Soft Tissue Balancing In Total Knee Arthroplasty
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Soft Tissue Balancing In Total Knee Arthroplasty
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Author : Shuichi Matsuda
language : en
Publisher: Springer
Release Date : 2017-05-02
Soft Tissue Balancing In Total Knee Arthroplasty written by Shuichi Matsuda and has been published by Springer this book supported file pdf, txt, epub, kindle and other format this book has been release on 2017-05-02 with Medical categories.
In this booklet, experts from across the world, including members of the ISAKOS Knee Arthroplasty Committee, offer clear, up-to-date guidance on all aspects of soft tissue or ligament balancing in primary total knee arthroplasty with the aim of enabling the reader to achieve optimal patient outcomes. After an introduction explaining the normal soft tissue condition in the native knee, surgical procedures are described, including techniques for the management of severe deformity. The most striking feature of the booklet, however, is the many pages devoted to the accurate evaluation and clinical relevance of ligament balancing. Different techniques and devices for intraoperative soft tissue assessment are discussed, highlighting, for example, the use of gap-measuring devices or trial liners with load-bearing sensors to achieve more objective evaluation. Above all, special attention is devoted to the crucial issue of the impact of intraoperative soft tissue balance on postoperative results. In the closing chapter, very experienced surgeons introduce intraoperative troubleshooting in order to assist successful completion of arthroplasty.
Soft Tissue Balancing In Primary Total Knee Arthroplasty
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Author : Roberto Rossi
language : en
Publisher:
Release Date : 2012
Soft Tissue Balancing In Primary Total Knee Arthroplasty written by Roberto Rossi and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2012 with Medical categories.
Ligament Balancing In Total Knee Arthroplasty
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Author : Leo A. Whiteside
language : en
Publisher: Springer Science & Business Media
Release Date : 2012-12-06
Ligament Balancing In Total Knee Arthroplasty written by Leo A. Whiteside and has been published by Springer Science & Business Media this book supported file pdf, txt, epub, kindle and other format this book has been release on 2012-12-06 with Medical categories.
The varus knee has a group of bone and ligament abnormalities that must be addressed to correct the deformity. The mechanical axis of the femur is tilted medially relative to the long axis of the tibia. The distal femoral surface usually remains in valgus alignment to the long axis of the femur. Most of the varus deformity is caused by deficiency in the medial tibial plateau. The deep and superficial medial collateral ligaments are contracted and deformed by osteophytes.
Total Knee Replacement
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Author : Arlen D. Hanssen
language : en
Publisher: Elsevier Health Sciences
Release Date : 2009-01-01
Total Knee Replacement written by Arlen D. Hanssen and has been published by Elsevier Health Sciences this book supported file pdf, txt, epub, kindle and other format this book has been release on 2009-01-01 with Medical categories.
This multimedia resource offers you all the how-to guidance you need to perform all of the latest and best techniques in total knee replacement. The complete, lavishly illustrated volume is made even better with a state-of-the-art companion web site! With chapters on such hot topics as cementless fixation, quadriceps sparing MIS TKR, unicompartmental TKR, soft tissue balancing, and extensor mechanism allografting, you, as well as the members of your cross-disciplinary team, will appreciate the clear and concise, but detailed and visual approach of this atlas and video collection. The result is a detailed, easy-to-use reference that no orthopaedic surgeon should be without. Stay on top of your field with detailed discussions of the hottest topics, including cementless fixation, quadriceps sparing MIS TKR, unicompartmental TKR, soft tissue balancing, extensor mechanism allografting, and much more! Search the book online with full-text web access and links to PubMed. Watch experts perform key techniques via video clips online and on the included DVD. See exactly what to do using step-by-step intraoperative photos demonstrating each technique and radiographs showing presenting problems and post-surgical outcomes. See cases as they present in real life using full-color photographs and interpretive diagrams that highlight key anatomical structures. Improve the quality of your technique and optimize outcomes with pearls and pitfalls from the authors. Be more thoroughly prepared with important details on positioning, exposures, instrumentation, and implants. Get just the information and guidance you need with the book's hands-on, clinical emphasis. Your purchase entitles you to access the web site until the next edition is published, or until the current edition is no longer offered for sale by Elsevier, whichever occurs first. If the next edition is published less than one year after your purchase, you will be entitled to online access for one year from your date of purchase. Elsevier reserves the right to offer a suitable replacement product (such as a downloadable or CD-ROM-based electronic version) should access to the web site be discontinued.
