Rupture Of The Patellar Tendon

Kelikian Patelar Tendon Ruptures

Rupture of the patellar tendon after total knee replacement is a rare and typically devastating problem Fig. 13.1 . Unfortunately, the results of several methods of acute repair are almost uniformly Numerous theories have been postulated to explain the etiology of late rupture of the patellar tendon following TKA. As mentioned previously, improper surgical technique that malaligns the knee or the position of any single component can play a contributory role. Some authors have found its...

Robert E Booth and Frank P Femino

Scuderi Technique Quadriceps

Rupture of the quadriceps tendon after total knee arthroplasty is rare and there is scant information in the literature regarding this problem.1-3 In the nonimplant population, quadriceps tendon rupture is the more common malady in the older patient and patellar tendon rupture in the younger patient.4-6 The reverse seems to be true after knee replacement despite the older average age of this population. The causes of quadriceps rupture in the total knee arthroplasty patient are multiple. They...

Medial Release for Fixed Varus Deformity

Insall Burstein Knee Replacement

Scuderi, and John N. Insall Varus deformity of the knee is one of the most common deformities seen at the time of total knee arthroplasty. When a fixed deformity is present, the pathoanatomy usually involves erosion of medial tibial bone stock with medial tibial osteophyte formation, and contractures of the medial collateral ligament MCL , pos-teromedial capsule, pes anserinus, and semimembranosus muscle Fig. 3.1 . Elongation of the lateral collateral ligament is a...

The Basic Principles

Flexion Extension Gap Balancing

In primary total knee arthroplasty, whether a posterior cruciate-retaining or posterior cruciate-substituting design is implanted, the clinical results are influenced by the surgical technique. Adherence to the basic principles of the surgical technique ensures a successful outcome. The goal of primary total knee arthroplasty is to reestablish the normal mechanical axis with a stable prosthesis that is well fixed Fig. 1.1 . This is achieved by both the bone resection and the soft tissue...

Instrumentation in Total Knee Arthroplasty

Femoral Sulcus Anatomy

In the early 1970s the total condylar knee arthroplasty was designed at the Hospital for Special Surgery and emphasized the concepts of ligament balance and knee alignment.1 After the introduction of polymethylmethacrylate, there was a rapid increase in design work because the major obstacle of fixation was relieved. Although the knee implant designs continued to undergo refinement, instrumentation lagged significantly behind the design technology. This dichotomy occurred because the emphasis...