Comprehensive Guide in Knee and Hip Arthroplasty: Asia-Pacific Arthroplasty Society—Delta Compendium Parag Sancheti, Ashok Shyam, Rami Sorial, Sunny S Gugale
INDEX
Page numbers followed by b refer to box, f refer to figure, and t refer to table
A
Abductor lever arm 305
Abductor muscle 355
lever arm 27
produce equal forces 26f
Abductor musculature 27
Above knee amputation 481, 457
Abrasion 64
Accurate bone resection 129
Accurate gap balancing 177
Acetabular bone
defects 407
loss 409t
Paprosky classification for 409t
Acetabular cage, large 411f
Acetabular component 342, 399, 407, 408f
size of 57
Acetabular cup 359
inferior portion of 309f
location 349
loosening 432f
oversizing of 345
reaming of 287f
Acetabular defects 306f, 408, 425, 426f, 430f, 432f, 436f
classification of 426
evaluation 426f
management of 428
Paprosky classification of 409f
Acetabular deficiency 425
Acetabular erosion 392, 394
progressive 386
Acetabular failure, revision of 438
Acetabular fixation screws, number of 407
Acetabular fracture 310, 397, 400f, 438
delayed management of 397
fixation 401f
Acetabular implant choice 349
Acetabular loosening 423
Acetabular preparation 398
Acetabular pressurizer 34f
Acetabular protrusio 301
Acetabular reaming 399
Acetabular reconstruction 349, 356
Acetabular screws, safe placement of 12
Acetabular shell design 467
Acetabular targeting device 380f
Acetabular teardrop 426f
Acetabulum 12, 33, 305, 305f, 309f
anatomic position of 298f
cemented 318
different center of rotation of 304f
lower portion of 309f
medialization of 13
old fracture of 310f
triradiate fracture of 439f
Achieve rigid prosthetic fixation 441
Achilles tendon 277
allograft 181, 183, 183f
Acid-fast bacilli 488
Acinetobacter 452
Acute coronary syndrome 76
Additional bony procedures 67
Adductor brevis 15, 305
Adductor canal 8
Adductor gracilis 15
Adductor longus 15, 305
Adductor magnus 15, 305
Adductor pectineus 15
Adjacent lateral intermuscular septum 117
Adverse local tissue reactions 517
Akagi's line 103
Allergic reactions 494
Allograft reconstruction 183
All-polyethylene
patellar components 80
tibial component 212f
Altered hip center 300f
Alumina 40
matrix composite 41, 41t, 46
on-alumina 41, 55
American Academy of Orthopaedic Surgeons 73, 408, 441, 452, 486, 492
Classification 409t, 410f, 426, 435, 442f
American College of Chest Physicians 73
Guidelines 391
Amoxicillin 495
Amputation 481
Anatomic allograft-prosthesis composite 450
Anderson Orthopedic Research Institute 256, 256f, 257, 258, 267, 509
Classification 256t, 268f, 269
Angiography 425
Angular deformity 68, 147
Ankle, transmalleolar axis of 103
Ankylosing spondylitis 388
Anterior column screw 439f
Anterior compartment musculature 120
Anterior cruciate ligament 19, 101, 160, 200, 204f, 214, 226, 227
deficiency 200
Anterior knee soft tissue, vascular supply of 5, 7
Anteromedial tibia 203
Anteroposterior axis 101, 125
Anteroposterior cuts 133
Antibiotic 30, 497
bone cement 494b
pharmacokinetics 492
postoperative 511
prophylactic 510
prophylaxis 492
suppression 477
therapy selection 493
Antifibrinolytic agent 198
Antimicrobial prophylaxis 30
Antioxidant 65
polyethylene, large diameter 369f
Antiprotrusio cages 433f
Antiseptics 497
Apixaban 75
Arcuate complex 119
Arcuate ligament 10, 67, 117
Arteriogram, intraoperative 6
Artery distance 5
Arthritic joint 293
Arthritic knee 19
cases of 68
Arthritis
bicompartmental 229
inflammatory 117
post-traumatic 397
Arthrodesis 427, 444, 480
complication of 457
Arthrofibrosis 148, 239
Arthropathy, inflammatory 179, 200
Arthroplasty 30, 39, 46, 102, 179, 477, 480
bipolar 394
revision of 409t, 412t, 425
science of 1
surgeries, number of 76
Arthroscopic chondroplasty, use of 187
Arthrotomy 215
Articular capsule 14
Articular cartilage 19
assessment of 215
conformity 19
grafting 187
Articular geometry 19
Articular surface replacement 59
Articulating hip spacer, femoral part of 504f
Aseptic failure 447
Aseptic loosening 201, 239, 393, 405, 466
influence development of 421f
Aseptic lymphocyte-dominated vasculitis-associated lesion 43, 50, 59, 421
Aspirin 74
Aufranc retractor 288
Augmented patella skyline view 184f
Austin-Moore device 386
Austin-Moore prosthesis 386, 393
proximal migration of 386
Australian National Joint Replacement Registry 405, 461
Australian Orthopaedic Association National Joint Replacement Registry 59, 188, 461
Autologous bone 112
Autologous hamstring graft 278f
Avascular necrosis 239, 390
head femur 388, 389
B
Balanced flexion-extension gap 260
Balanced knee after
bumpectomy 95f
pie-crusting 95f
Ball-and-socket designs 163
Banana peel method 238
Barium sulfate 30
Bearing dislocation 155, 156f
Bearing surfaces 38
articulation 42
Benzoyl peroxide 30
Biceps femoris 10, 131
Bicolumnar construct posterior plate 439f
Bicondylar roll-back 160
Bicortical screw 167
Bigelow, ligament of 14
Bimodal modular stems 448f
Biolox-4™ delta, constituent of 41t
Biomet ceramic femoral head 369f
Bipolar head, intraprosthetic dislocation of 373f
Birmingham hip resurfacing 43
Bladder fistula 34
Blood loss 89, 198
Blunt dissection 285
Body mass index 92, 192, 213, 230, 372
Bombaci's approach 289
Bone 5
bed preparation 33, 315
cement 30, 32
commercial constituents of 30t
components of 31f
extruded 35
implantation syndrome 35
interdigitation 33
column 436
fixation 438
intact 436
defects 112, 215, 267, 268, 269t, 306f
classification systems for 268t
extent of 407
types of 256f
deficiency encountered, severity of 246
deformity 19, 267
erosion 117
fixation 249f
grafting 112, 129, 301, 302f, 412, 428
advantages of 247
impaction 444f, 450, 451f
support of 248f
ingrowth 423
loss 255
causes of 255
classification of 256
evaluate amount of 441
extensive 267
lateral femoral 117
management of 256, 258
minimal 409
Rand classification of 256t
major defect of 250f
platform, implant fixation functions of 246f
preparation 319
preserving implant 221
quality of 408
reconstitution of 256
repair, changing pattern of 248f
resection 133, 144
scan 338f
stock, restoration of 441
tumors 144
Bony cuts 125
mechanism of 92
Bony defect 441
Bony deformities 131
Bony resections 149
Broken femoral stems 415f
Broken revision stem 415f
Bumpectomy 93
Bungee-effect 228
Burch-Schneider
acetabular cage 410f
style cage 468
type cage 437, 437f, 440
Burmese position 159f
C
Cadaveric femora 101
Calcar loading 326, 327
Calcar replacement 444f
Calcar resorption 392, 394
Calcium 56
stearate 63
Canal plugging 315
Canal stenosis 239
Cancellous bone 191, 321
Cancellous screw 67
augmenting fixation 411f
Cancellous trabeculae bone 315f
Capsular acetabular attachment 14f
Capsuloligamentous structures 66, 200
Carbon-fiber-reinforced polyether 60
Cardiac arrhythmias 34
Cardiomyopathy 59
Catalyse polymerization 30
Catastrophic ceramic bearing failure 422f
Cefazolin 493
Cefepime 494
Ceftazidime 494
Ceftriaxone 494
Cefuroxime 30, 493
Cellular interactions 418f
Cement
disease 417
extrusion 392
interdigitation 33f
mantle 314
Barracks grading of 423
fragmentation of 407
integrity of 407
thickness 321
mixing 316
penetration, depth of 321
polymerization of 316
pressurizer 320f
restrictor 33, 315
retrograde filling of 316f
techniques
first-generation 291
