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Total shoulder arthroplasty

See also Video 7.1 . Total shoulder arthroplasty is a well-established procedure with an excellent long-term track record of pain relief and functional improvements. The primary indication for total shoulder arthroplasty is end-stage glenohumeral joint degeneration with an intact rotator cuff. Preparation of the humerus ■ Place the patient in the beach chair position using a headrest to allow positioning of the patient at the top…

Revision Total Knee Arthroplasty Using Kinematic Alignment Principles

Overview This is the last chapter in a book conceived of as a resource for surgeons interested in rethinking alignment in total knee arthroplasty (TKA). The aim is to improve the function of TKAs above and beyond the currently accepted standard. The idea that an individualized approach to TKA alignment focusing on the restoration of the patient’s native joint line and axis of rotation as the…

Retaining the Posterior Cruciate Ligament and Restoring the Prearthritic Tibial Joint Line Reduces the Risk of Early-Onset Tibiofemoral Instability After Calipered Kinematically Aligned Total Knee Arthroplasty

Overview This chapter contains discussion and videos that assist the surgeon in (1) reducing the risk of early-onset tibiofemoral instability) and (2) managing the instability when it occurs after calipered kinematically aligned (KA) total knee arthroplasty (TKA). The chapter draws from the author’s experience treating over 1527 primary TKAs implanted from 2017 through 2019. In each, the target for setting the components was coincident to the…

Reducing the Risk and Management of Patellofemoral Instability After Calipered Kinematically Aligned Total Knee Arthroplasty

Overview The discussion and video links in this chapter assist the surgeon in reducing the risk of patellofemoral instability and in managing it when it occurs after calipered kinematically aligned (KA) total knee arthroplasty (TKA). The first section reports the incidence, time of onset, and causes of patellofemoral instability using currently available femoral components designed for mechanical alignment (MA). The second section uses results from in…

Reducing the Risk and Management of Early and Late Tibial Component Failure After Calipered Kinematically Aligned Total Knee Arthroplasty

Outline The discussion and videos in this chapter assist the surgeon in (1) reducing the risk of aseptic loosening of the tibial component and (2) managing both early and late tibial component failure from insert wear after calipered kinematically aligned (KA) total knee arthroplasty (TKA). The chapter draws from the author's experience treating of over 5300 primary KA TKAs from 2006 to 2020 without restrictions on…

Reducing the Risk and Methods of Managing Stiffness After Calipered Kinematically Aligned Total Knee Arthroplasty

Overview This chapter contains a discussion and videos to assist the surgeon in reducing the risk and managing stiffness management after calipered kinematically aligned (KA) total knee arthroplasty (TKA). The treatment of over 5300 primary TKAs from 2006 to 2020 with the anatomic target of restoring the patient’s prearthritic femoral and tibial joint lines regardless of knee deformity, without ligament release with posterior cruciate ligament (PCL)–retaining…

Postoperative Management

Overview Similar to the preoperative evaluation, postoperative management of the kinematically aligned (KA) patient does not stray from traditional management. Outpatient surgery, physical therapy, and office and radiographic evaluations will certainly vary among surgeons. This chapter presents some framework for optimal care of the KA total knee arthroplasty (TKA) patient. Given the short-term data and lack of long-term data, patients should be followed closely, and data…

Kinematic Alignment Technique for Unicompartmental Knee Arthroplasty

Overview The kinematic alignment (KA) technique for unicompartmental knee arthroplasty (UKA) has been successfully performed for decades and presents potential clinical benefits. The discussion and videos in this chapter assist the surgeon in understanding how to perform KA UKA with the calipered technique. The first section defines the KA UKA technique; the second section provides the rationale; the third lists the potential benefits of this technique…

Managing Severe Deformities With Calipered Kinematic Alignment

Overview Currently, there is lack of consensus about the universal definition of severe deformity for the arthritic knee. Some consider a deviation of more than 10 degrees for a varus knee as a significant deformity. Others consider a severe deformity as more than 15 degrees for the varus knee and more than 20 degrees for a valgus knee. , These angles are relative to a hip-knee-ankle…

Clinical Outcome, Postoperative Alignment, and Implant Survivorship After Kinematically Aligned Total Knee Arthroplasty

Overview This chapter reviews the clinical outcome, postoperative alignment, and implant survivorship after kinematically aligned (KA) total knee arthroplasty (TKA) based on results of international randomized controlled trials (RCTs), case-control studies, meta-analyses, and single-surgeon case series. The first section describes differences in patient-reported outcome scores and range of motion between patients treated with KA TKA and mechanical alignment (MA) TKA. Featured are a chronologic review of…

Calipered Kinematically Aligned Total Knee Arthroplasty Closely Restores the Tibial Compartment Forces of the Native Knee

Overview Tibial forces in the medial and lateral compartments following calipered kinematically aligned (KA) total knee arthroplasty (TKA) are of high interest for two reasons. One reason is that knowledge of the tibial compartment forces provides a quantitative indication of how well the goal of restoring biomechanical variables characterizing knee function to native has been achieved. A second is that differences in tibial forces between the…