Total Knee Arthroplasty
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Author : Theofilos Karachalios
language : en
Publisher: Springer
Release Date : 2015-06-06
Total Knee Arthroplasty written by Theofilos Karachalios and has been published by Springer this book supported file pdf, txt, epub, kindle and other format this book has been release on 2015-06-06 with Medical categories.
This book focuses on the current clinical practice, outcome and the future development of Total Knee Arthroplasty (TKA) in surgical settings. A major objective of this work is to address “What is the optimal design and fixation of the implants we use for knee arthroplasty reconstruction? What are the gold standards? and, Can we do better?”. In an attempt to throw light on these questions, the authors evaluate data from clinical studies and assess various factors which may influence the long term outcome of TKA. Many variables such as age, severity, implant design and surgical techniques for appropriate component placement and soft tissue balancing are explored in great detail by expert surgeons in the field. Total Knee Arthroplasty: Long Term Outcomes will be a useful resource for recently qualified surgeons in search of an introduction to this topic and for more experienced surgeons seeking an in-depth critical review of current practices in TKA.
A Force Distribution Measurement System For Soft Tissue Balancing During Total Knee Arthroplasty
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Author : Mohd Hanafi Mat Som
language : en
Publisher:
Release Date : 2014
A Force Distribution Measurement System For Soft Tissue Balancing During Total Knee Arthroplasty written by Mohd Hanafi Mat Som and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2014 with Soft tissue injuries categories.
The ligament balance, which is a crucial parameter for the success of Total Knee Arthroplasty (TKA) only qualitatively assessed in a manner of subjective feel of the surgeon. Thus, the goal of this study is to develop a force distribution measurement system based on pressure-sensitive conductive rubber.
The Technique Of Total Knee Arthroplasty E Book
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Author : William M. Mihalko
language : en
Publisher: Elsevier Health Sciences
Release Date : 2022-05-03
The Technique Of Total Knee Arthroplasty E Book written by William M. Mihalko and has been published by Elsevier Health Sciences this book supported file pdf, txt, epub, kindle and other format this book has been release on 2022-05-03 with Medical categories.
In 1990, Dr. Kenneth Krackow wrote The Technique of Total Knee Arthroplasty to teach the basics of TKA for end-stage arthritis—everything from nonsurgical to surgical intervention and postoperative rehabilitation. Now completely revised for a new generation of surgeons, the 2nd Edition of this classic text continues its original goal of helping advanced practitioners acquire more knowledge and skill in primary and revision total knee arthroplasty. This fully updated volume, revised by Dr. Krackow and his former fellows Drs. William M. Mihalko and Michael A. Mont, keeps you current with major changes and advances in field, including patient optimization, outpatient procedures, robotics and new technology, difficult decisions during surgery, and more. Offers comprehensive and expert coverage of both inpatient and outpatient primary TKA, now fully revised with new chapters on Patient Considerations, Modifications, Optimizing the Important Comorbidities, TKA Balancing, and more. Addresses key issues of patient optimization such as obesity, diabetes, heart disease, rheumatoid arthritis, and peripheral vascular disease. Provides evidence for TKA outcomes and complications: “What do I tell my patient? Focuses on the latest and best techniques and surgical approaches, including computer and robotic assisted surgery, uncemented TKA, assessing and planning for the difficult TKA, outpatient TKA considerations, and preventing readmissions post-surgery. Discusses how to handle all deformity aspects of the lower extremity, bone defects, and ligamentous insufficiency during surgery. Includes numerous illustrations, line art, radiographs, and clinical photos for optimal visualization of each procedure.