fourth-generation 291
grading of 317
second-generation 291
third-generation 291
Cementation 36f, 215, 218, 319
Cemented acetabular
components 428
cup 318, 423, 428
fixation, outcome predictors of 321t
Cemented acetabulum, technique of 319
Cemented femoral stem 312, 321
loosening 423t
Cemented femur 334
Cemented fixation 193
Cemented medial Oxford unicompartmental knee arthroplasty 201f
Cemented polyethylene 184f
Cemented prosthesis 448
Cemented stems 269, 313, 318
Cemented tapered stem 331
Cemented total hip arthroplasty 312
Cementing surgical technique 313, 314
Cementing techniques, evolution of 34
Cementless acetabular
component, removal of 415f
cup designs, current status of 342
Cementless cup 438, 439f
Cementless femoral component 209f, 423
Cementless fixation 191
Cementless implantation 191, 209f
Cementless modular stem 416f
Cementless porous tantalum monoblock tibial implants 193
Cementless proximally-coated stems 442f
Cementless stem 323
classification of 323
revision of 333
Cementless tibial baseplate 209f
Cement-loaded stainless stem 504f
Center of rotation 20, 293, 345, 346
Centers for Disease Control and Prevention 492, 498
Central femoral metaphyseal defect 250f, 251, 253f
Ceramic 40
fourth-generation 56
head 41f
liner displacement 48
liner fracture 47, 47f
on-ceramic 43, 46, 55
articulation 43, 46
on-ceramic bearing 56, 421
articulation 44f
revision of 58f
on-metal 43, 46
articulation 50
on-polyethylene 56
bearing 56f
Chandler and Pennenberg classification 435
Charnley cemented total hip arthroplasties 296
Charnley concept of medialization of acetabulum 28
Charnley principle 27
Charnley retractors 378
Charnley zones 425f
Chemical thromboprophylaxis 74
Chemical vapor deposition 42
Chemoprophylactic agent 76
Chemoprophylaxis regimen 76
Chondrolysis 241
Chondroplasty, arthroscopic 187
Chromium oxide 41, 46
Chunli consummate modular augmented cup 436, 437f
Chunli metaphyseal-diaphyseal sleeve 253f
Ciprofloxacin 494, 495
Clatworthy and Gross classification 246f, 247f
Clindamycin 493, 494, 495
Closed wedge high tibial osteotomy 138
Cloxacillin 494
Clunk syndrome 179
Cob's elevator 285
Cobalt chrome 344
on-cobalt chrome 55
Cobalt-based alloys 40
Cobalt-chromium 38, 53, 342
molybdenum 40f
Collagen vascular diseases 277
Collared stems 443f
Collateral ligaments 144
Colony forming unit-granulocyte 419
Comminuted intertrochanteric fracture femur 388
Comminuted periprosthetic fracture 464f
Comminuted tibia fracture 253f
Common peroneal nerve 8f
Complete extensor mechanism 277
Complex primary surgery 336
Complex regional pain syndrome 239
Component malrotation, influence of 99
Component orientation 373
Component placement 319
Component repositioning and revision 374
Component rotational alignment 99
Composite-beam fixation 314
Compression 310f
Compressive elastic stockings 76
Computed tomography 240, 257, 397, 425, 438f
scan 397, 441
Computer navigated surgery 196
Computer-assisted surgery 145, 148, 230
Condylar bone loss 250f
Condylar defects 252f
Condylar hypoplasia 140
Cones and sleeves 250
types of 251f
Coonse and Adams approach 237
Corail stem, painful 447f
Coronary ligament 10
Corrective osteotomy, simultaneous operation of 142
Cortical strut allograft 442, 444f
reconstruction 444f
C-reactive protein 240, 406, 447, 453, 454, 484486, 488, 502, 508, 512f, 515, 516
synovial 487
Cross-legged sitting 159f
Cross-linked polyethylene 54f, 55, 56, 57f, 318
Crowe and Hartofilakidis classification 356t
Crowe, classification of 349, 350f
Cruciate ligaments 113
Cruciate retaining 106, 116, 131, 133, 193
knees 80, 241
C-shaped Homan retractor 288
Cup
dissociation of 405f
fixation 343
medialization technique 351f
profile 343
Cup-cage
lower flange of 309f
placement of 309f
revision done 303f
technique 438, 440
Cylinder axis 161
D
Dabigatran, doses of 76
Dalteparin 75
Deep fascia 10, 87
Deep flexion 162
Deep infection 466
Deep medial collateral ligament 66, 94, 94f, 110
Deep trochlear groove 79
Deep vein thrombosis 239, 512
recurrent 73
Deformed femoral neck 300, 304
Deformity
assessment of 110, 113
correction of 8
degree of 145
distance of 145
dynamic assessment of 177
mild 115
moderate 115
recurrence of 116, 129
Diabetes 179, 497
Diaphyseal engaging stem 250f
Diaphyseal fixation 445
stem extension 249f
Diaphyseal stems 270, 271, 272f
Diaphysis 324
Di-benzoyl peroxide 30
Dislocated bone deficient patella 184f
Dislocated femoral head articulates 355f
Dislocated meniscal-bearing component 201f
Dislocations 372, 387, 392, 393, 466
mechanism of 371
secondary 372
Displaced fracture 467
Displaced intracapsular fracture neck femur 388
Dissect medial collateral ligament 138
Distal axis lines 147
Distal cement plug, length and thickness of 407
Distal femoral
angle, lateral 125
bone, quality of 408
cut 125, 215, 217
metaphysis 101
osteotomy 100
overstuff 263
resection 110
tube 448f
Distal femur 167f, 216f, 445
central cavitary loss of 254f
cut, accurate execution of 169f
deformity 146f
degree of anterior bow of 408
malunited fracture 144f
medial epicondylar sliding osteotomy 147f
osteotomy 144
Distal intramedullary flexible reaming 338
Distal procedure 236
Distal straight reaming line 338
Distal tibial angle, lateral 125
Dome shaped patella 78, 79f
modified 79
Dorr classification 13
Double wedge stem 323
Dual mobility 366f
cup 344, 344f, 374, 375f
earlier version of 365f
role of 365
hip replacement 365
total hip arthroplasties 368f
Dual-energy X-ray absorptiometry 424
Dye 30
Dynamic valgus stress 124
Dysplasia 350f, 390
bilateral high developmental 358f, 360f, 361f
developmental 361f
Dysplastic acetabulum 388
Dysplastic hips 391
Dysplastic lateral femoral condyle 117
Dysuria 34
E
Ectopic para-articular bone 393
Electromyogram 17
Electron beam radiation 54
End-stage arthritis 301
End-stage osteoarthritis, development of 355
Engh and Glassman classification 435
Enoxaparin 75
Enterobacteriaceae 494, 495
Epicondylar axis 67
Epicondylar line 101
Epicondylar osteotomy, lateral 67, 68
Epicondyles 102
lateral 101
Erythrocyte sedimentation rate 240, 406, 447, 454, 484488, 502, 508, 512f, 515
Erythromycin 31
Ethylene oxide 53
gassing 64
Excessive tibial bone resection 220f
Excise small fragments 181
Excision arthroplasty 444
Extended lateral femoral osteotomy 449
Extended trochanteric osteotomy 340f, 412, 414f, 449f, 469, 470f
Extension gap 66
assessment 111
Extensively-coated long stem 443f
Extensor apparatus 236
Extensor mechanism
allograft 183, 183f
deficiency 179
disruption of 181
Extra-articular correction 147
Extra-articular deformities 67, 144, 147, 174
intra-articular correction of 149f
severe 147
Extramedullary tibial shaft axis 101
F
Fabella syndrome 242
Fabellofibular ligament 10
Facetectomy, lateral 187
Failed cup-cage construct, removal of 410f
Fat pad 87
Fatigue 31
Femoral alignment 71
Femoral anteversion, abnormal 353f
Femoral artery, course of 16f
Femoral bearing 156
Femoral bone
cuts 125
defects 268f
classification of 410
Mallory classification of 412f
management of 441, 442
deficiency, classification of 441
loss
management 267
Mallory classification of 412t
quality, Dorr classification of 329f
status, evaluation of 447
Femoral canal 135
