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A Practical Operative Guide for Total Knee and Hip Replacement

A Practical Operative Guide for Total Knee and Hip Replacement

          
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About the Book

The protocols and techniques of total knee and hip replacement surgeries are mentioned in sequential order.
Extension of chapters like total knee replacement (TKR) by navigation system, important points and total hip replacement (THR) in difficult situations, bone cement, ultrasonic system for cemented and uncemented revision surgeries, complications and revision THR, physiotherapy in TKR and THR has been made.
Postoperative pain management has been described.
Management of complications like supracondylar fracture femur and infection following TKR have been included.
Technique of revision TKR and THR has been mentioned.
Various techniques of postoperative analgesia like patient-controlled analgesia (PCA) have been added in addition to epidural analgesia.
To make these special surgeries easier, diagrammatic and some more original photographs have been included.
Useful reading for surgeons, orthopedicians and practitioners.

About the Author

Ajit Kumar Mehta MBBS D Ortho MS (Ortho)



Table of Contents:
1. Introduction 1 History and Clinical examination 1 Investigations 2 Radiographic classification of osteoarthritis of knee 2 Physiotherapy, Education and Training 3 Medicines to be started 3 Medicines to be stopped prior to surgery 4 Informed Consent for surgery 4 Patient and relatives’ signature for Risk/Benefit ratio 5 Preoperative planning for TKR 5 Applied anatomy 7 Types of total knee replacement 9 Preparation of the patient for surgery and arranging blood 10 2. Total Knee Replacement (Cruciate-substituting Fixed Bearing TKR) 11 Tourniquet Application 11 Positioning 11 Scrubbing 12 Draping 12 Incision 13 Exposure of Knee 13 Tibial Cut 14 Femoral Cut 15 Resurfacing of Patella 24 Tibial Preparation 25 Cementing 26 Application of Tibial Insert 31 Wound Closure 32 Transfer of Patient from Ot 32 Postoperative Advice 32 Follow-up Schedule 36 Assessment during Follow-up 36 3. Difficult Situations and Important Points 38 Total Knee Replacement (Tkr) in Difficult Situations 38 Post-Hto Tkr 48 Important Points 51 Implants and Cement Required for Primary Tkr 58 Knee Implants 59 Summary of TKR (Steps in Sequence) 59 Instruments Required for Tkr 60 4. Rotating Platform High Flexed TKR 62 Fixed Bearing versus Mobile Bearing TKR (RPF) 62 Instruments Required for RPF TKR 65 Fundamentals of TKR 65 Contents xiv A Practical Operative Guide for Total Knee and Hip Replacement 5. Complications and Revision TKR 67 Periprosthetic Fracture 67 Infection 70 Knee Arthrodesis with Limb Reconstruction System in Cases of Infected Tkr 75 Extensor Mechanism Patellar Tendon Rupture 81 Aseptic Loosening 85 Revision TKR 86 Standard condylar revision knee system 88 Implants required during Revision TKR 95 Two-stage Revision TKR for late infections 97 TC3 RP and MBT revision tray system (TC3 RP System and Metaphyseal Sleeve Fixation) 99 S-ROM Noiles Rotating Hinge Knee System 105 6. TKR by Navigation system 107 Steps 108 Additional Instruments Required during Tkr by Naviagation System 111 7. Total Hip Replacement 112 Preoperative Planning 112 Positioning—Lateral Position 117 Draping 118 Posterior Approach 118 Uncemented Thr (Summit Stem) 120 Instruments Required for Uncemented Thr (Summit stem) 133 Instruments Required for Pinnacle Cup and Head 134 Instruments Required for Delta Motion Cup and Head 135 Implants Required for Uncemented Thr (Summit stem) 135 Implants Required for Pinnacle Cup and Head (Ceramic on Ceramic or Ceramic on Polyethylene Liner) 135 Implants Required for Delta Motion Cup and Head 135 Different Measurements of Femoral Stem 136 Features of Summit Tapered Hip System 136 Cemented THR (C-stem) 137 Instruments Required for Cemented THR (C-stem) 142 Implants and Cement Required for Cemented Thr (C-stem) 143 Features of Triple Taper C-stem 144 Assessment during Follow-up 144 Summary of Thr (Steps in Sequence) 145 8. Important points and THR in difficult situations 147 Important Points 147 Total Hip Replacement in Difficult Situations 151 9. Bone Cement 172 Indications 172 Contraindications 172 Precautions 173 Special Warnings 173 Information for Use 173 Undesirable Effects 174 Package Quantities 174 xv Contents 10. Ultrasonic System for Cemented and Uncemented Revision Surgeries 175 Goal 175 Principle 175 Ultrasonic System 175 Technique 176 Factors that Affect Risk of Thermal Energy 178 Precautions during Surgical Procedures 179 11. Complications and revision THR 180 Complications 180 Acetabular Defects 180 Femoral Defects 183 Stem Fracture 189 Periprosthetic Fracture 193 Infection 199 Implants Required for Revision Thr 206 Moreland Instruments Required for Removal of Bone Cement and Failed Implants 208 12. Physiotherapy in TKR and THR 209 TKR 209 THR 209 13. Patient’s guide to Arthritis and Joint Replacement 211 Suggestions to the Patients 213 Job Recommendation for Person who has Undergone Tkr and/or Thr 213 14. OT Setup for Joint Replacement surgery 214 Vertical Laminar Flow Ventilation 214 Prevention of Infection 216 Factors Responsible for Contamination in Ot 216 Recommendation by British Medical Council for Ot Setup 216 Nano Tio2 (Titanium Dioxide) Enviro-shield 216 Bibliography 217 Index 221


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Product Details
  • ISBN-13: 9789351524823
  • Publisher: Jaypee Brothers Medical Publishers
  • Binding: HARDCOVER
  • Edition: 2
  • Language: English
  • Returnable: Y
  • Weight: 700 gr
  • ISBN-10: 9351524825
  • Publisher Date: 31 Mar 2015
  • Depth: 25
  • Height: 279 mm
  • No of Pages: 223
  • Spine Width: mm
  • Width: 216 mm


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