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.

This comprehensive reference on total knee arthroplasty describes all surgical techniques and prosthetic designs for primary and revision arthroplasty, discusses every aspect of patient selection, preoperative planning, and intraoperative and postoperative care.

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.

This open access book describes and illustrates the surgical techniques, implants, and technologies used for the purpose of personalized implantation of hip and knee components. This new and flourishing treatment philosophy offers important benefits over conventional systematic techniques, including component positioning appropriate to individual anatomy, improved surgical reproducibility and prosthetic performance, and a reduction in complications. The techniques described in the book aim to reproduce patients’ native anatomy and physiological joint laxity, thereby improving the prosthetic hip/knee kinematics and functional outcomes in the quest of the forgotten joint. They include kinematically aligned total knee/total hip arthroplasty, partial knee replacement, and hip resurfacing. The relevance of available and emerging technological tools for these personalized approaches is also explained, with coverage of, for example, robotics, computer-assisted surgery, and augmented reality. Contributions from surgeons who are considered world leaders in diverse fields of this novel surgical philosophy make this open access book will invaluable to a wide readership, from trainees at all levels to consultants practicing lower limb surgery

Evidence-Based Orthopedics is an up-to-date review of the best evidence for the diagnosis, management, and treatment of orthopedic conditions. Covering orthopedic surgery as well as pre- and post-operative complications, this comprehensive guide provides recommendations for implementing evidence-based practice in the clinical setting. Chapters written by leading clinicians and researchers in the field are supported by tables of evidence that summarize systematic reviews and randomized controlled trials. In areas where evidence is insufficient to recommend a practice, summaries of the available research are provided to assist in decision-making. This fully revised new edition reflects the most recent evidence using the approved evidence-based medicine (EBM) guidelines and methodology. The text now places greater emphasis on GRADE—a transparent framework for developing and presenting summaries of evidence—to allow readers to easily evaluate the quality of evidence and the strength of recommendations. The second edition offers a streamlined presentation and an improved standardized format emphasizing how evidence in each chapter directly affects clinical decisions. Incorporating a vast amount of new evidence, Evidence-Based Orthopedics: Features thoroughly revised and updated content, including a new chapter on pediatric orthopedics and new X-ray images Provides the evidence base for orthopedic surgery as well as pediatric orthopedics and orthopedic conditions requiring medical treatment Covers the different methods for most orthopedic surgical procedures, such as hip replacements, arthroscopy, and knee replacements Helps surgeons and orthopedic specialists achieve a uniform optimum standard through a condition-based approach Aligns with internationally accepted guidelines and best health economic principles Evidence-Based Orthopedics is an invaluable resource for orthopedic specialists, surgeons, trauma surgeons, trainees, and medical students.

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.

Early in its development, the subject matter of any field of surgery is too ill-defined and opinions are too fluid for the production of a book on the subject to be possible. Late in its development, controversy is at an end, and although it is still possible to produce a textbook, it is too late to produce a book that might stimulate discussion and crystallise ideas. This book has that objective, it being the Editor's view that the field of the surgical treatment of arthritis of the knee had reached an appropriate intermediate stage in 1978 when this text was written. Three broad issues stand out as being in need of resolution before the optimum form of surgical treatment for a given knee can be defined more convincingly than is possible at present: Firstly: What symptomatic and physical features of the knee are to be recorded pre- and post-operatively, upon the basis of which comparisons can be made between the results obtained by two different surgeons or with two different tech niques. The resolution of this issue requires general agreement not only upon what features of the knee should be recorded but, crucially, upon how these features should subsequently be presented so as to characterise a particular group of knees.

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.

Built on a solid foundation of basic anatomy, pathology, and diagnostic techniques, this best-selling reference offers comprehensive coverage of value to anyone involved in the diagnosis and treatment of knee disorders. JBJS considered the previous edition" ... destined to become a classic in the field ... [providing] exposure to the type of expert insight that, up to now, was available only to those undertaking postgraduate fellowship training in knee surgery ..." Covers the clinical and basic science aspects of the full range of knee surgeries, including normal and abnormal anatomy. Provides the latest information in all areas of relevance to knee surgery, such as imaging and biomechanics soft tissue cartilage ligament/meniscal repair and reconstructions joint replacement fractures tumors and the arthritic knee. Written by a veteran author and noted, internationally recognized authority on knee surgery and sports medicine

This book addresses the need for improved diagnostic and treatment guidelines for patients in whom total knee arthroplasty (TKA) has had an unsatisfactory outcome. It opens by discussing the basics of TKA and the various causes of failure and pain. Diagnostic aspects are considered in detail, with attention to advances in clinical investigation, laboratory analysis and in particular, imaging techniques. In addition, helpful state of the art diagnostic algorithms are presented. Specific pathology-related treatment options, including conservative approaches and salvage and revision TKA strategies, are then explained, with identification of pitfalls and key points. A series of illustrative cases cover clinical scenarios frequently encountered in daily clinical practice. The evidence-based, clinically focused guidance provided in this book, written by internationally renowned experts, will assist surgeons in achieving the most effective management of these challenging cases.