Femoral component 67, 99, 101, 154, 161, 163, 406
design 79
extraction 470f
loosening 422
malrotation of 99
placement 130
removal of 261f, 262f
rotation of 94f, 99, 100
size 67, 93
types of 407
Femoral condyles 71, 162, 204, 215
posterior 100, 101, 114
Femoral cortex 189f
Femoral cuts 94f
Femoral defect 247f
Femoral deformations 304
Femoral flange 79
Femoral fractures 392
Femoral geometry 13
Femoral head 12, 40f
cartilage 399f
diameter 373
large diameter 374
osteonecrosis of 397
Femoral loosening 392
Femoral medial offset stem 272f
Femoral neck 13
osteotomy 398
Femoral nerve 17
palsy 17
Femoral offset and leg length, restoration of 373
Femoral peel 238
Femoral perforation 392
Femoral preparation 204
Femoral prosthesis 72f
Femoral reconstruction 350, 356
Femoral rollback incorporating 153
Femoral rotational alignment, methods of 100
Femoral shortening osteotomy 305f
Femoral side revision total hip replacement 447
Femoral status 448f
Femoral stem
insertion 317
preparation 350
Femoral strut allografts 467f
Femoral tibial contact point 70f
Femur 13
anterior surface of 67
clinical transepicondylar axis of 102
defect, assessing type of 441
different center of rotation of 304f
distal cut 133
head neck trochanter distance 13
osteotomy of 310f
posterior condylar offset of 160f
surgical transepicondylar axis of 102
varus remodeling of 414
Fetotoxicity 59
Fibula, tip of 144
Final kinematic analysis 171f, 175f
Final limb alignment analysis 175f
Finishing tibial preparation 215, 218
Fixation, types of 407
Fixed flexion deformity 83, 113, 116, 200
management of 116
Fixed-bearing total knee replacement 24
Fixed-bearing unicompartmental knee arthroplasty 212, 212f, 213, 214f
surgical technique of 215
Flexion 163, 262
and extension gap balancing 93f
assessment of 215
contracture 82, 96
absence of 123
severe 110
deformity 113, 168, 171f, 172, 173f, 174f
correction of 175f
persistence of 113, 116
postoperative care 115
severe 175f
surgical technique 114
extension gap 67
technique 104
gap 66
assessment 111
knee balancing 98
mediolateral symmetry 67
reduce 115f
instability 82
normal knee 161f
Fondaparinux 75
Fracture 46, 239, 394, 405
line, bone grafting of 440
location 461
neck femur 388
pathological 388
nonunion 466
transverse part of 439f
Free computer navigation system 167
Fully cemented stems 258
Fully uncemented stems 258
Fusidic acid 495
G
Gait analysis 107
Gamma irradiation 64
breaks down 64
Gamma sterilization 53, 64
Ganz-type cage 436
plus cementless cup 436
Gap balancing 168, 272
Gap imbalance
correction of 171f
management of 264t
Gas plasma 53, 64
Gastrocnemius 129
lateral head of 131
Geniculate artery 87
Gentamicin 30, 494
Gerdy's tubercle 10, 117, 118f, 119, 120, 125
Gigli saw 262, 262f
Girdlestone arthroplasty 339f
Gluteus maximus
and hamstrings 15
fascia 381
Gluteus medius 15, 305, 379, 381f
anterior fibers of 15
Gluteus minimus 15, 305, 381f
Gracilis muscles 87
Greater tibiofemoral contact 162
Greater trochanter 285
coronal osteotomy of 289
nonunions 374
Grit blasted titanium 336
Groin pain 386
Gross classification 246, 435, 442t
Gross technique 450f
H
Half total knee replacement 70
Hamstring tendon graft 278
Hard-on-hard bearings 43
mechanical failure of 46
Hard-on-soft bearings 42
Hardware
complications 237
removal 138
Harris grading of loosening 422
Harris hip score 389
Hartofilakidis classification 349, 350, 350f, 355
Head-neck junction 356
Health Insurance Portability and Accountability Act 214
Healy's method of proximal recession 121
Hemarthrosis, recurrent 239, 243
Hematoma 34
Hematuria 34
Hemiarthroplasty 388
Hemi-digastric incisions 289
Hemiellipsoid profile 343f
Hemispherical cups 428
Hemorrhage 34
Heterotopic ossification 239, 397
High biomechanical stresses 164
High body mass index 267
High flexion
femoral components 162
knees 163
tibial inserts 162
High hip center 12
High knee flexion 163
High offset stem 374
High tibial osteotomy 137, 138, 140f, 200
Highly cross-linked polyethylene 38, 39f, 41, 53
Hinge knee system 141
Hip
anterior ligaments of 14f
arthritis of 26, 243
arthroplasty 36, 371, 454
bipolar 386, 389
center 28, 300, 426
height and offset 448
location 28f
of rotation of 293
congenital dislocation of 304, 338, 339
developmental dysplasia of 336, 349, 355, 356, 360f, 371
dislocation 398
initial assessment of 373
surgical management of 371
dysplasia of 17, 324, 371, 390
fracture
dislocation of 307f, 308, 308f
surgery 74
high grade developmental dysplasia of 355
in joint replacement surgery 283
joint 12, 13f, 26f, 27f, 284f, 285f, 300
arthritis of 243
biomechanics of 26
center of 91
forces affecting 26
optimal contact 15
reconstructing 298f
ligaments 14
muscles of 15
origin 239
osteoarthritis of 389
osteonecrosis 389
pathology 239, 243
posterior ligaments of 15f
replacement 283
implants in situ, bilateral 177f
surgical approaches of 283
Hodgkinson classification 320
Hohmann retractor 6, 261, 379
placement 16
Homan retractor 288
Hybrid
fixation 25
stems 258, 270
technique 114
Hydrophilic polyurethane 59
Hydroquinone 30
Hydroxyapatite 324, 336, 343, 428
coated stem 327, 328f
Hyperextension deformity 172, 172f, 174, 174f, 175f
Hypertension, pulmonary 73
Hypothyroidism 59
I
Iatrogenic fractures 438
Iliac spine, anterior superior 413
Iliofemoral ligament 14
Iliotibial band 10, 66, 117, 126, 126f, 131, 305, 378
contraction of 122
Iliotibial tract 92, 118
Imipenem 494
Impingement syndromes 242
Implant
bone osseointegration 191
design 49, 276
osteotomy, after placement of 310f
selection 132
In vivo fluoroscopic studies 82
Infected hip and knee arthroplasty, management of 452
Infection 239, 392, 405
acute 239
classification of 476, 497
prevention of 454
Infectious Diseases Society of America 452, 453, 479, 512
Inferior lateral genicular artery 237
Inflammation, signs of 240
Infrapatellar fat pad 120
Injury, types of 279
Innate single nucleotide polymorphisms 419
Insall's quadriceps turndown 236, 236f
Intact cortical tube and contents 442
Intercondylar
bone resection 112
osteophytes 101
Interfascial stresses, higher levels of 154
Interleukin 420, 516
Interlocking cementless long-stem prosthesis 443f
Intermittent pneumatic compression devices 76
Intermuscular septum 88
Internal fixation 397
International Knee Social Pain Score 137
Inter-teardrop line 356
Intra-articular correction 145, 146f, 147
Intra-articular fractures 397
Intra-articular pathology, examination of 215
Intramedullary canal 149
Intramedullary femoral guide 144
Intramedullary nail 145
Intramedullary rod 114, 199, 204
Intraoperative fracture, risk of 112
Intrapatellar fat pad, remove 235
Intrapelvic cement mushrooms, presence of 407
Intraprosthetic dislocation 368, 368f
Intraprosthetic dissociation 408f
Invasive unicompartmental knee replacement 222f
Ipsilateral hip, examination of 240
Ischial lysis 426f
Ischial osteolysis, extensive 428
Ischiofemoral ligament 14
Isoelastic bombelli stem 340f
J
Japanese Orthopaedic Association 390
Joint
arthrosis 91
assessment of 203
capsule and
deep medial ligament 10
lateral collateral ligament 10
exposure 139
geometry, impact of 28
line
elevated 81
restoration of 256
replacement, fundamental principle of 300
subluxation 200
Jumbo cup 310f, 311f, 429, 429f, 436
use of 301, 310
K
Kerboull's intussusception technique 450, 451f
Ketone 60
Kinematics
alignment 97, 198
analysis 170f, 172f, 175f
conflict 20
restoration of 199
Kirschner wire 112
Knee
anteromedial aspect of 94
arthroplasty 35, 108, 454
kinematics of 19
partial 196
balancing 260
chronic periprosthetic joint infection of 502f
deep layer of lateral side of 11f
deformities 92, 149
segmental 144
extension 66, 108
flexion 108, 158, 161, 163
anatomy 160
angle 108
contractures 113
degree of 5
kinematics 160
measurement 158
moment 108
types of 158, 159f
function, dynamic 108
joint 19, 83f
aspiration of 240
kinematics 20, 22f, 23
lateral aspect of 8f
lateral radiographs of 146f
lateral side of 10
malalignment, degree of 147
medial aspect of 10f
medial side of 9, 9f
osteoarthritis of 227
pain 243
anterior 78, 99
positions of 22f
posterior stabilized 241
power absorption 108
radiographs 112
range of motion 89
recurvatum 172
replacement, bi-unicompartmental 229f
Society Score 80, 89, 107, 125, 182, 192, 456
surgical approaches to 87
valgus alignment of 123f
with flexion deformity 66
Kocher-Langenbeck approach 398
Kohler's line 298, 301, 301f, 351, 352, 426f, 427, 428
Krakow's classification 117
Krakow's method 121, 120
Kyocera bi-surface knee 163, 163f
L
Laryngeal mask airway 414
Lateral collateral ligament 66, 82, 92, 97, 101, 117, 128, 131
contraction of 122
Lateral condyle, hypoplasia of 135
Lateral femoral condyle 22f, 118, 129, 204f
hypoplasia 131
Lateral intramuscular septum 118
Lateral parapatellar approach 89, 120, 125, 127
Lateral patellofemoral shear forces 79, 80
Lateral retinacular
defect 120
release 89, 139
Lateral soft tissue structures, contracture of 117
Lateral tibial condylar margin 66
Lateral transtrochanteric approach 286
Leg length discrepancy 349
management of 353
Leukocyte esterase 485, 487, 488
Levofloxacin 494
Ligament balance 129, 262, 264
assessment of 263f
science of 66
Ligament imbalance 166
Limb
length discrepancy 405
salvage procedure 388
Liner displacement 48
Local bony deformation 66
Long femoral stem 501f
Long stem fixation 444f
Long tibial stem, placement of 273f
Lotus position 159f
Low protein binding 494
Low virulence 239
Lower limb 149
Low-friction principle, application of 387
Low-molecular-weight heparin 74, 391
M
Macrophage 419
colony stimulating factor 419, 420
inflammatory protein 420
Macrotextured titanium 336
Magnesium 56
Magnetic resonance imaging 17, 23, 214, 227, 240, 260, 276, 421f, 423
scan 407, 441
Major acetabular bone loss, management of 435
Major bone defects, management of 246f
Malalignment 166, 239, 242
passive correction of 215
situations 155
Mallory-head classification 442, 442t
Mallory-head system 336, 441
Malrotation femur 239
Malrotation
risk of 101
tibia 239
Malunited distal femur fractures 131
Malunited femur fracture 144
Malunited fractures 144
Maquet or Hauser procedure 103
Matrix metalloproteinase 9, 39, 418
Mayo clinic series 366t
Mechanoreceptors, different types of 107
Medial bumpectomy 94f
Medial collateral ligament 19, 82f, 83f, 93, 120, 123f, 124f, 131, 160, 203, 226, 241
laxity of 81, 82
pie crusting 95
Medial compartment
arthropathy, pathomechanics of 72
osteoarthritis, isolated 222f
Medial condylar
block 112
bone, posterior 112
osteotomy 67
Medial epicondylar osteotomy 237
Medial epicondyle 101, 102
Medial femoral condyle 72f, 112, 125, 207f
medial surface of 93
radius 22f
Medial femoral osteophytes 93
Medial migration 428
Medial monocompartment osteoarthritis 201f
Medial osteoarthritis, pathomechanics of 70
Medial parapatellar
approach 179, 180f, 188
arthrotomy 87, 88f, 89, 90, 125
Medial patellofemoral ligament 22, 278f
Medial pivot knee 24
Medial posterior condylar bone 111
Medial proximal tibial angle 125, 139, 140f
Medial soft tissue 117, 131
Medial unicompartmental knee
arthroplasty 215f
replacement 229f
Medical grade pure alumina 41
Mediolateral
balance 67
imbalance 67
instability 81, 134
soft tissue imbalance 67
Meniscal bearing knee 153
Meniscal failure 186
Meniscal preservation 188
Menisci 19
Meropenem 494
Metal alloys 40
Metal artifact reduction sequence 407, 423
Metal attenuation reduction sequence 50
Metal augments 430
Metal backed tibial component 213f
Metal on polyethylene
articulation 54f
couplings 46
Metal step wedges 112
Metal surface 60
Metal-on-metal 41, 43, 46, 55
articulation 43f
bearings 58, 419
metasul liner 408f
surface replacement 421f
total hip arthroplasty 48f
total joint 38
Metal-on-polyethylene 55, 56
properties of 56
Metaphyseal bone defects 247, 249f, 252f
Metaphyseal jacket 253f
Metaphyseal stems 270, 271f
Methacryloyloxyethyl phosphorylcholine 42
Methicillin-resistant Staphylococcus aureus 477
Methylmethacrylate 290
monomer 30
Microparticulate wear debris 155
Mid-flexion instability 81
causes of 81
clinical diagnosis of 82
management options 83
Mid-flexion range 82
Midline longitudinal skin incision 88f
Midvastus approach 88, 89f
Midvastus muscle-splitting 88
Migration 392
Mini-incision hip replacement, anterior 289
Minimally invasive surgery 177, 221, 377
anterior 339
approach 202f, 203, 221
concepts, motivations, and challenges 377
posterior approach variants 377
Minocycline 495
Mixed infections 494, 495
Mobile meniscal bearing designs 201, 210
Mobile polyethylene ball 344f
Mobile-bearing
biomechanical concepts of 152
comparative studies 154
designs 152f, 155
classification of 153t
clinical results of 154
evolution of 152
dislocations of 201
knees 161
option 200
patella 78
rotating-platform designs 154
total knee arthroplasty 151, 155
advantages of 155
design rationale 151
history of 151
Modern cementing
methods, goal of 314
technique 290, 315, 318f
Modular bipolar prosthesis 388f
Modular distal fixation
prosthesis 443f
stem 340f
Modular fluted-stem prosthesis 443f
Modular porous coated sleeve 336
Modular prosthesis 448f
Modular stems 258
Modular tibial offset stem 272f
Modular tibias, conventional cemented 193
Molybdenum 38
Monoblock bipolar prosthesis 388f, 389f
Monocyte chemotactic protein 420
Mont group classification 323
Moore prostheses 389
Morcellized bone 308f, 310
graft 301f, 307f, 308f
Multimodal thromboprophylaxis 74
Multiple intra-articular punctures 119f
Multiradii design 82
Multiradii femoral component 81
Multiradii implant design 82f
Muscles strength 406
Musculoskeletal Infection Society 453, 484, 485
Mycobacterium 486
Myocardial infarction, risk of 76
Myositis 239
ossificans 392
N
Native knee 19
Navigation system, component of 166
Near normal active knee flexion 223f
Neck
extension stems 444f
osteotomy 398
Neisseria meningitidis 452
Nerve
entrapment 35
palsy 359
root compression 239
Neuroma 239
Neuropathy 35
Neurovascular injuries 116
Nonabsorbable suture 184
Nonarthroplasty operative options 187
Nonresurfaced patella 79
Nonsteroidal anti-inflammatory drugs 224
Nonunion fracture neck femur 388
Normal knee
function 222
range of movements of 19
Norwegian hip registry 321
Nottingham knee score 193
Nuclear
bone scan 240
factor-Kappb ligand, receptor activater of 418, 420
O
Oblique popliteal ligament 9, 67
Obturator internus 15
Obturator nerve 17
injury 17
Omnifit prosthesis 336
One-stage septic exchange 502
Open reduction and internal fixation 463f, 466f
Open wedge high tibial osteotomy 138, 139
Optimal acetabular anteversion 297
Optimum soft tissue balancing 68
Optoelectric system 108
Oral conversion therapy 495f
Oral paracetamol 224
Orthopedic
implants 63
pathology 179
Ortiguera and Berry classification 277t
Osseous defects, classification of 408
Osteoarthritic knees 113
Osteoarthritis 192, 220, 226, 228, 229f, 298, 388, 394
contralateral compartment 200
monocompartment 200
pathological processes like 92
tibiofemoral 186
unicompartmental 221
Osteogenesis imperfecta 144
Osteointegration 308f
Osteolysis 46, 155, 417, 419, 467
around tantalum cone 252f
biological pathway of 418f
extensive 54f
higher rate of 54
particle-induced 42
pathogenesis of 406f
Osteonecrosis 118, 129, 394
Osteopenia 467
Osteopetrosis 144
Osteophyte 66, 93, 149, 239
excision 66, 68, 110
posterior 114f, 208f, 210
prominent 113
removal 66, 215, 216f
Osteoporosis 179, 212, 237, 313, 467
Osteoporotic bones 301
Osteoprotegerin 419
Osteotome 93
curved 114f
Osteotomy 90, 237, 310, 359, 399f, 470f
corrective 470f
derotational 139
fixation of 147
nonunion of 147, 237
procedure 272f
site 147
malunion of 148
nonunion of 148
stabilizing hardware 148
subtrochanteric 352, 353f
Oxford knee score 198
Oxford unicompartmental knee 202
arthroplasty 202, 202f
Oxidized zirconium bearing surface 41
P
Paget's disease 144, 313
Pain 34, 179, 405
and disability, intensity of 240
location of 240
nature of 240
progress of 240
Painful total knee
arthroplasty
causes of 239, 239t
evaluation of 239, 240
replacement, specific causes of 240
Paprosky classification 409f, 409t, 427, 435, 435f, 467
Paprosky graft 430
Paradoxical anterior femoral slide 69f
Paragon cementless stem 338, 339f
design of 340f
Parkinson's disease 371
Partial porous coated stem 324f
Partial replacement unicondylar meniscal-bearing knee 153
Patella 258
alta 278
baja 239
bilateral dislocation of 278f
fracture 276, 277, 279
migrates, contact point of 22f
overstuffing of 239
smooth tracking of 189f
Patellar augmentation 183, 184
Patellar avascular necrosis 125
Patellar baja 139, 142, 179
Patellar bone loss 182
Patellar clunk 79, 99, 180
syndrome 180, 239, 241
Patellar component
articular surface of 78
design 78, 78f, 80
Patellar contact area 79
Patellar dislocation, preoperative 179
Patellar eversion 139
Patellar fat pad 239, 242
Patellar fracture 129, 181
Patellar impingement 142
Patellar implant, placement of 80
Patellar instability 129
causes of 99
Patellar ligament rupture 276
Patellar maltracking 134, 155
Patellar resurfacing 142
Patellar subluxation 99
Patellar tendon 87, 88
medial border of 89
rupture 181, 182, 277, 278f, 279
Patellar tracking 128
Patellectomy 187
Patellofemoral
arthroplasty 186, 190
clinical presentation 186
design concepts of 187
options for management 186
pathoanatomy and epidemiology 186
recent literature and registry review 188
steps to success 188
articulation 123
complications 99
contact
area 80
forces 187
points 100
crepitus, postoperative 78
dislocation 99
dysplasia, congenital 103
failure, isolated 99
instability 99, 182, 182f
incidences of 119
joint 78, 99, 229f
kinematics of 22
replacement 230
kinematic 78, 139, 162
ligament 102
malalignment 129
maltracking 103, 130
offset 161
osteoarthritis, isolated 186, 187f
prosthetic joint 78
symptoms, incidence of 154
tracking 104, 128, 155
view 132
Pelvic discontinuity 310f, 411, 427, 433, 433f, 435, 437, 438
mild 438
moderate 438
severe 440
Pelvic tilt 108
Pelvis, height of 351f
Penicillin G 494
Percutaneous-assisted total hip 380
Periosteal site adhesion 139
Periosteum 118
lateral femoral 117
Peripatellar fibrous nodule formation 79
Peripheral arterial disease 7
Periprosthetic acetabular fractures 466, 467
Periprosthetic femoral fractures 461, 462b
Periprosthetic fracture 489
intraoperative 273
management of 181, 461
risk of 274f
Periprosthetic hip fractures 468
Periprosthetic incidental fractures 167
Periprosthetic joint infection 408f, 475, 484, 485, 487, 488, 493, 497, 501f, 508
development of 492
diagnosis of 515
management of 497, 501
one-stage septic revision of 501
prevention of 515
two-stage septic revision of 501
Periprosthetic patella fracture 181, 181t
Ortiguera and Berry classification 277t
Peroneal nerve 119, 120
function 124
palsy 8, 16, 129, 134
Persistent synovitis 239, 243
Pes anserinus 66
Pes bursitis 239
Pie-crusting method 119
Pie-crusting techniques 8, 118
Pinning tibial tuberosity 235
Piriform fossa 382
Piriformis 382
tendon and minimus 382f
Planning extended trochanteric osteotomy 470f
Plate fixation 433f
Pneumatic compression device 76
Polycythemia 59
Polyethylene 38, 56t, 63, 64, 142, 344f, 407
and base plate 152
articulation 57
biomembrane modification of 42
components, sterilization of 64
contact areas 152f
conventional 39f
cup cemented into cage 412f
metal sandwich displaced implant 408f
noncross-linked 64
performance of 65
powder
grades 63
production 63
production 63
wear 24, 64
Polymerase chain reaction 517
Polymethylmethacrylate 30, 247, 258, 290, 318, 478, 503
Polymorphonuclear neutrophils 487, 509
Polythene wear 239
Popliteal artery thrombosis 5, 6
Popliteal fossa 6f
Popliteal vessels 5
Popliteofibular ligament 11, 66
Popliteus 92, 119, 239
contracture of 122
muscle 11
tendon 117, 119, 131
Porous coated anatomic prosthesis 336
Porous hydroxyapatite 209f
Porous metal-bone contact area 191
Positron emission tomography 424
Posterior capsule tented over osteophytes 114f
Posterior condylar
axis 102, 135
line 93, 98, 101, 102, 197
offset 160, 160f
surfaces 101
Posterior condyle 98, 162
Posterior cruciate
ligament 23, 82, 92, 101, 106, 119, 122, 141, 160, 214, 218f, 241
kinematics of 106
role of 107, 114
sacrificing mobile-bearing prosthesis 154
Posterior femoral
condylar cut and setting femoral component rotation 215, 217
condyles, rotation of 145f
Posterior mini-incision hip replacement 288
Posterior oblique ligament 94
Posterior stabilized
fixed-bearing 154
rotating-platform 153
Posterior wall acetabulum, loss of 401f
Posterolateral capsule 97, 118, 126, 131
Posterolateral cartilage 204
Posterolateral corner 10, 142
Posteromedial capsular resection 111
Posteromedial capsule 66
Post-knee replacement 113
Postoperative weight-bearing protocol 329
Postsurgical post-thigh tibial osteotomy 122
Post-thrombotic syndrome 73
Prearthroplasty gastrocnemius flap 180f
Pre-existing bony anomalies 122
Press fit condylar sigma 80
Primary total hip arthroplasty 281, 342
procedures 405
Primary total hip replacement 338
Primary total joint arthroplasty 475, 498
Primary total knee arthroplasty 452, 475
noncemented 191
Proliferative inflammatory synovials 511f
Prophylaxis 74
anesthesia 74
chemical prophylaxis 74
Propionibacterium acnes 486, 488
Prosthesis 449
allograft construct 250
augment fixation of 248f
bipolar 386, 393
choosing type of 448
custom 445, 445f
design 313, 314, 324f
dislocation 405
factors 419
implantation 511
retaining treatment 477
semiconstrained 141f
volumetric ratio of 315f
Prosthetic design 162
influence of 162
Prosthetic joint
diagnosis of 457
infection 193, 452, 453t, 454, 495t
classification of 452, 476b, 497b
diagnosis of 453
