Full Description
Early in its development, the subject matter of any field of surgery is too ill-defined and opinions are too fluid for the production of a book on the subject to be possible. Late in its development, controversy is at an end, and although it is still possible to produce a textbook, it is too late to produce a book that might stimulate discussion and crystallise ideas. This book has that objective, it being the Editor's view that the field of the surgical treatment of arthritis of the knee had reached an appropriate intermediate stage in 1978 when this text was written. Three broad issues stand out as being in need of resolution before the optimum form of surgical treatment for a given knee can be defined more convincingly than is possible at present: Firstly: What symptomatic and physical features of the knee are to be recorded pre- and post-operatively, upon the basis of which comparisons can be made between the results obtained by two different surgeons or with two different tech niques. The resolution of this issue requires general agreement not only upon what features of the knee should be recorded but, crucially, upon how these features should subsequently be presented so as to characterise a particular group of knees.
Contents
1. Biomechanics.- Movements of the Normal Knee.- Forces Transmitted Through the Normal Knee.- Mode of Transmission of Force Through the Normal Knee.- The Strength of the Normal Knee.- Forces in Misaligned Natural Knees.- Biomechanics of Knee Replacement.- References.- 2. The Surgical Anatomy and Pathology of the Arthritic Knee.- Normal Alignment and Movement.- Incidence of Deformity.- Relevant Observations at the Hip.- The Nature of the Morbid Anatomical Changes Responsible for Deformity of the Knee in OA and RA.- Conclusions.- References.- 3. Clinical Assessment.- Collection of Data.- Radiological and Ancillary Methods of Examination.- Recording of Data.- Storage, Retrieval, and Analysis of Data.- Presentation of Data.- Discussion.- References.- 4. Radiological Examination of the Knee Joint and Other Special Investigations.- Special Radiographs.- Arthroscopy in Degenerative Arthritis.- Scintigraphy.- Conclusion.- References.- 5. Conservative Management.- Rheumatoid Arthritis.- Osteoarthrosis.- References.- 6. Soft-Tissue Operations.- Synovectomy.- Removal of Baker's Cyst.- Soft-Tissue Release Procedures.- Resection of the Anterior Cruciate Ligament.- Nerve Resection.- Meniscectomy.- Débridement (the Spring-clean Procedure).- Patellectomy.- Summary.- References.- 7. Arthrodesis.- Historical Background.- Disadvantage of Stiffness at the Knee.- Indications for Primary Arthrodesis of the Knee in 1977.- Arthrodesis as a Revision Procedure.- Requirements for Successful Arthrodesis.- Techniques of Fusion Useful in the Revision of Failed Arthroplasty.- Excision Arthroplasty as a Salvage Procedure.- References.- 8. Osteotomy.- Pathogenesis of Osteoarthritis of the Knee.- Rationale for Surgical Treatment of OA of the Knee.- Choice of a Surgical Procedure.- Post-operativeTissue Changes.- Clinical and Radiological Results.- Conclusions.- References.- 9. Tibio-femoral Replacement Using Four Components with Retention of the Cruciate Ligaments. (The Polycentric Prosthesis).- Historical Development.- Discussion.- References.- 10. Tibio-femoral Replacement Using Two Components, with Retention of the Cruciate Ligaments. (The Geometric and Anametric Prostheses).- History.- The Evolution of the Geometric Prosthesis.- Biomechanics as They Relate to the Geometric Prosthesis.- Indications.- Results.- Complications.- The Future.- Operative Technique.- Patello-femoral Replacement.- References.- 11. Tibio-femoral Replacement Using a Totally Constrained Prosthesis and Cruciate Resection. (The Guépar Prosthesis).- Historical Account and Introduction.- Mechanical Findings on Total Hinged Prostheses.- Types of Hinged Prosthesis.- Complications.- Functional Results.- Conclusions and Indications.- References.- 12. Tibio-femoral Replacement Using a Semi-stabilised Prosthesis and Cruciate Resection (The Sheehan, GSB, Attenborough and Spherocentric Prostheses).- Design Features.- Clinical Results.- Further Remarks on Individual Series.- Summary.- References.- 13. Tibio-femoral Replacement Using Two Un-linked Components and Cruciate Resection. (The ICLH and Total Condylar Prostheses).- ICLH (Freeman-Swanson) Arthroplasty.- Total Condylar Arthroplasty.- References.
