A Practical Operative Guide for Total Knee and Hip Replacement

Written by authors who have performed more than 800 total knee and hip replacement surgeries, this full-color book offers step-by-step guidance on this type of procedure Hip and knee replacement surgery can improve the quality of life significantly in a wide variety of conditions and disorders, but total knee and hip replacement surgeries are special operations. The surgeons require the highest order of aseptic precaution, surgical skill, and a team of specialists in preoperative, perioperative, and postoperative techniques and protocols. This book fully explains step-by-step procedures and precautions to be observed in undertaking this kind of surgery. Full-color photographs and a DVD of surgical procedures enhance the book's usefulness. Ajit Kumar Mehta, MBBS, D Ortho, MS (Ortho), is Consultant Orthopedic Surgeon, Orthopedic and Joint Replacement Centre, Jagjivan Ram Hospital, Mumbai, India Contents Chapter 1 Introduction  History and clinical examination 1  Investigations 2  Physiotherapy, education and training 3  Consent for surgery 3  Patient and relative?s signature for risk/benefit ratio 4  Preoperative planning for TKR 4  Arrangement of neurovascular structures around the knee 6  Blood supply to the knee 6  Preparation of the patient for surgery and arranging blood 7 Chapter 2 Total Knee Replacement (Cruciate-Substituting Fixed Bearing TKR) 8  Tourniquet application 8  Positioning 8  Scrubbing 8  Draping 9  Incision 10  Tibial cut 11  Femoral cuts 12  Resurfacing of patella 21  Tibial preparation 23  Cementing 24  Application of tibial insert 27  Wound closure 28  Postoperative advice 28  Follow-up schedule 34  Assessment during follow-up 34 Chapter 3 Difficult Situations and Important Points 36  Total knee replacement (TKR) in difficult situations 36  Post HTO TKR 45  Important points 49  Take care of (precautions to prevent peroperative complications) 52  Avoid silly mistake 53  Contraindications of TKR 53  Ideal indicated patients for successful TKR 53  Complications 53  Implants and cement required for primary TKR 54  Summary of TKR (steps in sequence) 55  Instruments required for TKR 56 Chapter 4 Rotating Platform High Flexed TKR (RPF) 59  Fixed bearing versus mobile bearing TKR (RPF) 59  Instruments required for RPF TKR 63 Chapter 5 Management of Complications after TKR 64  Periprosthetic fracture 64  Infection 66  Knee arthrodesis with LRS in cases of infected TKR 71  Aseptic loosening 75  Revision TKR 76  Implants required for revision TKR 86  Instruments required for revision TKR 87 Chapter 6 OT Setup for Joint Replacement Surgery 89  Introduction 89  Vertical laminar flow ventilation 90  Prevention of infection 91 Chapter 7 Total Hip Replacement 92  Preoperative planning 92  Positioning ? Lateral position 101  Draping 102  Posterior approach 103  Cemented THR (C-stem) 104  Instruments required for cemented THR (C-stem) 110  Features of triple taper C-stem 111  Bone cements 112  Uncemented THR (Summit stem) 115  Combinations in hip replacement 123  Assessment during follow-up 128  Instruments required for uncemented THR (Summit stem) 130  Implants and cement required for cemented THR (C-stem) 131  Implants required for uncemented THR (Summit stem) 131  Implants required for metal on metal, Articulating surface replacement (ASR) 132  Instruments required for metal on metal, ASR and Pinnacle 133  Implants for metal on metal or ceramic on ceramic, Pinnacle cup and head 134  Different measurements of femoral stem 134  Features of summit tapered hip system 135  Important points 136  Summary of THR (Steps in sequence for cemented and uncemented) 143  Proxima hip 144  Proxima instruments 147  Proxima implants 147 Chapter 8 Patient's Guide to Arthritis and Joint Replacement 148 Chapter 9 High Tibial Osteotomy by Hemicallotasis Using a Dynamic Axial Fixator 151 Bibliography 171 Index 175