Introduction Tibial plateau fractures have been documented in the literature as early as the 1820s, and the mainstay of treatment was nonoperative until the 1950s. Many reports in the 1970s and beyond suggest that open reduction and internal fixation is…
Introduction Demographics Fractures involving the tibial articular surface account for a little over 1% of all long bone fractures, 56.9% of all proximal tibia fractures/dislocations, and 8% of all fractures in the elderly. These fractures have an annual incidence of…
Introduction The anatomy of the proximal tibia involves a complex interaction between bone, ligaments and their attachment sites, cartilage, and muscles. The knee is an intricate hinge joint consisting of the tibia, femur, and patella. Ligamentous and muscular attachment sites…
OVERVIEW Chapter synopsis Osteoarthritis (OA) is a progressive degenerative joint disease that leads to considerable disability and plagues our aging population with pain and impaired function. There are currently no treatments that reverse or halt the progression of osteoarthritis. Various…
OVERVIEW Chapter synopsis Proximal tibiofibular joint instability is an uncommon injury that can often be difficult to diagnose. Anterior instability is the most common pattern of instability involving disruption or attenuation of the posterior ligaments. If conservative treatment fails, anatomic…
OVERVIEW Chapter synopsis Arthrofibrosis of the knee is a preventable complication that presents many challenges to the treating physician. Effective treatment involves working closely with rehabilitation staff, with the overall objective being to regain symmetrical knee extension, knee flexion, and…
OVERVIEW Chapter synopsis In patellofemoral surgery, complex decision-making is common, given the variability of anatomic, structural, psychosocial, and functional factors pertaining to patellofemoral disorders. History and physical examination are always important. Listening closely to the patient is essential regarding the…
OVERVIEW Chapter synopsis Tibial tuberosity osteotomy (TTO), often performed in conjunction with other proximal realignment procedures, is an effective treatment to address patellofemoral instability, patellar and trochlear focal chondral defects, and patellofemoral arthritis. TTO is a powerful tool that can…
OVERVIEW Chapter synopsis Trochlear dysplasia has been recognized as the most common anatomical anomaly associated with recurrent lateral patellar dislocation. A thorough physical exam and imaging evaluation is important to identify the small percentage of patients with high-grade trochlear dysplasia…
OVERVIEW Chapter synopsis Important points Indications Patients with medial patellar subluxation or dislocations Patients with excessive lateral patellar laxity undergoing medial patellofemoral ligament reconstruction Relative contraindications Unaddressed symptomatic patellofemoral chondral damage Surgical technique Soft tissue-based reconstruction with a semi-tendinosis allograft…