Curbside Consultation in Knee Arthroplasty 49

Are you looking for concise, practical answers to those questions that are often left unanswered by traditional knee arthroplasty references? Are you seeking brief, evidence-based advice for complicated cases or controversial decisions?Curbside Consultation in Knee Arthroplasty: 49 Clinical Questionsprovides quick answers to the thorny questions most commonly posed during a "curbside consultation" between orthopedic surgical colleagues. Dr. Craig J. Della Valle has designed this unique reference which offers expert advice, preferences, and opinions on tough clinical questions commonly associated with knee arthroplasty. The unique Q&A format provides quick access to current information related to knee arthroplasty with the simplicity of a conversation between two colleagues. Numerous images, diagrams, and references are included to enhance the text and to illustrate the management of the knee. Curbside Consultation in Knee Arthroplasty: 49 Clinical Questionsprovides information basic enough for residents while also incorporating expert advice that even high-volume clinicians will appreciate. Practicing orthopedists, orthopedic residents, and non-physician personnel will benefit from the user-friendly and casual format and the expert advice contained within. Some of the questions that are answered: bull; I have a patient who has a deformity of the distal femur and arthritis of the knee. Should I do an osteotomy to correct the deformity? bull; If I am doing a total knee arthroplasty and the patella does not seem to track well, what should I do? bull; I am doing a total knee in a patient with a varus deformity. I have done my standard release and the knee is still tight medially. What should I do? bull; What do I do if I cut the MCL intra-operatively? bull; How do you assess joint line position at the time of revision TKA? What are the clinical consequences if it is elevated?

Craig J. Della Valle, MD is an Adult Reconstructive Surgeon who focuses on Total Hip and Knee Arthroplasty at Rush University Medical Center in Chicago, IL. He specializes in complex primary and revision surgery as well as unicompartmental arthroplasty of the knee and hip resurfacing. Dr. Della Valle completed his residency at the Hospital for Joint Diseases in New York City and his fellowship in adult reconstructive surgery at Rush. In addition to his clinical duties, he is involved in numerous clinical research projects. Dr. Della Valle serves as an Associate Professor of Orthopaedic Surgery at Rush University Medical Center.

