Soft Tissue Balancing in Total Knee Arthroplasty 1st edition by Shuichi Matsuda, Sébastien Lustig, Willem van der Merwe – Ebook PDF Instant Download/Delivery: 3662540819 , 978-3662540817
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ISBN 10: 3662540819
ISBN 13: 978-3662540817
Author: Shuichi Matsuda, Sébastien Lustig, Willem van der Merwe
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 Total Knee Arthroplasty 1st Table of contents:
Part I: Native Knee
1: Anatomy and Biomechanics of the Native Knee and Its Relevance for Total Knee Replacement
1.1 Introduction
1.2 Anterior Cruciate Ligament
1.3 Posterior Cruciate Ligament
1.4 Posterolateral Corner
1.5 Medial/Posteromedial Structures
1.6 Conclusions and Future Perspectives
References
2: Soft Tissue Balance of the Native Knee Provides Guidance for Balancing a Total Knee Arthropla
2.1 Definition of Soft Tissue Balance
2.2 The Laxities of the Native Knee: A Measure of Soft Tissue Balance
2.3 Using the Soft Tissue Balance of the Native Knee to Guide Balancing During TKA
2.4 Potential Consequences of Not Restoring Native Soft Tissue Balance
2.5 Summary
References
3: Kinematics of the Normal Native Knee
3.1 Introduction
3.2 Why Should We, Orthopaedic Surgeons, Bother with Kinematics?
3.3 Historic Insights in Tibiofemoral Kinematics
3.4 Why Do Kinematic Descriptions of the Knee Vary So Much?
3.5 The Influence of Load on Tibiofemoral Kinematics
References
Part II: Operative Procedure 1: Primary TKA
4: Primary Principles in Soft Tissue Balancing
References
5: Measured (Anatomical Reference) Resection Technique for Cruciate-Retaining Total Knee Arthropl
5.1 Introduction
5.2 Exposure and Resection of Osteophytes
5.3 Preparation of the Femur
5.3.1 Determining the Rotational Alignment of the Femoral Component
5.3.2 Sizing the Femoral Component by Anterior Reference
5.4 Preparation of the Tibia
5.4.1 Posterior Tibial Slope and PCL Preservation
5.4.2 Adjusting the Flexion-Extension and Medial-Lateral Gaps
5.4.3 V-Shaped Osteotomy with Cancellous Bone Graft (VOCG) for PCL Release
5.5 Fixation of the Components
5.6 Drain and Wound Closure
References
6: PS: Gap Technique
6.1 Operative Procedure: Flexion Gap First (Gap Technique)
6.2 Operative Procedure: Extension Gap First (Modified Gap Technique)
References
7: Bicruciate-Retaining TKA: How to Achieve Near-Normal Kinematics
7.1 Theory of Joint Reconstruction
7.2 History of Bicruciate-Retaining TKA
7.3 Results
7.4 Contemporary Bicruciate Retaining TKA
7.5 How Would BCR TKA Be Used?
7.6 Summary
References
8: Five Quality Assurance Steps for Balancing a Kinematically Aligned Total Knee Arthroplasty
8.1 Overview
8.2 Goal One: Restore the Native Tibial-Femoral Articular Surfaces
8.3 Goal Two: Restore the Native Knee and Limb Alignments
8.4 Goal Three: Restore the Native Laxities of the Knee
8.5 Technique for Kinematically Aligning the Femoral Component to the Native Articular Surface
8.6 Technique for Kinematically Aligning the Tibial Component to the Native Articular Surface
8.7 Balancing the Kinematically Aligned Total Knee Arthroplasty
8.8 Examples of Severe Varus and Valgus Deformity Treated with Kinematically Aligned Total Knee
8.9 Summary
References
Part III: Operative Procedure 2: Primary TKA
9: Operative Procedure: Varus Knee
9.1 Introduction
9.2 Step 1: Cruciate Retaining (CR) or Posterior Stabilized (PS)
9.3 Step 2: Osteophytes
9.4 Step 3: Superficial Medial Collateral Ligament
9.5 Step 4: Posterior Oblique Ligament
9.6 Step 5: Semimembranosus (SM)
9.7 Step 6: Pes Anserinus, Medial Epicondyle Osteotomy, Medial Tibial Plateau Resection, and Later
9.8 Recent Evidence
References
10: Valgus Knee: Severe Cases Included
10.1 Introduction
10.2 Valgus Knee Deformity
10.3 Anatomy of the Lateral Compartment of the Knee
10.4 Radiological Assessment of the Arthritic Valgus Knee
10.5 General Considerations in TKA Management in Valgus Knee
10.6 Approach Choice
10.6.1 Medial Approach
10.6.2 Lateral Approach
10.7 Bone Cut Management in Valgus Knee
10.8 Patella Management
10.9 Ligament Balancing and Matching of Bone Cuts
10.10 Type of Implants Used in Complex Valgus TKA
10.10.1 TKA in Major Valgus Knee
10.10.2 TKA After High Tibial Osteotomy
References
11: Complicated Cases: Recurvatum and Severe Contracture
11.1 Introduction
11.2 Severe Contracture
11.2.1 Surgical Technique
11.2.2 Postoperative Regimen
11.2.3 Results
11.3 Recurvatum
11.3.1 Surgical Technique
11.3.2 Results
References
12: Operative Procedure for Primary TKR: How to Increase ROM
