Written by authors who have performed more than 800 total knee and hip replacement surgeries, this full-color book offers step-by-step guidance on this type of procedureHip and knee replacement surgery can improve the quality of life significantly in a wide variety of conditions and disorders, but total knee and hip replacement surgeries are special operations. The surgeons require the highest order of aseptic precaution, surgical skill, and a team of specialists in preoperative, perioperative, and postoperative techniques and protocols. This book fully explains step-by-step procedures and precautions to be observed in undertaking this kind of surgery. Full-color photographs and a DVD of surgical procedures enhance the book's usefulness.

Ajit Kumar Mehta, MBBS, D Ortho, MS (Ortho), is Consultant Orthopedic Surgeon, Orthopedic and Joint Replacement Centre, Jagjivan Ram Hospital, Mumbai, India.

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A Practical Operative Guide for Total Knee and Hip Replacement

9780071634373

0071634371

Summary

Author Biography

Table of Contents

Contents

Chapter 1—Introduction 1

• History and clinical examination 1

• Investigations 2

• Physiotherapy, education and training 3

• Consent for surgery 3

• Patient and relative’s signature for risk/benefit ratio 4

• Preoperative planning for TKR 4

• Arrangement of neurovascular structures around the knee 6

• Blood supply to the knee 6

• Preparation of the patient for surgery and arranging blood 7

Chapter 2—Total Knee Replacement (Cruciate-Substituting Fixed Bearing TKR) 8

• Tourniquet application 8

• Positioning 8

• Scrubbing 8

• Draping 9

• Incision 10

• Tibial cut 11

• Femoral cuts 12

• Resurfacing of patella 21

• Tibial preparation 23

• Cementing 24

• Application of tibial insert 27

• Wound closure 28

• Postoperative advice 28

• Follow-up schedule 34

• Assessment during follow-up 34

Chapter 3—Difficult Situations and Important Points 36

• Total knee replacement (TKR) in difficult situations 36

• Post HTO TKR 45

• Important points 49

• Take care of (precautions to prevent peroperative complications) 52

• Avoid silly mistake 53

• Contraindications of TKR 53

• Ideal indicated patients for successful TKR 53

• Complications 53

• Implants and cement required for primary TKR 54

• Summary of TKR (steps in sequence) 55

• Instruments required for TKR 56

Chapter 4—Rotating Platform High Flexed TKR (RPF) 59

• Fixed bearing versus mobile bearing TKR (RPF) 59

• Instruments required for RPF TKR 63

Chapter 5—Management of Complications after TKR 64

• Periprosthetic fracture 64

• Infection 66

• Knee arthrodesis with LRS in cases of infected TKR 71

• Aseptic loosening 75

• Revision TKR 76

• Implants required for revision TKR 86

• Instruments required for revision TKR 87

Chapter 6—OT Setup for Joint Replacement Surgery 89

• Introduction 89

• Vertical laminar flow ventilation 90

• Prevention of infection 91

Chapter 7—Total Hip Replacement 92

• Preoperative planning 92

• Positioning — Lateral position 101

• Draping 102

• Posterior approach 103

• Cemented THR (C-stem) 104

• Instruments required for cemented THR (C-stem) 110

• Features of triple taper C-stem 111

• Bone cements 112

• Uncemented THR (Summit stem) 115

• Combinations in hip replacement 123

• Assessment during follow-up 128

• Instruments required for uncemented THR (Summit stem) 130

• Implants and cement required for cemented THR (C-stem) 131

• Implants required for uncemented THR (Summit stem) 131

• Implants required for metal on metal, Articulating surface replacement (ASR) 132

• Instruments required for metal on metal, ASR and Pinnacle 133