staging system 476t
treatment of 454, 494t
prevention of 457
Prosthetic medullary plug 407
Prosthetic replacement, primary 386
Protecting sciatic nerve 398
Protrusio acetabula, cases of 307
Protrusio acetabuli 301, 301, 386
Proximal bone cutting 140
Proximal conical milling 338
Proximal femoral
allograft 340f, 445
reconstruction 446, 446f
bone 464f
fracture 464f
Proximal femur 504f
longitudinal femoral osteotomy of 503f
varus remodeling of 408f
Proximal ligament, translocation of 121
Proximal medial collateral ligament, Krakow's technique of 120f
Proximal metaphyseal bone 447
Proximal migration of cup 408f
Proximal procedure 236
Proximal shaft 447
Proximal tibia 167f, 216f
extramedullary cutting guide of 217f
fracture 146f
major bicondylar bone loss of 254f
reduction osteotomy of 111
Proximal tibial
articulation 154
bone piece 218f
cut 216
accurate verification of 169f
malunion 139
resection 110
Pseudomonas aeruginosa 494, 495
Pseudotumor, inflammatory 59
Psoas tendon impingement 369
Pubofemoral ligament 14
Pulse lavage 33
Pyrexia 34
Q
Q-angle 79
Quadratus femoris 15, 379
Quadratus piriformis 15
Quadriceps contracture 179
Quadriceps snip 89, 90f, 139, 236
technique of 89
Quadriceps tendon 236
disruption 276
incidence of 181
rupture 181, 239, 243, 279
Quadriceps turndown 89, 243
R
Radiolucency 320
Radiolucent lines 193, 321
Raised trochanter, effect of 305f
Ranawat's grading 131t
Ranawat's triangle 298f, 350, 351f
classic 297
Rand classification 256t, 269
Randomized controlled trials 383
Real prosthesis, manufacture of 440
Recalcitrant deformity 111
Reconstructive cages 431
Rectangular flexion gap 100
Rectus
femoris 15
sartorius 15
snip approach 236, 236f
Recurrent dislocation, treatment of 367t
Recurvatum 123
Red blood cells 485
Reduction osteotomy 93
Regional nerve blocks 8
Residual deformity 67
Residual stiffness, disadvantage of 181
Resistant bacteria, low percentage of 494
Restoration system 341
Restore hip biomechanics 441
Restore synovial recesses over femoral condyles 235
Retroacetabular osteolysis 407f
Revision hip replacement 366, 367t
Revision knee arthroplasty, success of 235
Revision total hip arthroplasty 403, 441
principles of 405
Revision total hip replacement 391
Revision total knee
arthroplasty 87, 233, 235, 246, 260, 264, 268, 276, 508
replacement 271f273f
Rheumatoid 497
arthritis 92, 131, 221, 239, 240, 301, 307f, 314, 388390
Rifampin 494, 495
Rivaroxaban 75
Robotic total knee replacement 148
Robotic-assisted surgery 145
Rotating mobile-bearing total knee arthroplasty 151
classification 153
clinical evidence 154
Rotating platform 153
knee 153, 163
Rotating total knee arthroplasty, types of 153
Rotation hip, high center of 308, 308f
S
Safe total knee arthroplasty 5
Sagittal plane deformity 174
Salvage procedures 480
Saphenous nerve 87
Scarred extensor mechanism 237
Sciatic nerve 16, 398
course of 17f
injury 466
Scott's modification 236
Sensorimotor functions 107
Septic
hip revision arthroplasty 505
knee revision arthroplasty 505
Serum D-dimer 515
Shallow acetabulum 300, 301
Shanz screws 167
Shattered acetabulum 303
cases of 307, 308
Shenton's line 351f
Short femoral stem 325
Mont classification of 326
Short stem, advantages of 326
Shortened tapered conventional stems 327
Sickle cell disease 314, 318
Silicon nitride 41
bearings 60
Simpler surgical technique 269
Single axis knee 161
Single wedge stem 323
Skeletal dysplasia 144
Skin
incision 87, 138, 215, 215f, 284f, 287f
guidelines 235
loss, severe pretibial 180f
Sleeve, different types of 337f
Sliding epicondylar osteotomy 67, 127
Sliding medial condylar osteotomy 111
Smiley face femoral calcar retractor 378f
Smith-Peterson approach 13
Soft tissue 92, 122, 239
anterior knee 7f
balancing 129, 134, 140, 166
lateral releases 134
medial soft tissue 134
perform lateral release 134
closure 374
contractures 131
healing of 374
impingement 239
integrity of 441
management 375
reaction 501f
release
and balancing 126
role of 70
titration of 177
sleeve tensioning 374
stability, restoration of 256
status of 441
tension 67, 112
tensioning device 263f
unstable 258
Solid implants, removal of 503f
Sources of prosthetic joint infections 452
Spacer types 504
Spherical patellar component 80
Spine
examination 240
origin 239
pathology 239, 243
Squeeze socket 401
S-rom modular stem 336
S-rom prosthesis 444f
Stabilization techniques 374
Stab-incision technique 118
Standard anteromedial parapatellar arthrotomy 128
Staphylococcus
aureus 408f, 393
epidermidis 39, 493
resistance 494
Startup pain 406
Stem
breakage 405
centralizer 33
distal migration of 408f
extension, role of 268
fixation 269
implantation 288f
insertion of 337
length and diameter 270
offset 271
protrusion 392
tip pain 273
types of 329, 329t
Sterilization 63, 290
Straight leg raise 279
Streptococcus
agalactiae 494, 495
canis 517
Stress
around S-rom stem 338f
distribution across stem 312f
fracture 144, 239
propagation of 465f
Strontium aluminate 41
Structural bone graft 251f
Stryker dual mobility cup 369f
Submetaphyseal bone defects 247, 249f, 252f
Subvastus approach 87, 88f, 89
Superficial medial collateral ligament 94, 95
Superior bone defect
prosthetic augmentation of 436
structural bone graft of 436f
Superior defect plus cementless cup, structural bone graft of 436
Superior lateral geniculate artery 129
Superior migration 428
Superolateral defects 305f
Superolateral migrated hip center 351f
Superpath access window 382f
Support revision instruments 449, 449f
Suppressive antibiotic therapy 477, 499
Suprapatellar pouch, capsule of 88
Suprapatellar synovial hypertrophy 181f
Surgical quadrants system 12f
Swedish hip registry 321
Symphysis 413
Synovial fluid 59f, 485
Synovium 102
Synthetic ligament augmentation 183
T
Tantalum
alloys 40
revision cup 429
Tapered cementless stem 331
Teardrop, complete destruction of 428
Tendinous allograft 183
Tensile modulus 59
Tensor fascia latae muscles 15
Thigh pain 386
Third-generation ceramic 47, 56
Thompson prosthesis 386
Three-dimensional computed tomography scan 355f
Thromboembolic disease 73, 392
Thromboembolism 74
Thrombophlebitis, postoperative 34
Thromboprophylaxis 76, 391
regimen 76
Tibia 67, 267
preparation 33f
prosthesis of 252f
third degree defect of 252f
Tibial anterior offset stem 272f
Tibial baseplate impacted 209f
Tibial bearing 156
Tibial bone defects 268f
large 237
Tibial bony cuts 126
Tibial component 71
malrotation of 99
removal of 261f
revision 181
rotation 103
size of 218f
stem of 140f
Tibial cut 133
Tibial defect 129, 247f
Tibial deformity, extra-articular 176f
Tibial fracture 237
Tibial hybrid fixation 271f
Tibial implant, impingement of 138
Tibial insert thickness 67
Tibial metaphysis and diaphysis centers, anatomical mismatch of 272f
Tibial osteophytes, posterior 103
Tibial osteotomy 147
Tibial plate, fracture of 201
Tibial plateau 210, 215
fractures 131
Tibial polyethylene 223f
Tibial resection 139
Tibial segment 206f
Tibial side preparation 203
Tibial stem extender 112
Tibial subsidence 201
Tibial templates 204
Tibial tubercle osteotomy 90, 139, 237, 237f, 260
rates of 101
Tibial tuberosity 87, 103, 183
medial transfer 139
osteotomy 180f, 187
Tibiofemoral articulation 148
