Before proceeding with unicompartmental knee arthroplasty (UKA), the surgeon must decide at arthrotomy whether the patient is an appropriate candidate. Both cruciate ligaments should be intact, although a deficient anterior cruciate ligament (ACL) occasionally is acceptable if certain criteria are…
In theory, unicompartmental knee arthroplasty (UKA) is an attractive alternative to osteotomy and total knee arthroplasty (TKA) in selected osteoarthritic patients. Advantages of UKA over osteotomy include higher initial success, fewer early complications, greater longevity, better cosmetic limb alignment, easier…
Mobile-bearing articulations for knee arthroplasty have been available since the 1970s. Nevertheless, for decades, they never gained great popularity and remained an alternative technique embraced by a small group of surgeons. In the early 2000s, interest in these articulations was…
Patients are rightfully trying to become more educated about their surgery and recovery. They often obtain (mis)information on the Internet or from friends. They need to be informed about their surgeon’s individual postoperative protocol, and they need to have their…
Many problems or mishaps can be encountered during routine and not-so-routine total knee arthroplasty (TKA). In this chapter, I address several of these and offer potential solutions. Choosing the Correct Incision Wound necrosis after TKA can be a minor inconvenience…
Sepsis occurring after total knee arthroplasty (TKA) is a disastrous complication. I was fortunate in my career in that after more than 6000 primary TKAs, none of my patients had experienced an early deep infection. I have seen late “metastatic”…
Because arthritis of the knee has a significant incidence of bilaterality, both patients and surgeons often consider the possibility of bilateral simultaneous total knee arthroplasty (TKA). I am a strong advocate of this procedure in properly selected patients, and the…
Femoral Deficiency Options available for reconstitution of deficient bone stock on the femoral side include bone grafting, cement alone, cement plus screw augmentation, augmented components, trabecular metal augments and custom components. Bone Grafting Bone grafting is appropriate for all contained…
Total knee arthroplasty (TKA) in patients with rheumatoid arthritis has unique features that are different from those encountered in patients with osteoarthritis. Through the years, I have taken care of a large number of patients with rheumatoid arthritis requiring TKA…
Conversion of osteotomy to total knee arthroplasty (TKA) can be extremely difficult for multiple reasons including the presence of prior incisions, difficult operative exposure, the presence of retained hardware, joint line angle distortion, malunion, nonunion, patella baja, offset tibial shafts,…