Knee Surgery Ashok Rajgopal
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1KNEE SURGERY2
3KNEE SURGERY
Ashok Rajgopal MS MCh FRCS Chairman Medanta Bone and Joint Institute Medanta—The Medicity Gurgaon, Haryana, India Forewords Kim C Bertin Chitranjan S Ranawat
4
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Knee Surgery
First Edition: 2014
9789351522256
Printed at
5Dedicated to
The Joy of Walking6
7CONTRIBUTORS 11FOREWORD
Treatment of disorders of the knee has become the most commonly performed group procedures for the practicing orthopedic surgeons. Presently, there are almost over one million knee replacements and more than two million knee arthroscopic procedures performed in the world every year. This book is a timeless resource for the practicing orthopedic surgeons to understand and master these two procedures.
This book of Knee Surgery comprehensively handles the state-of-the-art knee replacement. The readers will be exposed to every essential aspect of knee replacement surgery. Single compartment replacement, through total knee replacement, is thoughtfully addressed. In a unique way, the readers will understand the advantages and disadvantages of different techniques and current options in knee arthroplasty.
This book also addresses most common arthroscopic interventions. The chapters begin with anatomy and examination and proceed through more difficult and complex topics of posterior cruciate ligament (PCL) and posterolateral corner reconstruction. Each chapter is well-written and the illustrations help clearly convey the authors' intended message.
The assembled contributors are established experts in their respective fields and have written authoritative chapters sharing their expertise. The chapters are well-designed to build on each other and construct a solid foundation of knowledge for treating a wide variety of knee problems. The experienced surgeon and the novice alike will appreciate the book as each seeks to better his skill. The clinical utility of the book is made evident by the inclusive discussion on anesthesia, postoperative pain management and rehabilitation of the knee.
As a student of knee surgery for over three decades, I would compliment the contributors and strongly recommend the book to the residents and surgeons for increasing their understandings of knee pathology and treatment.
Kim C Bertin md
Orthopedic Surgeon
Utah Bone and Joint Center
5323, Woodrow Street
Suite-202
Salt Lake City
Utah, USA12
13FOREWORD
Ashok Rajgopal has invited various authors who are experts in the field of knee surgery. Many of these authors have extensive publication expertise in their respective specialties.
Knee Surgery covers topics on total knee surgery and sports medicine which are of current interest, some of which deal with controversial issues. These include management of major and minor cartilage defects, meniscal transplant, tibial osteotomy and isolated patellar femoral replacement.
Looking towards the future, the book offers many insightful points of view on custom-jig, robotic surgery, pain control, patient satisfaction, early diagnosis of infection and noncemented fixation.
It is with great pleasure and honor that I write the foreword for this multi-authored book on surgery of the knee, which I strongly recommend for postgraduates, practicing orthopedic surgeons and individuals interested in research.
Chitranjan S Ranawat md
Orthopedic Surgeon
535, East 70th Street
6th Floor
Hospital for Special Surgery
New York, USA14
15PREFACE
The field of orthopedics, especially that of the knee, has evolved over the years. Our understanding of the kinematics and biomechanics of the knee has evolved by leaps and bounds in recent years. Better understanding of the knee biomechanics is leading to design changes at a very fast pace. While certain concepts, which were thought to be flawed earlier, are the gold standards today, others are open to debate. To retain or sacrifice the posterior cruciate ligament, fixed or mobile-bearing surfaces, cemented or uncemented are all issues which have still not seen a conclusive end. Computer navigation, patient-specific instrumentation and robotics are all emerging concepts. Wear pattern analysis and newer technology have led to the introduction of highly crosslinked polyethylene and ceramics that were previously unknown.
Anatomic reconstruction of the anterior cruciate ligament (ACL) has, today, replaced the transtibial ACL reconstruction. Open ligament reconstructions are a thing of the past era.
Encouraged by my peers and friends, I undertook to put together in Knee Surgery. As I embarked on this endeavor, the enormity of this gratifying and enriching challenge dawned upon me.
The book focuses on total knee replacement and arthroscopy of the knee. It represents present-day concepts, on various aspects of knee surgery, sports medicine and biomechanics. It also represents current issues such as recent advances and evolving technology. The book is intended to be a reference guide for orthopedic surgeons with abundant pictorial contents and an atlas on MRI images and arthroscopic appearances of normal and pathological situations.
Contributors, renowned in the similar field, have unhesitatingly made the time and effort to write the chapters. Each of them is an expert in his respective field, with extensive personal contributions in peer-reviewed journals, enhancing the art and science of knee surgery. Each chapter in the book goes beyond the present available literature, incorporating new thoughts and ideas based on the knowledge and experience of years by the contributors to provide a clear thought process to the reader. I would like to express my gratitude for their contribution.
I would also like to acknowledge the tremendous help from my own group and friends for their constant encouragement during the innumerable hours spent in putting the book together. A special word of thanks to Drs Attique Vasdev, Vivek Dahiya and Puneet Puri for burning the midnight oil with me. I would also like to acknowledge my patients without whom my journey of knee surgery, over the years, would not have been possible. Finally, a grateful appreciation to my family, who put up with my long hours devoted to the compilation of the book.
Ashok Rajgopal16
17ACKNOWLEDGMENTS
An acknowledgment to the people who impacted my career: