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Revision Total Knee Arthroplasty PDF

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Revision Total Knee Arthroplasty Revision Total Knee Arthroplasty James V. Bono, MD Associate Clinical Professor, Department of Orthopaedic Surgery, Tufts University School of Medicine; Attending Orthopaedic Surgeon, New England Baptist Hospital, Boston, Massachusetts Richard D. Scott, MD Professor of Orthopaedic Surgery, Harvard Medical School; Chief, Joint Arthroplasty Service, New England Baptist and Brigham and Women’s Hospitals, Boston, Massachusetts Editors Forewords by Chitranjan S. Ranawat, MD, and Roderick H. Turner, MD With 275 Illustrations in 365 Parts,82 in Full Color James V.Bono,MD Richard D.Scott,MD Associate Clinical Professor Professor ofOrthopaedic Surgery Department ofOrthopaedic Surgery Harvard Medical School Tufts University School ofMedicine and and Chief Attending Orthopaedic Surgeon Joint Arthroplasty Service New England Baptist Hospital New England Baptist and Brigham and Boston,MA 02120 Women’s Hospitals USA Boston,MA 02120 USA Library ofCongress Cataloging-in-Publication Data Revision total knee arthroplasty / James V.Bono,Richard D.Scott,editors ;forewords by Chitranjan S.Ranawat and Roderick H.Turner. p. ; cm. Includes bibliographical references and index. ISBN 0-387-22352-5 (alk.paper) 1. Total knee replacement—Reoperation. I. Bono,James V. II. Scott,Richard D. (Richard David),1943– [DNLM: 1. Arthroplasty,Replacement,Knee. 2. Knee–surgery. 3. Reoperation.WE 870 R45481 2005] RD561.R4923 2005 617.5¢820592—dc22 2004058912 ISBN 0-387-22352-5 Printed on acid-free paper. © 2005 Springer Science+Business Media,Inc. All rights reserved.This work may not be translated or copied in whole or in part without the written permission ofthe publisher (Springer Science+Business Media,Inc.,233 Spring Street,New York,NY 10013,USA),except for briefexcerpts in connection with reviews or scholarly analysis.Use in con- nection with any form ofinformation storage and retrieval,electronic adaptation,computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication oftrade names,trademarks,service marks,and similar terms,even ifthey are not identified as such,is not to be taken as an expression ofopinion as to whether or not they are subject to proprietary rights. While the advice and information in this book are believed to be true and accurate at the date ofgoing to press,neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made.The publisher makes no warranty,express or implied,with respect to the material contained herein. Printed in China. (BS/EVB) 9 8 7 6 5 4 3 2 1 SPIN 10938447 springeronline.com To my wife,Meg To my children,Andrew,Olivia,Caroline,and Thomas To my father for his guidance and inspiration To Rod Turner for his pioneering work in revision surgery JVB To my wife,Mary To my sons,Jordan and Andrew To our residents and fellows through the years RDS FOREWORD I Revision Total Knee Arthroplasty, edited by Drs. James V. This book is especially useful as a compendium ofthe Bono and Richard D.Scott,is a comprehensive review of editors’ personal philosophy, which has been tested and revision arthroplasty.The book includes discussions on all forged by many years of concentrated practice.I hope all aspects of this technically challenging surgery, including total knee surgeons will partake ofthe wisdom that these detailed surgical techniques, exposure issues, allographs, surgeons have so willingly and capably dispensed in this custom implants, alignment, and TKA after other failed book. procedures.Invaluable pointers on technique,the authors’ personal experience,useful illustrations,and an in-depth Chitranjan S.Ranawat,MD review of published literature further enhance the value Chairman,Department of Orthopedics of this wide-ranging text.This volume is indispensible to Lenox Hill Hospital any surgeon who performs knee arthroplasty, including surgeons in practice,fellows,and senior residents. vii FOREWORD II As senior editor of this excellent treatise on complicated Perhaps most important of all is the high regard knee surgery,Dr.Richard D.Scott brings three decades of which Dr.Scott’s peers have for his judgment and techni- experience in arthroplasty surgery to focus sharply on the cal ability. Many physicians, including a number of title subject. Dr. Scott serves as Chief of the Implant orthopedic surgeons,have sought out Dr.Scott when they Service at the two of the busiest orthopedic implant needed major joint replacement. He is truly a surgeon’s services in the nation: New England Baptist Hospital surgeon. and Brigham and Women’s Hospital.He is a proven edu- Dr.James V.Bono is some 18 years younger than Dr. cator at all levels: medical student, resident, fellow, and Scott,but his career is following a similar pattern to that postgraduate. ofthe senior author.His list ofpublications,chapters,and In addition to lectures and surgical demonstrations in presentations would number well over 150. He was a over a dozen different countries, Dr. Scott has authored pioneer,over a decade ago,in the use ofcomputer graph- more than 200 scientific publications.These publications ics in medical presentations and digital templating in include 35 book chapters in well-established orthopedic joint replacement surgery. These presentations by Dr. texts. Bono are made with skill,clarity,and always come across Working primarily with Dr.Thomas Thornhill,Dick with strong visual impact. Scott has designed entire implant systems for primary Jim Bono was the lead author of a text entitled and revision knee arthroplasty. These designers have Revision Total Hip Arthroplasty with Drs. McCarthy, made many innovations,such as the use ofmodular tibial Bierbaum,Thornhill,and myself. wedges for bone deficiency. They also have designed a I have read the current volume Revision Total Knee total hip replacement system. Arthroplasty in its entirety and have found it to be thor- Working with Drs.Insall,Dorr,and W.N.Scott,Dick ough,accurate,readable,and very helpful.I congratulate Scott designed and published the Knee Society Clinical the skillful co-editors and all of the contributors for Rating System, which is universally accepted as the gold putting together a classical and excellent orthopedic text. standard knee rating system. To enumerate Dr.Scott’s lectureships and professional Roderick H.Turner,MD presentations for any given year would take several pages. Clinical Professor,Orthopaedic Surgery A legion of postgraduate fellows from the United States Tufts University School of Medicine and elsewhere have come to study with him at both the Honorary Trustee Brigham and Baptist Hospitals. New England Baptist Hospital ix PREFACE Revision Total Knee Arthroplastywas proposed as a “how- the ensuing chapters.Management ofthe extensor mech- to”text for the diagnosis and management of the failed anism is included as a separate entity. total knee arthroplasty,with step-by-step descriptions of Part III draws attention to the wide dimension of surgical techniques of revision total knee arthroplasty. complicating issues that frequently occur in revision knee The text was intended to be a practical reference for stu- surgery. These chapters address the topics of infection, dents,residents,fellows,and attending surgeons engaged periprosthetic fracture,and stiffness and discuss the com- in the treatment and follow-up of patients who have plexities of total knee arthroplasty after failed high tibial undergone knee replacement surgery. osteotomy,after fractures about the knee,and after prior In Part I, the need for reoperation after total knee unicompartmental and hinged knee replacement. The arthroplasty is summarized from the prospective of one topics of insert exchange, aseptic synovitis, and the eco- surgeon’s practice and brings to light Dr. Scott’s vast nomics of revision total knee arthroplasty are discussed experience in total knee arthroplasty. This is comple- individually. The final chapter discusses the role of mented nicely by Dr. Thornhill’s chapter on the painful arthrodesis as a salvage procedure. total knee arthroplasty, where it is emphasized that the We feel fortunate to have received the support of so etiology of the patient’s pain must be elucidated prior to many well-known master surgeons who have contributed embarking on revision surgery. Part I also includes the to the text.We are grateful to all ofthem and are honored definitive treatise on ultra-high molecular weight poly- to have been able to present their combined experience in ethylene in knee arthroplasty as well as a compendium the ensuing pages. of the radiological evaluation of the failed total knee We are especially grateful to Dr.Ranawat for writing arthroplasty. the foreword and acknowledge the profound personal Part II emphasizes general principles of revision impact he has had on our understanding ofjoint replace- surgery, including management of skin, surgical expo- ment surgery through his commitment to patient care, sure, and removal of femoral and tibial implants at the teaching,and musculoskeletal research. time of revision. The fundamental aspects of revision total knee arthroplasty,alignment,management of bone James V.Bono,MD defects,and use of constrained implants are discussed in Richard D.Scott,MD xi CONTENTS Foreword I by Chitranjan S.Ranawat . . . . . . . . . . . . . . . . . . vii Foreword II by Roderick H.Turner . . . . . . . . . . . . . . . . . . . . ix Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xvii Part I Diagnosis and Evaluation Chapter 1 Reoperation After Total Knee Arthroplasty . . . . . . . . . . . . . . 3 Richard D.Scott Chapter 2 Ultra-High Molecular Weight Polyethylene in Total Knee Arthroplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 A.Seth Greenwald and Christine S.Heim Chapter 3 The Painful Total Knee Arthroplasty . . . . . . . . . . . . . . . . . . . 24 Nigel M.Azer and Thomas S.Thornhill Chapter 4 Radiological Evaluation ofTotal Knee Arthroplasty . . . . . . . 36 David A.Feiock,Joel S.Newman,and Arthur H.Newberg Part II General Principles of Revision Surgery Chapter 5 Skin Exposure Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 Ginger E.Holt and Douglas A.Dennis Chapter 6 Exposure Options for Revision Total Knee Arthroplasty . . . 63 Gerard A.Engh xiii xiv Contents Chapter 7 Removal ofthe Femoral and Tibial Components for Revision Total Knee Arthroplasty . . . . . . . . . . . . . . . . . . . . . 76 Daniel J.Berry Chapter 8 Allograft in Revision Total Knee Arthroplasty . . . . . . . . . . . . 81 J.Craig Morrison and Donald T.Reilly Chapter 9 Modular Augments in Revision Total Knee Arthroplasty . . . 97 J.Bohannon Mason Chapter 10 Custom Implants in Revision Total Knee Arthroplasty . . . . . 105 J.Craig Morrison,David K.DeBoer,and Michael J.Christie Chapter 11 Femoral Alignment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117 James Huddleston,Reuben Gobezie,and Harry Rubash Chapter 12 Tibial Alignment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129 James V.Bono Chapter 13 Use ofStems in Revision Total Knee Arthroplasty . . . . . . . . 137 Thomas K.Fehring Chapter 14 Restoration ofStability,Maintaining Joint Line,Gap Balancing,and Constraint Selection . . . . . . . . . . . . . . . . . . . 145 Brian McDermott Chapter 15 Management ofthe Extensor Mechanism During Revision Total Knee Arthroplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152 Richard S.Laskin and Burak Beksaç Part III Special Considerations Chapter 16 Infection in Total Knee Arthroplasty . . . . . . . . . . . . . . . . . . . 167 Carl Deirmengian,Samir Mehta,and Jess H.Lonner Chapter 17 Periprosthetic Fractures After Total Knee Arthroplasty . . . . 183 Michael E.Ayers,Richard Iorio,and William L.Healy Chapter 18 Total Knee Arthroplasty After Failed High Tibial Osteotomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195 Michael C.Dixon and Richard D.Scott Chapter 19 Total Knee Arthroplasty Following Prior Unicompartmental Replacement . . . . . . . . . . . . . . . . . . . . . . 206 William P.Barrett Chapter 20 Hinge Implants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219 David W.Manning,Peter P.Chiang,and Andrew A.Freiberg Chapter 21 Total Knee Arthroplasty After Fractures About the Knee . . . 237 Russell E.Windsor and William L.Walter

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