Ligament Balancing in Total Knee Arthroplasty: An Instructional Manual

by Leo A. Whiteside

Overview

The varus knee has a group of bone and ligament abnormalities that must be addressed to correct the deformity. The mechanical axis of the femur is tilted medially relative to the long axis of the tibia. The distal femoral surface usually remains in valgus alignment to the long axis of the femur. Most of the varus deformity is caused by deficiency in the medial tibial plateau. The deep and superficial medial collateral ligaments are contracted and deformed by osteophytes.

Product Details

ISBN-13:	9783642639241
Publisher:	Springer Berlin Heidelberg
Publication date:	09/15/2011
Edition description:	Softcover reprint of the original 1st ed. 2004
Pages:	115
Product dimensions:	7.60(w) x 10.63(h) x 0.01(d)

Table of Contents

1. Introduction.- 2. Patella.- 3. Posterior Cruciate Ligament.- 3.1. Tight Posterior Cruciate Ligament.- 3.2. Release of the Posterior Cruciate Ligament.- 4. Varus Knee.- 4.1. Tight Medially in Flexion, Loose in Extension.- 4.2. Tight Medially in Extension, Balanced in Flexion.- 4.3. Tight Medially in Flexion and Extension.- 4.4. Tight Popliteus Tendon.- 4.5. Compensatory Lateral Release — Extension Only.- 4.6. Compensatory Lateral Release — Flexion and Extension.- 4.7. Pitfalls of the Varus Knee.- 5. Valgus Knee.- 5.1. Tight Laterally Flexion and Extension.- 5.2. Tight Laterally in Extension, Normal Stability in Flexion.- 5.3. Tight Laterally in Flexion, Normal Stability in Extension.- 5.4. Deficient Posterior Cruciate Ligament.- 5.5. Pitfalls of the Valgus Knee.- 6. Flexion Contracture and Femoral Sizing.- 6.1. Varus Knee with Flexion Contracture.- 6.2. Pitfalls with Flexion Contracture.- 7. Recurvatum.- 8. Summary.

Editorial Reviews

Reviewer: Riad Barmada, MD (University of Illinois at Chicago College of Medicine)
Description: This book demonstrates the technique of total knee replacement and, in particular, how to assess intraoperatively ligament balance and detailed balancing procedures.
Purpose: Ligament balancing affects the end results of knee replacement. The objective of this publication is to demonstrate how to manage ligament imbalance.
Audience: The intended audience includes orthopedic surgeons and residents.
Features: The author starts with an excellent introduction explaining anatomical alignment of the knee and the role of the various ligaments and muscles in stabilizing anatomical alignment of the knee and the role of these structures in stabilizing the joint. The subsequent chapters provide detailed presentations of techniques to balance soft tissue structures and other technical aspects of total knee replacement in the presence of fixed deformity such as valgus, varus, and flexion contracture.
Assessment: This is an outstanding book that describes the various factors involved when doing knee replacement for knees with fixed deformity and presents detailed information on surgical techniques — how and when to do soft tissue balancing. This is an extremely helpful publication for any orthopedic surgeon involved in joint replacement surgery and should be on the priority list of readings for orthopedic residents.

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