Tibiofemoral contact stresses 155
Tibiofemoral crepitus 186
Tibiofemoral instability 127
Tibiofemoral joint
kinematics of 21
space 187f
Tibiofemoral kinematic 140
Titanium 342
alloys 40
carbonitride 42
niobium nitride 42
nitride 42
Tobramycin 31
Toothbrush saw 208f
Torque stresses 155
Total condylar prosthesis 162
Total hip arthroplasty 12, 14, 26, 32, 38, 46, 53, 55f, 57f, 73, 270, 289, 296, 300, 301, 312, 323, 336, 337t, 349, 353, 355, 360, 361, 365, 366t, 367t, 369f, 371, 388, 389, 397, 405, 417, 452, 475, 493, 501f, 505, 508
acute 400
number of 461
Total hip replacement 28, 75, 293, 298, 308f, 313, 331, 340, 425, 438, 340f, 373f, 447, 456
fundamental principle of 293
mechanics of 293
prosthesis in situ 54f
Total joint arthroplasty 493t
Total knee arthroplasty 5, 8, 19, 23, 32, 66, 69, 73, 81, 91, 92, 99, 99f, 106, 107, 110, 117, 122, 131, 137, 138, 151, 158, 160f, 161, 179, 186, 191, 196, 212, 215f, 220, 247, 247t, 255, 267, 276, 277t, 278f, 475, 484, 492, 493, 501, 503f, 504, 508, 512f, 513
complication of 179
conversion 138
design 78, 152f
femoral component of 79
fixation 192t
painful 239
success of 196
surgical technique 161
Total knee replacement 23, 35, 69, 72f, 75, 91, 113, 122, 144, 149, 166, 198, 220, 226, 253f, 256, 258, 279t
bilateral 177f, 278f
classification 166
conventional cemented 220f
in valgus knees
algorithmic approach 122
history and physical examination 123
pattern of pathology 122
radiological studies 124
Touch tibial lateral cortex 140f
Trabecular cup 433f
Trabecular metal
augments 399
cup 429, 429f
patellar prosthesis 258
Tracking system 166
Traction injury 8
Transcondylar valgus angle 101
Transepicondylar axis 98, 101, 135
Transepicondylar line 98, 140
Transfemoral osteotomy 445
Transmalleolar axis 103
Transpiriformis 379
Transverse acetabular ligament 12, 293, 399
Trendelenburg gait 355
Trendelenburg sign 406
Tricompartmental osteoarthritis, advanced 221f
Triflanged cage, postoperative radiograph of 440f
Trivector-retaining arthrotomy 89
Trochanteric bone, quality of 408
Trochanteric osteotomy 287f
closure of 288f
Trochlea 135
flush, anterior 189f
Trochlear groove 79, 101
Trochlear implant, rotational axis of 189f
Trochlear morphology, lateral 188
True acetabulum, morphology of 355f
Tumors
around hip 388
necrosis factor 418, 420
Two-stage septic exchange 504
U
Ultrahigh-molecular weight polyethylene 23, 39, 55, 56, 80, 386, 419
use of 63
Uncemented acetabular components 428
Uncemented cups 423
Uncemented stems 270
revision of 333
Uncorrectable varus 172f
Unicompartmental knee arthroplasty 186, 200, 212, 213t, 214, 216f
advantages of 200
painful 218f
surgical technique 200
Unicompartmental knee
failure of 201
replacement 69, 70, 71f, 72f, 202, 220, 220f, 222f, 223f, 224f, 226
long-term results of 221
minimally invasive 224f
Unicondylar knee arthroplasty 220, 212
minimal invasive 220
Unicortical Schanz screw 167f
Unstable hip, evaluation of 372
V
Valgus alignment 79, 123f
Valgus angle 129
tibiofemoral 128
Valgus contractures 117
Valgus deformity 117, 118f, 120, 124f, 129135, 172, 173f
assessment of 123
correction of 119, 173f
incidence of 131
postoperative residual 129
recurrence of 134
severe 117
Valgus knee 66, 67, 98, 117, 121, 126f, 130, 131, 133, 140, 140f, 141f, 241
balancing 97
bone defect 255f
deformity, grades of 123f
grading of 132f
management principles 117
postoperative X-rays of 132f
preoperative X-ray of 132f
Ranawat's grading 131t
severe 131
technique 119
Valgus malalignment 129
Valgus position 29
Valgus stress 92, 124f
Valgus varus stability 100
Vancomycin 31, 493, 494
Vancouver classification 461b, 462f
Varus condition, severe 176f
Varus deformity 66, 110, 110, 117, 168, 170f, 171f, 172, 200
Varus knee 66, 67
balancing 92
steps of 93
bone defect 255f
X-ray image of 93f
Varus osteoarthritic knee 141f
Varus tightness 95f
Varus valgus 239
alignment, correct 260
laxity 82
stability 100
Vastus medialis 88
bulk of 88
oblique 22
Venous thromboembolism 73, 74
Visual analogue scale score 89, 198
Volumetric wear 368, 368t
W
Wandering acetabulum 300, 301
Watson-Jones approach 13
Weight-bearing flexion 158
Well-fixed cemented stem 414
Well-fixed cementless stem 414
Well-fixed proximally-coated ingrowth stem 470f
Western Ontario and McMaster universities
arthritis index 198
osteoarthritis index 129
White blood cell 484, 485, 487, 488, 502, 508
count 484
synovial 487
Whiteside's line 101, 111, 125, 126, 128, 130, 135, 148, 197
Whiteside's modification 237
Window technique 415f
Windshield-wiper-effect 228
Wound infection 34
Y
Y-ligament 14
Yttrium stabilized zirconium oxide 41
Z
Zimmer biomet 163
Zimmer durom hip 59
Zimmer unicompartmental knee 224
Zirconia 41, 56
toughened alumina 41
Zirconium 40
dioxide 30
niobium alloy 60
oxide
layer of 60
surface 41
Zweymüller implants 359
Zweymüller stems 358
×
Chapter Notes

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Comprehensive Guide in KNEE AND HIP ARTHROPLASTY: ASIA-PACIFIC ARTHROPLASTY SOCIETY—DELTA COMPENDIUM
Comprehensive Guide in KNEE AND HIP ARTHROPLASTY: ASIA-PACIFIC ARTHROPLASTY SOCIETY—DELTA COMPENDIUM
Third Edition
Editors
Parag Sancheti FRCS (Ed) MS (Ortho) DNB (Ortho) MCh (UK) Professor and Chairman Sancheti Institute for Orthopedics and Rehabilitation President, Asia-Pacific Arthroplasty Society (APAS) President, Maharashtra Orthopedic Association (MOA) Secretary General, BJD (Bone and Joint Decade)—WHO Pune, Maharashtra, India parag@sanchetihospital.org
Ashok Shyam MS (Ortho) Consultant Orthopedic Surgeon Sancheti Institute for Orthopedics and Rehabilitation Chief Researcher and Head Indian Orthopedic Research Group Pune, Maharashtra, India drashokshyam@gmail.com
Rami Sorial FRACS FAOrthA Consultant Orthopedic Surgeon and Head Department of Orthopedics Nepean Hospital Sydney, Australia pharoah1@bigpond.net.au
Sunny S Gugale DNB (Ortho) Consultant Arthroplasty and Arthroscopy Surgeon Department of Arthroplasty and Sports Medicine Sancheti Institute for Orthopedics and Rehabilitation Pune, Maharashtra, India dr.sunnygugale@gmail.com Forewords CS Ranawat Lawrence D Dorr Daniel J Berry Wui K Chung
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Comprehensive Guide in Knee and Hip Arthroplasty: Asia-Pacific Arthroplasty Society—Delta Compendium
Third Edition: 2019
9789352701360
Printed at
Our Patients
Contributors Foreword
The third edition of the Comprehensive Guide in Knee and Hip Arthroplasty from Asia Pacific Arthroplasty Society is of excellent quality. It is a compilation of knowledge by the best minds in Asia and covers basic concepts to complex arthroplasty problems and offers practical surgical recommendation.
The number of arthroplasties in Asia is growing rapidly, and challenges faced by the Asian surgeons are different than the western world. The Compendium is a contribution by surgeons from Asia and addresses these challenges and provides solutions. Revision surgeries are one of the emerging challenges in arthroplasty and I am happy that the book has dedicated sections on both Knee and Hip Revisions. Another area of prime importance is the prevention and management of prosthetic joint infection in the last section of the book.