Deformity Correction In Total Knee Arthroplasty
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Author : Arun B. Mullaji
language : en
Publisher: Springer
Release Date : 2014-05-07
Deformity Correction In Total Knee Arthroplasty written by Arun B. Mullaji and has been published by Springer this book supported file pdf, txt, epub, kindle and other format this book has been release on 2014-05-07 with Medical categories.
With rapid advancement in technology and materials in total knee arthroplasty (TKA), long-term survival and function of the total knee is now more and more dependent on restoring accurate limb alignment, precise component position and optimum soft-tissue balance. Proper technique is key to ensuring this and is all the more crucial and challenging to achieve in arthritic knees with severe and complex deformities. Correction of such knee deformities forms an important part of TKA for orthopedic surgeons working in both emerging and developed nations. Deformity Correction in Total Knee Arthroplasty fills the void that exists in treating severe and complex knee deformities and the use of computer-navigation in TKA. It covers the principles of deformity correction and soft-tissue balancing in primary TKA in an illustrative, step-wise and algorithmic fashion. Starting with the initial key step of preoperative planning, this book goes on to specifically describe how to deal with different types of deformities encountered in patients who undergo TKA - varus, valgus, flexion, hypertension, rotational and extra-articular deformities - as well as the stiff knee, the unstable knee, osteotomies in primary TKA and postoperative pain management and rehabilitation. This focused how-to manual includes plentiful images and clear, concise text from authors who have performed thousands of TKAs, making it a must-have reference for any surgeon unfamiliar or frequently confronted with this type of procedure.
Total Knee Arthroplasty Exposures And Soft Tissue Balancing
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Author : John N. Insall
language : en
Publisher:
Release Date : 1994-07-01
Total Knee Arthroplasty Exposures And Soft Tissue Balancing written by John N. Insall and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1994-07-01 with categories.
(Producer) This video presents the latest arthroscopic and joint replacement procedures performed by top orthopaedic surgeons. This six-volume set offers a compelling first hand view of advanced techniques. For each procedure, the surgeons review the rationale, indications and contraindications, surgical exposures and technique and point out how to avoid pitfalls and complications. Innovative technical tips are highlighed throughout. These volumes provide valuable advice and expert consultation as you prepare for your difficult cases.
Sensor Guided Total Knee Arthroplasty May Improve Early Pain And Function Outcomes
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Author : Patricia Franklin
language : en
Publisher:
Release Date : 2017
Sensor Guided Total Knee Arthroplasty May Improve Early Pain And Function Outcomes written by Patricia Franklin and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2017 with categories.
INTRODUCTION: Intraoperative ligament and soft tissue balancing during total knee arthroplasty (TKA) has a well-demonstrated role in establishing knee stability, improving limb alignment, and preventing implant loosening; therefore, appropriate soft tissue balancing is important for primary TKA success and avoiding revision surgery. The goal of ligament balancing is to reverse the soft tissue changes secondary to the bony deformities characteristic of arthritic changes; however, the evaluation of u201cbalanceu201d intraoperatively remains largely subjective, and therefore prone to variation. Sensor-guided soft tissue balancing is a recent development in TKA, and current literature has not established a strong connection between sensor-guided tissue balancing and improved patient reported knee-specific function, pain relief, and TKA longevity. This feasibility study explores the use of sensor-guided technology for soft tissue balancing in primary knee replacement, investigating first whether the sensors demonstrate a need for further soft tissue work, and second how patients with sensor-guided TKA perform in the early post-operative period with regard to clinical knee performance functional testing and patient reported pain when compared to patients whose knees were balanced by traditional methods.METHODS: The sensor group consisted of patients that underwent sensor-guided primary TKA with a single surgeon, as identified by retrospective chart review. The control group in this sequential series contained consecutive patients who underwent primary TKA with the same surgeon immediately prior to the sensor-guided cohort. The sensor (Versasense by Orthosensor) takes the form of a tibial trial component with