Introduction and Diagnosis Critical Points Introduction and Diagnosis Patients with chronic insufficiency of the lateral and posterolateral structures may develop a gait abnormality characterized by excessive knee hyperextension during the stance phase of the gait cycle. Gait abnormality is easily…
Clinical Concepts The protocol described in this chapter was designed for opening-wedge high tibial osteotomy (HTO) and distal femoral osteotomy (DFO). The operative techniques, detailed in Chapter 26 , prevent delayed union or nonunion and collapse at the osteotomy site…
Indications Critical Points Indications Varus osseous malalignment: weight-bearing line <50% of tibial width Mild to moderate symptomatic arthrosis medial tibiofemoral compartment Articular cartilage retained in medial tibiofemoral compartment To achieve normal limb alignment before: Medial meniscus transplant Articular cartilage restorative…
Clinical Concepts Critical Points Clinical Concepts Initial rehabilitation goal: prevent excessive compressive and shear forces through limited weight bearing General Postoperative Healing Expectations Rapid healing of peripheral meniscus repairs Delayed healing of complex meniscus repairs in middle third region Further…
Indications Critical Points Indications Prior meniscectomy Age ≤50 years Pain in the meniscectomized tibiofemoral compartment No radiographic evidence of advanced joint deterioration; ≥2 mm of tibiofemoral joint space on 45-degree weight-bearing PA radiographs No or only minimal bone exposed on tibiofemoral…
Introduction The crucial roles of the menisci in the human knee are well understood and include load bearing, load transmission, shock absorption, knee joint stability, and lubrication and nutrition of articular cartilage. Meniscectomy frequently leads to irreparable joint damage, including…
Clinical Concepts Medial ligament injuries are among the most frequently treated problems of the knee joint. Whereas isolated superficial medial collateral ligament (SMCL) ruptures are common, concomitant damage to the anterior cruciate ligament (ACL) occurs in many cases, especially in…
Indications Medial ligament injuries are among the most frequently treated problems of the knee joint, with the majority not requiring operative intervention. Whereas isolated superficial medial collateral ligament (SMCL) ruptures are common, concomitant damage to the anterior cruciate ligament (ACL)…
Clinical Concepts Critical Points Clinical Concepts Protocol for posterior cruciate ligament reconstruction for procedures with high-strength two-strand graft (quadriceps tendon-bone, bone-patellar tendon-bone). Progress patient on athletic and occupational goals, condition of the articular surfaces and menisci, return muscle function, postoperative…
Indications Critical Points Indications 6- to 10-mm increased lateral tibiofemoral joint opening 20 degrees of flexion. ≥15 degrees increased external tibial rotation 30 degrees, 90 degrees of flexion. ± Varus recurvatum, standing and supine. ± Hyperextension gait abnormality. Double or…