Parag Sancheti was my fellow and has progressed to a leadership position as President of APAS. I would like to congratulate APAS, the editors and the contributors of this compendium for compiling a valuable resource for all arthroplasty surgeons, specifically from Asia. I wish APAS Compendium all the best.
CS Ranawat
Hospital for Special Surgery
New York, USA
Foreword
Perhaps no operations in medicine have had the improvements of Total Hip and Total Knee Arthroplasty. Without a doubt, those of us who made the career decision to be joint replacement surgeons have had a wonderful life. We do the operation that has been judged the best ever developed. Think about the accomplishments of improved patient lives. Even the patients who received Charnley's failed Teflon cup THR's that lasted 2-3 years thanked him for the relief he gave them for that time period. Today the improvements in materials and surgical technique have prolonged those two years of survival to thirty years! Highly cross-linked polyethylene (HXLPE) has been the most important evolution of arthroplasty articulation since Charnley switched to High Molecular Weight Polyethylene, and it is now known to be superior no matter the joint being replaced. Because of HXLPE the number of revisions of hip replacement is much less than projected because osteolysis is effectively eliminated, at least for these past 15–20 years. But the improvements in surgical technique and patient care have paralleled this material improvement. The biggest frontier in these operations today is personalizing our technique to the patient's anatomy. We are learning now that must include the spinopelvic mobility because of its influence on impingement. The use of smart tools in the operating room is exponentially increasing, and current residents will all use computers and robots to facilitate their surgery in their careers. Patient expectations now are shorter surgery, shorter recovery, and longer durability of their operation. Because of these expectations we, as an orthopedic community, must be careful that we do not raise false hopes among ourselves or our patients. Large femoral heads and anterior incisions have given us more options, but they are not the Holy Grail that supplants good surgical technique of tissue care, biomechanical reproduction, and implant positioning. We must strive our whole career to become a better surgeon and always have as our goal a perfect operation. That is the reason this book is so very relevant at this time. It has multiple experts describing for you, the reader, the state-of-the-art techniques and patient care treatments to improve your surgeon and doctor skills. I appreciate the time and work that Parag Sancheti and his co-editors have spent to publish this third Comprehensive Guide in Knee and Hip Arthroplasty. I will use the advice in this book and suggest you plan to do the same.
Lawrence D Dorr
Professor
USC Medical School
LOS Angeles, California, USA
Foreword
Joint arthroplasty has expanded rapidly worldwide in the last decade: with this expansion has come a great increase in worldwide expertise and the need for worldwide training and educational material in arthroplasty. This excellent Comprehensive Guide in Knee and Hip Arthroplasty will play a key role in the process of broader dissemination of arthroplasty concepts and techniques in the Asia-Pacific region.
This compendium covers a wide range of fundamental concepts and also essential and evolving surgical techniques. At the foundational level, the book covers topics including anatomy, joint kinematics, biomechanics, biomaterials, operative approaches and proven techniques to solve common problems in hip and knee arthroplasty. Other chapters cover more complex and advanced subjects such as management of challenging primary total hip arthroplasty and total knee arthroplasty diagnoses and revision hip and knee arthroplasty. Management of common complications—important for any surgeon to perform effectively—receives excellent coverage in the book. Finally, the book has chapters on state-of-the-art areas that are evolving rapidly including computer-based navigation and practical clinical topics such as how to establish a successful arthroplasty practice.
Authors of the book represent many of the most experienced arthroplasty surgeons and respected leaders and educators in the Asia-Pacific area. Several chapters are also written by international experts from outside the region, providing a worldwide perspective on selected topics.
Some readers will use this book as a reference for specific topics as they arise in clinical practice. Others, reading the compendium from start to finish, will gain a solid and strong background in current practice of hip and knee arthroplasty. No doubt, howsoever this excellent and comprehensive compendium is utilized, it will be highly valued by readers.
Daniel J Berry MD
LZ Gund Professor
Department of Orthopedic Surgery
Mayo Clinic
Rochester, Minnesota, USA
Foreword
The third edition of the Comprehensive Guide in Knee and Hip Arthroplasty represents more than the printed articles. It is a huge effort on the part of President Professor Parag Sancheti to bring together contributors of various nationalities to a common purpose and spirit.
The idea of a compendium came about all those years ago when the Delta Instructional Courses proved to be highly popular all across Asia-Pacific, and it was thought that a printed version of the instructional lectures may be a helpful addition to the verbal discourse. The Delta Foundation is an independent offshoot of Asia-Pacific Arthroplasty Society (APAS). More than 20 instructional courses had been conducted in more than 8 countries, under its’ banner over the years and these had been hugely popular. These courses pivoted on live-surgery and were aimed at straight-talking honest sharing of surgical experiences. The compendium is its written expression.
Thousands of copies of the compendium are still in circulation in numerous countries. There was even a Mandarin version of the second edition. This, the third edition is a long-time coming and I have no doubt that it will prove helpful to young surgeons seeking to further their knowledge about hip and knee arthroplasty.
This, the third edition of the Delta Compendium is a worthy tribute to the Presidency of Parag Sancheti.
Wui K Chung FRACS
Professor
Founding Chairman—APAS
Founder, Delta Foundation
Preface
The third edition of Comprehensive Guide in Knee and Hip Arthroplasty was an amazing academic experience for all of us in the editorial team. We had the enriched base of the second edition on which we had to build-up the new and updated edition. The journey started more than two years back and we are sure the final output adds value to everyone reading it.
The whole aim of this compendium was to produce a document, which is not only accurate, and evidence based, but also is rich in the personal experiences of the authors. The selection of topics and authors was a major exercise to meet this aim. We wanted authors from all parts of the globe and also authors who have done significant work in the field and have good clinical experience on the topics they will be writing. The final version of the table of content took a good amount of time, but we feel the current content and authors list does justice to the compendium.
The Compendium is organized in six sections starting with the Science of Arthroplasty, Primary Knee Arthroplasty, Revision Total Knee Arthroplasty, Primary Total Hip Arthroplasty, Revision Total Hip Arthroplasty and Periprosthetic Infection. Readers should begin with the first section, but further each section is standalone and can be read in any order. One of the most essential sections of the book is the section on Periprosthetic Infection and is a must read for every arthroplasty surgeon. The book provides the core concepts as well as the surgical tips and tricks for dealing with simple as well as complex arthroplasty surgeries. Each chapter is written with care to meet the main aim of the book of providing an experience rich academic content to the readers. We have tried to arrange chapters chronologically in the way of increasing complexity of the surgeries and management protocol in every section.
Parag Sancheti
Rami Sorial
Ashok Shyam
Sunny S Gugale
Acknowledgments
Producing an academic work like Comprehensive Guide in Knee and Hip Arthroplasty is not an easy task and was possible only by contributions of many. This book is a compilation of gracious contributions by all our Authors. We would like to thank each and every one of them to have taken time out of there busy schedule and contribute their personal experiences to the book. They have included most recent knowledge to make this book an updated one.
My sincere gratitude to Dr Rami Sorial for his constant encouragement and guidance at every step of making of the book. I would also thank to my co-editors Drs Ashok Shyam and Sunny S Gugale for helping me to bring this book to existence. I would also thank to Dr Wui K Chung to have started the concept of this book and getting the first edition complied which formed the foundation of this third edition.
We would like to thank all APAS members who contribute to APAS and make it a dynamic society which can produce works like APAS Delta Compendium. We have put in sincere efforts for two years and we hope this book will be useful for every arthroplasty surgeon in the world.
I thank Dr KH Sancheti, founder Chairman of Sancheti Hospital and my Father, who has been a constant source of inspiration and motivation to all of us and has guided me on this pursuit of Academic Excellence. I take this opportunity to thank Drs CS Ranawat, Lawrence D Dorr, and Daniel J Berry, who are living giants in the field of arthroplasty, to have gone through the book and contributed their forewords.
I also wish to thank all my family members, especially my Mother, my wife Archana and my children Aman and Anaya for their unconditional support and for bearing up with me.
Lastly, we would like to thank Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director), Ms Chetna Malhotra Vohra (Associate Director—Content Strategy), Ms Kritika Dua (Senior Development Editor) and all the staff of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for their untiring support during these two years.
Parag Sancheti