Anatomy of the knee joint is one of the most complicated when compared to other joints in the human body. Due to high demands and strong forces acting on the knee joint, it is also one of the most injured joints. Every structure in the joint can be damaged and some of the damages demand earlier treatment. Except intraarticular fractures, stress fractures of the proximal tibia, as a result of lower extremity malalignment, need earlier treatment to prevent the dislocation of the fragments. Damage to the articular cartilage needs earlier treatment due to its tendency to involve wider area of the joint. Meniscus rupture is not an indication for earlier treatment, except a "bucket handle" rupture due to its potential to block the movements of the knee joint. Collateral ligament injury needs early treatment to prevent chronic laxity of the joint. Anterior cruciate ligament early reconstruction in top athletes results in their complete rehabilitation and return to the previous level performance. Total knee replacements may result in a number of complications, some of which need prompt treatment. Septic arthritis is a condition that requires prompt treatment, without any hesitation. Failure of earlier or prompt treatment of the conditions of the knee mentioned in this chapter may result in permanent damage to the knee joint.
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Multimodal analgesia and anesthesia have become the gold standard in total joint arthroplasty to reduce postoperative pain and opioid consumption and minimize complications associated with opioid use. There are several elements in an effective multimodal protocol, including oral medications, periarticular injection, regional nerve blocks, and spinal and general anesthesia. Many nonopioid medications are often used, such as acetaminophen and NSAIDs.
View Article and Find Full Text PDFRevision total knee arthroplasty (rTKA) is an increasingly common challenge for arthroplasty surgeons. The survivorship of rTKA is significantly lower than that of primary total knee arthroplasty, resulting in increasing numbers of repeat rTKA. These repeat rTKAs present unique challenges including potentially massive bone loss and increased risk of infection.
View Article and Find Full Text PDFRevision total knee arthroplasty (rTKA) is an increasingly common challenge for arthroplasty surgeons. The survivorship of rTKA is significantly lower than that of primary total knee arthroplasty, resulting in an increasing incidence of repeat rTKA. These cases present multifactorial challenges including the skin and soft-tissue envelopes, bone loss, ligamentous compromise, and often a history of periprosthetic joint infection.
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January 2025
Ankle arthritis is a severely disabling condition. Treatment poses many unique challenges to orthopaedic surgeons because ankle kinematics differs from that seen in the hip or knee joint and the loads transmitted through the ankle are greater during activity. Historically, motion-sacrificing procedures dominated management of ankle arthritis.
View Article and Find Full Text PDFOsteotomies around the knee have a variety of indications, including pain reduction, functional improvement, knee joint stabilization, and articular cartilage preservation. Thorough preoperative planning is essential, including a determination of the precise location of any deformity (proximal tibia, distal femur, or both). High tibial osteotomies and distal femoral osteotomies can be performed in isolation, or jointly in the form of a double-level osteotomy, for correction of coronal and/or sagittal deformity of the knee.
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