interests
None declared.
References
1. Kozinn SC, Scott R. Unicondylar knee
arthroplasty. J Bone Joint Surg Am 1989;
71:145-150.
2. Pennington DW, Swienckowski JJ,
Lutes WB, et al. Unicompartmental knee
arthoplasty in patients sixty years of age
or younger. J Bone Joint Surg. 2003;85-
A:1968-1973.
3. Tabor OB Jr, Tabor OB, Bernard M, et al.
Unicompartmental knee arthroplasty:
Long-term success in middle-age and
obese patients. J Surg Orthop Adv
2005;14:59-63.
4. Christensen NO. Unicompartmental
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