microprocessor sensors that wirelessly transmit data to a monitor intra-operatively. It measures the medial and lateral compartment pressures (lbf.), tibiofemoral rotation, and the point of contact (Figure 1). After completion of the femoral and tibial bone cuts during TKA, the surgeon assessed soft tissue balancing and made surgical modifications as necessary. The surgeon then placed the femoral and tibial trial, and inserted the sensor into the tibial tray in lieu of a polyethylene trial. The knee was then guided through the range of motion as the sensor wirelessly transmitted loading pressure readings to the monitor. Data was relayed to the monitor in real-time during the full knee range of motion, and initial measurements were recorded at 10u00b0, 45u00b0, and 90u00b0 of flexion for each patient. The sensor designers defined the goal range of pressures as u201cgreenu201d at 5-40 lbf., moderately high pressures as u201cyellowu201d at 41-70 lbf., and high-pressures as u201credu201d over 70 lbf.. The surgeon used these guidelines and initial pressure values to inform further soft tissue modification, after which the sensor was inserted again to record the definitive pressures (Figure 2). Early post-operative function was measured for both groups using the Timed Up and Go (TUG) test, during which a patient stood from seated, walked ten feet, then returned to sit in the chair. The TUG test was completed at the last physical therapy session immediately prior to a TKA patientu2019s discharge, typically on post-operative day two. Patient-reported pain scores were also recorded at this session, based on the Wong-Baker 0-10 scale. Data was analyzed for differences between the sensor and control groupsu2019 TUG and pain scores, and for differences between the initial and definitive sensor measurements. Two-tailed student t-tests assuming unequal variance were conducted to determine if differences were statistically significant. Institutional Review Board approval was obtained for this study.RESULTS: 60 patients total were enrolled in the study, 36 in the sensor group and 24 controls. Within the sensor group, 14 patients began with an initial reading in the Red zone, 10 in the Yellow, and 8 began in the Green. After balancing, 2 patients were in the Red, 17 in Yellow and 15 in Green (Figure 3). The average absolute sensor pressure reading during the initial measurement was 30.20 lbf. (SD 18.61), compared to a lower average pressure reading of 24.30 lbf. (SD 8.53) in the definitive measurement. This average decrease of 5.90 lbf. in absolute pressures between initial and definitive measurements was found to be statistically significant (p = 0.000479). In comparing the TUG scores, the sensor group had an average TUG of 40.54 seconds (SD 20.75), which was significantly faster than the control groupu2019s mean TUG of 53.50 seconds (SD 23.60, p = 0.04711). Additionally, the sensor group reported an average pain level of 4.44 (SD 2.02) immediately prior to discharge, lower than the average pain level of 6.00 (SD 1.54) reported by the control patients (p=0.00171).DISCUSSION: This feasibility cohort study aims to determine whether sensor use in TKA may reliably guide soft tissue balancing, and whether this new technology is associated with improvements in early clinical outcomes. After preliminary balancing, the sensor detected that 24 patients had high contact pressures in the Red or Yellow categories, with an average pressure of 30.2 lbf. and a standard deviation of 18.61, demonstrating high variability in initial compartment pressures. After further soft tissue modification, only two patients had Red readings, the mean pressure was decreased to 24.30 lbf., and the standard deviation was reduced to 8.53 lbf., indicating a closer grouping of absolute pressures after sensor-guided balancing. The significant difference between initial and definitive trial pressures suggests the sensor readings do inform the surgeon in a way that allows them to make measurable changes in tissue balancing, and the closer distribution of final pressures indicates improved consistency of balancing with sensor use. Compared to the control group, the sensor group also had significantly faster TUG times and significantly less reported pain prior to discharge, suggesting sensor use improves early postoperative function and pain outcomes. SIGNIFICANCE/CLINICAL RELEVANCE: This feasibility cohort demonstrates that sensor trials can inform surgeon balancing associated with significant changes in absolute joint pressures, and also suggests patients with sensor-guided TKA have improved early post-operative pain and function outcomes, which may set them on a trajectory for better long-term outcomes and lower revision rates than patients without sensor-guided TKA. These preliminary data serve as the foundation for a larger pilot study exploring the long-term patient reported outcomes at 3, 6, and 12 months after sensor-guided balancing.