Dedication	p. v
Acknowledgments	p. xi
About the Editor	p. xiii
Contributing Authors	p. xv
Foreword	p. xix
Preoperative Questions
How Do You Decide When a Patient Is "Ready" for a Total Knee Replacement? Is There a Downside to Waiting Until They Have More Severe Disease?	p. 3
Management of Unicompartmental Osteoarthritis of the Knee	p. 7
I Have a Patient With a Deformity of the Distal Femur and Arthritis of the Knee. Should I Do an Osteotomy to Correct the Deformity at the Time of Total Knee Arthroplasty?	p. 11
If a Patient Has a Clearly Visible Calcified Vessel in the Posterior Aspect of Their Knee on the Preoperative Radiograph, Should I Use a Tourniquet? What About the Patient with a History of Prior Bypass Grafts?	p. 15
Should My Patients Donate Blood Prior to Surgery?	p. 19
When Do You Do a One-Stage Bilateral Total Knee Arthroplasty as Opposed to Staging Them?	p. 23
Should the Patella Be Routinely Resurfaced at the Time of Total Knee Arthoplasty?	p. 27
I Have a Patient Who Is Very Concerned About Their Range of Motion. Should I Use a High Flex Type Component?	p. 31
I Have a 43-year Old Male Who Needs a Total Knee: Should I Use Highly Cross-linked Polyethylene as a Bearing Surface?	p. 35
I Think My Patient May Have a Charcot (Neuropathic) Knee. Is This a Contraindication to Total Knee Arthroplasty?	p. 39
I Am Considering Implementing a Teaching Class Prior to Surgery for My Patients. Is This Beneficial? What Topics Should be Covered?	p. 43
Intraoperative Questions
If a Patient Has Had Prior Surgery, How Do I Decide Where to Make the Skin Incision?	p. 49
If I Am Doing a Total Knee Arthroplasty and the Patella Does Not Seem to Track Well, What Should I Do?	p. 53
How Do You Determine Appropriate Femoral Component Rotation at the Time of Surgery	p. 59
How Do I Determine Tibial Component Rotation in Total Knee Arthroplasty?	p. 63
How Do I Perform a Lateral Release?	p. 67
The Femoral Component Sizing Guide Is Measuring Between Two Sizes. Should I Choose the Smaller or Larger Size?	p. 73
What Is Flexion Instability and How Do I Prevent It During Total Knee Arthroplasty?	p. 77
I Am Doing a Total Knee in a Patient With a Varus Deformity. I Have Done My Standard Release and the Knee Is Still Tight Medially. What Should I Do?	p. 83
When Performing a Total Knee Arthroplasty in a Patient With a Valgus Deformity, What Structures Do You Release First?	p. 89
If I Am Doing a Total Knee and It Is Too Tight in Extension, But Otherwise Feels Well Balanced, What Should I Do?	p. 93
The Patella Measures 22 Millimeters Prior to Making My Osteotomy. How Much Bone Should I Remove?	p. 97
What Should I Do If I Cut the MCL Intraoperatively?	p. 101
When Do You Use Antibiotic-Loaded Cement?	p. 105
Do You Inject the Capsule With Anything at the End of the Case in an Effort to Decrease Perioperative Pain?	p. 109
Postoperative Questions
I Have a Patient Who Is 2 Weeks Postoperative From a Primary Total Knee Arthroplasty and the Wound Is Draining. What Should I Do?	p. 113
What Is the Best Method for Preventing Thromboembolic Events After Total Knee Arthroplasty?	p. 115
In the Recovery Room My Patient Does Not Have a Distal Pulse in the Operative Leg. What Should I Do?	p. 119
My Patient Has a Foot-Drop After Surgery. What Should I Do?	p. 123
What Criteria Do You Use for a Manipulation Under Anesthesia?	p. 127
I Have a Patient Who Fell 3 Months Postoperatively and Fractured Their Patella. Should I Try and Fix It?	p. 129
I Have a Patient Who Tripped and Fell 3 Months After a Total Knee Arthroplasty and Has a Supracondylar Femur Fracture. What Is the Optimal Method of Treatment?	p. 133
How Do You Manage Acute Extensor Mechanism Disruptions?	p. 137
Revision Questions
How Do You Evaluate the Patient With a Painful Total Knee Arthroplasty?	p. 143
What Is the Best Test for Diagnosing Periprosthetic Infection?	p. 147
If I Am Doing a Revision Total Knee and Can't Seem to Get Adequate Exposure, What Should I Do?	p. 151
When Doing a Revision Total Knee, Do You Start Reconstructing the Femur or Tibia First?	p. 155
Should I Use Stems on All of My Revision Total Knee Components?	p. 161
If I Use a Stem at the Time of a Revision Total Knee Arthroplasty, Should I Press-Fit the Stem or Cement It?	p. 165
When Do You Use an Offset Stem During Revision Total Knee Replacement?	p. 169
How Do You Handle Massive Bone Loss at the Time of Revision Total Knee Arthroplasty?	p. 173
How Do I Decide If I Should Retain the Patellar Component at the Time Of Revision Total Knee Arthroplasty?	p. 177
How Do You Manage the Patient With Severe Patellar Bone Loss at the Time of Revision Total Knee Arthroplasty?	p. 181
How Do You Assess Joint Line Position at the Time of Revision Total Knee Arthroplasty? What Are the Clinical Consequences If It Is Elevated?	p. 185
When Should I Use a Constrained Condylar Insert as Opposed to a Posterior Stabilized Insert?	p. 189
How Should I Manage the Patient With Chronic Extensor Mechanism Deficiency Associated with a Total Knee Arthroplasty?	p. 193
Do You Use Static or an Articulating Spacer for Resection Arthroplasty Prior to Reimplantation?	p. 199
What Are Your Indications for a Knee Fusion?	p. 203
How Do You Manage the Patient with an Unexpectedly Positive Culture at the Time of a Revision Total Knee Arthroplasty?	p. 207
Index	p. 211
Table of Contents provided by Ingram. All Rights Reserved.

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Curbside Consultation in Knee Arthroplasty 49 Clinical Questions

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