Infection in Total Knee Arthroplasty
Fig. 17.1 A small sinus present around the incision several years after TKA should raise the concern regarding the likelihood of a substantial chronic late infection Weight-bearing radiographs should be…
Assessing the High-Risk Patient for Revision Total Knee Replacement
Fig. 27.1 (a) Standing anterior-posterior radiograph of an obese patient with a pendulous fatty panniculus following massive weight loss . (b and c) Photographs demonstrating redundant skin overhanging the patella…
Management of the Stiff Total Knee Arthroplasty
Fig. 24.1. Heterotopic ossification is seen in the extensor mechanism and can limit flexion of the knee. Limited surgical dissection in the suprapatellar pouch may potentially avoid this complication However,…
Prodromes of Failure After Revision Total Knee Arthroplasty
Symptom Yes No 1. Pain 2. Swelling 3. Instability 4. Stiffness 5. Clicking 6. Progressive deformity 7. Grinding 8. Catching 9. Redness 10. Drainage 11. Fevers – – – –…
Removal of the Femoral and Tibial Components for Revision Total Knee Arthroplasty
Fig. 7.1 Disrupting the cement-metal interface of a femoral component with an osteotome. The goal is to debond the implant from the cement first and then to remove remaining cement…
Reoperation After Total Knee Arthroplasty
94 insert wear with lysis (most implanted in mid-1990s) 37 insert wear with synovitis 8 insert wear without symptoms 32 late metastatic infections 13 stiffness (8 treated with arthroscopy) 9…
Distal Femoral Nonunions
Fig. 11.1 a Anteroposterior and b lateral radiographs of the right knee showing hardware failure, shortening and varus The patient was evaluated and found only to have hepatitis C. The patient…
Principles of Nonunions
Fig. 1.1 Patient with right ankle injury treated with open reduction and internal fixation of fibula and closed treatment of distal tibia fracture. Referred for nonunion after progressive deformity developed. a–c…
Special Techniques for Nonunions Associated with Traumatic Bone Loss
Fig. 15.1 31-year-old male who suffered a moped accident with an isolated complex open intraarticular distal tibia and fibula fracture. He underwent staged management and with debridement and spanning external fixation,…
Tibial Nonunions
Open fracture Age Smoking Alcohol NSAIDs Nutritional deficiency Prior radiation Endocrinopathies Infection 13.2.1 Mechanical Instability may cause excessive motion at the fracture site, which encourages stem cells to differentiate into…