12.1 Introduction
12.2 Factors Affecting Knee Flexion
12.3 Quadriceps Muscle Release (The Forgotten Release)
12.4 Surgical Technique
12.5 Results of Quadriceps Release
12.6 Discussion
References
Part IV: Assessment in Primary TKA
13: Assessment in Primary TKA: Intraoperative Assessment Tensor
13.1 Introduction
13.2 Traditional Soft Tissue Balance Assessment
13.3 Soft Tissue Balance Assessment with an Offset-Type Tensor
13.3.1 Design and Parameters
13.3.2 Soft Tissue Balance with a Reduced PF Joint
13.3.3 Soft Tissue Balance with Femoral Component Placement
13.4 Different Patterns of Soft Tissue Balance in Specified Conditions
13.4.1 Soft Tissue Balance in CR and PS TKA
13.4.2 Soft Tissue Balance in Minimal Incision Surgery TKA
13.4.3 Soft Tissue Balance in Gap Technique
13.5 Clinical Relevance of Intraoperative Soft Tissue Balance Assessment
13.6 Perspective
References
14: Intraoperative Assessment with Computer Navigation
14.1 Introduction
14.2 Ligament Balancing in TKR
14.2.1 Gap-Balancing Technique
14.2.2 Measured Resection Technique
14.3 Measured Resection with CAS
14.3.1 Surgical Technique
14.3.2 Outcomes
14.4 Summary
References
Part V: Clinical Relevance: Primary TKA
15: Postoperative Changes in Soft Tissue Balance
15.1 Introduction
15.2 Classical Concept of Ideal Soft Tissue Balancing in TKA
15.3 Intraoperative Soft Tissue Balance in TKA
15.4 Soft Tissue Balance in TKA Over the Long Term
15.5 Possibility of Postoperative Change in Soft Tissue Balance in TKA
15.6 Postoperative Change in Soft Tissue Balance in Varus-Deformed Knees
15.7 Postoperative Change in Soft Tissue Balance in Valgus-Deformed Knees
15.8 Postoperative Change in Soft Tissue Balance in Flexion
15.9 Influence of Anesthesia on Measurement of Coronal Laxity
15.10 Factors for Spontaneous Correction of Soft Tissue Balance After TKA
15.11 Future Directions
References
16: Intraoperative Soft-Tissue Balance and Clinical Results (ROM, Function)
16.1 Introduction
16.2 Flexion and Extension Gap Balancing
16.3 Mediolateral Gap Balancing
16.3.1 Medial Release
16.3.2 Lateral Release
16.3.3 Intraoperative Mediolateral Gap Check Device
16.4 Patellofemoral Balancing
16.5 Summary
References
17: Soft Tissue Balance, Kinematics, and Patient Satisfaction
17.1 Intraoperative Soft Tissue Balance and Patient Symptoms
17.1.1 Extension Gap
17.1.2 Flexion Gap
17.1.3 Medial-Lateral Balancing
17.1.3.1 In Knee Extension
17.1.3.2 Knee Flexion
17.2 Soft Tissue Balance and Kinematics
17.3 Knee Kinematics and Clinical Results, Including Patient Satisfaction
17.4 Summary
References
Part VI: Patella
18: Surgical Techniques to Avoid Patellar Maltracking in Total Knee Arthroplasty
18.1 Simplified Mechanics of Patellar Tracking
18.2 What Is Tracking?
18.3 Orientation of the Extensor: A Dynamic Structure
18.4 The Trochlear Track
18.5 Maltracking
18.6 Tracking Is Difficult Because of Valgus Knee Alignment
18.7 What Are the Forces on the Patella?
18.8 Rotational Mechanisms that Centralize the Native Patella
18.9 Arthroplasty Component Positioning to Avoid Maltracking
18.9.1 Depicting Component Position
18.9.2 Position of the Femoral Component
18.9.2.1 Mechanical Axis Implications
18.9.2.2 Knee Alignment Options: Classic Versus Anatomic
18.9.2.3 Femur Rotation Around the “z” Axis: Varus-Valgus Alignment
18.9.2.4 Femoral Component Translation Along the “x” Axis: Medial-Lateral Position
18.9.2.5 Femur Rotation Around the “y” Axis: Internal-External Rotation
18.9.2.6 Femoral Component Position Summary: What Works and What Does Not
18.9.3 Position of the Tibial Component
18.9.4 Patella
18.9.5 Surgical Approach and Lateral Patellar Retinacular Release
References
Part VII: Trouble Shooting
19: Trouble Shooting: Intraoperative MCL Injury
19.1 Introduction
19.2 Lesion Type and Cause
19.3 Intraoperative Findings
19.4 Treatment Types
19.5 Tips to Prevent Iatrogenic MCL Injury
References
20: Extensor Mechanism Rupture
20.1 Introduction
20.2 Brief Anatomy
20.3 Risk Factors
20.4 Diagnosis
20.5 Management of Extensor Mechanism Injury
20.5.1 Direct Repair
20.5.2 Soft Tissue Augmentation
20.5.3 Synthetic Material Augmentation
20.5.4 Autograft Reconstruction
20.5.5 Allograft Reconstruction
20.6 Intraoperative and Postoperative Rehabilitation
20.7 Repair, Reconstruction, and Rehabilitation Guidelines
20.7.1 Guidelines for Treatment Strategies [42]
References
Index
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Tags: Shuichi Matsuda, Sébastien Lustig, Willem van der Merwe, Soft Tissue, Knee Arthroplasty