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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.
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.
Written in an accessible and instructive format, this richly illustrated text covers the analysis, planning, and treatment of lower limb deformities, with a view to teaching deformity correction. A foundation of understanding normal alignment is presented, using new nomenclature that is easy to remember and can even be derived without memorization. The work offers detailed information on deformities and malalignment, radiographic assessment, mechanical and anatomic axis planning, osteotomies, and hardware considerations. The part dealing with planning is further facilitated via an exercise workbook and an animated CD-ROM which is available separately. The methods taught are simple and intuitive.
"Take away my knee pain and give me better motion." This is what the arthritic patient expects from a Total Knee Arthroplasty (TKA). By virtue of standardization of the TKA procedure, surgeons can nowadays solve the pain issue for the majority of the patients. Restoration of function is a goal of a different order and forms the scope of this book. The editors confronted today's leading knee surgeons with the limitations of current surgical techniques and technology. They challenged them to define new thresholds of functional capacity after Total Knee Arthroplasty. "A Guide to Get Better Performance in TKA" describes the cutting edge in surgical techniques, prosthetic design and achievement of excellent function for these patients.
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.
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.

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