This comprehensive reference on total knee arthroplasty describes all surgical techniques and prosthetic designs for primary and revision arthroplasty, discusses every aspect of patient selection, preoperative planning, and intraoperative and postoperative care.

The introduction of total joint arthroplasty throughout the world has contributed manifold benefits to patients who suffer from joint diseases. Concurrently, however, there has been an increase in revision surgery. Many orthopedic surgeons agree that durability of prostheses is an eternal problem. In particular, periprosthetic osteolysis recently has been identified as one of the serious problems affecting prosthetic dura bility. To improve durability, osteolysis and many other problems must be investi gated and solved both experimentally and clinically with respect to such aspects as prosthetic material, design, and biological and biomechanical behavior. This book comprises 37 papers that were presented by orthopedic surgeons and biomedical engineers at the 28th Annual Meeting of the Japanese Society for Replace ment Arthroplasty, held in March 1998 in Kanazawa, Japan. The volume is thus a compilation of the latest knowledge about the pathogenesis and reduction of osteolysis and wear, newly developed total hip prostheses, and other current topics of total knee arthroplasty. We earnestly hope that this book will be of benefit to clinicians and researchers, and that it will contribute to the creation of more durable total joint prostheses in the future. SHINICHI IMURA v Contents Preface .................... '" .. .. .. ... . .. .. .. . ... .. . . .. . ... . . .. . V List of Contributors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . XI . . . . . . . . . . . . Part 1 Wear and Pathogenesis of Osteolysis Friction and Wear of Artificial Joints: A Historical Review N. AKAMATSU ................................................ , 3 Matrix Degradation in Osteoclastic Bone Resorption Under Pathological Conditions .

Total knee arthroplasty (TKA) is a frequently performed operation - in the U.S. alone, 5.2 million TKAs were performed from 2000-2010 - and partial (unicompartmental) knee arthroplasty (UKA) is another common operation that is done in younger, active individuals. Many patients require knee arthroplasty from osteoarthritis that develops after sports injuries or decades of participation in athletics. While much has been written regarding technical surgical details of arthroplasty, there is comparably little available on critical rehabilitation principles and guidelines that allow return to normal physical function, as well as recreational and sports activities. Filling this gap in the literature, this group of internationally recognized surgeons and therapists discusses all aspects of critical rehabilitation following both partial and total knee replacement, including: Advances in surgical techniques for robotic computer-navigated knee arthroplasty Effects of preoperative rehabilitation and nutrition on postoperative function Specific rehabilitation principles to avoid complications and return to daily activities Advanced physical therapy concepts to return to recreational and sports activities Objective testing to determine strength and physical function in the arthroplasty athlete Recommended guidelines for recreational and sports activities Key factors for achieving high patient satisfaction and quality of life after surgery Presenting the most up-to-date evidence and guidelines, Critical Rehabilitation for Partial and Total Knee Arthroplasty will be an invaluable resource for orthopedic surgeons, physical therapists, athletic trainers, personal trainers and all professionals caring for patients seeking to return to full activity after knee replacement.

Developed to help occupational therapists learn to use the COPM. Provides a self-directed program which allows learning at your own pace, links reference materials in a step-by-step fashion, and demonstrates examples and clinical scenarios.

This book addresses the need for improved diagnostic and treatment guidelines for patients in whom total knee arthroplasty (TKA) has had an unsatisfactory outcome. It opens by discussing the basics of TKA and the various causes of failure and pain. Diagnostic aspects are considered in detail, with attention to advances in clinical investigation, laboratory analysis and in particular, imaging techniques. In addition, helpful state of the art diagnostic algorithms are presented. Specific pathology-related treatment options, including conservative approaches and salvage and revision TKA strategies, are then explained, with identification of pitfalls and key points. A series of illustrative cases cover clinical scenarios frequently encountered in daily clinical practice. The evidence-based, clinically focused guidance provided in this book, written by internationally renowned experts, will assist surgeons in achieving the most effective management of these challenging cases.

This comprehensive book is more than a complete reference on knee fractures and associated injuries: it is also a decision-making and surgical guide that will assist trauma, knee, sports medicine, and total joint surgeons in planning and executing specific procedures for different traumatic conditions of the knee. Each chapter addresses a particular condition and its management, explaining the traumatic mechanism and preoperative workup and then describing in detail the surgical steps, from patient positioning to the postoperative regimen. Guidance is also provided on complications and their management, and to complete the coverage, results from the relevant literature are described. The authors are world-renowned experts keen to share their knowledge and expertise regarding specific traumatic conditions of the knee. Both experienced surgeons and orthopedic residents will find this book to be an invaluable tool that will improve their practice when dealing with knee fractures.

More than 20 years have passed since the International Symposium on Total Knee Replacement was held in London in 1974. Prosthetic design and operative technique have been greatly improved since then, and there is now an accepted standard concept of total knee arthroplasty. Thirteen years after the London symposium, another international symposium on total knee replacement was held, this time in Nagoya, Japan, in 1987. Its ambitious objective was to push forward the frontiers of continuous investigation and improve ment of total knee replacement. The fruits of the individual efforts presented at the Nagoya symposium were published in a volume of proceedings entitled Total Knee Replacement. In the years since 1987, further investigations have been conducted in various parts of the world regarding prosthetic design, fixation, long-term radiological follow-up, biomechanical evaluation, and biomaterials research. In knee ligament reconstruc tion, rapid progress has been made in the past five years in clinical practice and fundamental research by means of arthroscopic surgery and tissue transplantation, and we have come close to establishing a standard treatment. Under these circumstances, an international symposium on knee joint reconstruc tion was planned for 1994, again to be held in Nagoya, to provide ample opportunity for exchanging information and sharing clinical experience from around the world.