This book is published open access under a CC BY 4.0 license. White Paper on Joint Replacement This White Paper details the status of hip and knee arthroplasty care in Germany. Hip and knee replacements are amongst the most frequently performed procedures and usually become necessarily due to age-related wear of the joint, osteoarthritis and fractures of the femoral neck. In light of demographic change, demands with regard to standards of care and the procedures are likely to rise. Contents • This White Paper contains information on indications, procedures, health economic aspects and the healthcare system stakeholders involved. • It portrays current developments with regard to the prevalence of hip and knee arthroplasty, the healthcare situation and quality of care within the chain of medical care. • This book is complemented by a chapter assessing the current situation from an expert perspective with contributions from renowned experts in the fields of science, medical technology and medical practice. This book addresses people involved in shaping and representing the healthcare system from a variety of fields including medical professions, health insurances and health sciences as well as journalists and patient representatives.

Dr. James Wright, Associate Editor for the Journal of Bone and Joint Surgery, presents this landmark publication and novel approach to orthopaedic problems and solutions. This new, evidence-based reference examines clinical options and discusses relevant research evidence to provide you with expert recommendations for best practice. The consistent chapter format and featured summary tables provide "at-a-glance? access to the evidence-based literature and clinical options. Leading authorities contribute their expertise so you can apply the most effective clinical solutions to the persistent questions you encounter in your practice. You can even access the fully searchable and regularly updated text online The result is an outstanding resource in clinical orthopaedics, as well as a valuable framework for translating evidence into practice.

Infections of the bones (osteomyelitis) and joints (septic arthritis) are serious health problems which require antibiotics and often surgery. Awareness among health professionals of the causes and treatment options for various types of bone and joint infections is essential for effective resolution. Bone and Joint Infections takes a multidisciplinary approach in covering the diagnostic and therapeutic treatment of osteomyelitis and septic arthritis, including different types of implant-associated infections. Correct and rapid diagnosis of bone and joint infection is crucial, and requires the input of a variety of specialists. Bone and Joint Infection takes a similarly collaborative and comprehensive approach, including chapters authored by clinicians, laboratory specialists, and surgeons. Covering the basic microbiology and clinical aspects of bone and joint infection, this book will be a valuable resource both for researchers in the lab and for physicians and surgeons seeking a comprehensive reference on osteomyelitis and septic arthritis.

Written by leading experts from the Mayo Clinic, this volume of our Orthopaedic Surgery Essentials Series presents all the information residents need on hip, knee, shoulder, and elbow reconstruction in adults. It can easily be read cover to cover during a rotation or used for quick reference before a patient workup or operation. The user-friendly, visually stimulating format features ample illustrations, algorithms, bulleted lists, charts, and tables. Coverage of each region includes physical evaluation and imaging, evaluation and treatment of disorders, and operative treatment methods. The extensive coverage of operative treatment includes primary and revision arthroplasty and alternatives to arthroplasty.

This book presents a compilation of topics related to primary total knee arthroplasty. The chapters cover, in a clear and didactic way, the current themes, written by experts from the area, from different parts of the world. Topics related to the three surgical phases (before surgery, during surgery, and after surgery) are discussed here. This is very important because the surgeon is not a "factory worker." First of all, it is a medicine doctor who has to feel and understand the particularities of each patient. Demographic studies show an aging population. Osteoarthritis and inflammatory diseases are becoming much more prevalent. In addition, a worldwide epidemic of trauma has led to the need for arthroplasties much more frequently. Therefore, total knee arthroplasty will be an increasingly important subject.

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 .