MIS Techniques in Orthopedics
:
Giles R. Scuderi, Alfred J. Tria, und Richard A. Berger
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Giles R. Scuderi, Alfred J. Tria, Richard A. Berger
:
MIS Techniques in Orthopedics
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Springer-Verlag
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9780387293004
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1
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CHF 192,60
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:
Klinische Fächer
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English
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433
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Wasserzeichen/DRM
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PC/MAC/eReader/Tablet
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PDF
Sole reference in the field of orthopedic surgery
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Section III The Knee: Unicondylar Knee Arthroplasty
(p. 190-191)
12 Minimally Invasive Surgery for Unicondylar Knee Arthroplasty: The Bone-Sparing Technique
John A. Repicci and Jodi F. Hartman
When considering treatment options for osteoarthritis of the knee, the pathology and progression of the disease must be considered. Past studies examining osteoarthritis of the knee have demonstrated that the disease is slow, progressive, and typically limited to the medial tibiofemoral compartment.1–4 Moreover, the erosion of cartilage in the medial compartment is almost always limited to the anterior half of the medial tibial plateau and the corresponding contact area on the distal portion of the medial femoral condylar.4 Anteromedial osteoarthritis was coined by White et al. to describe this distinct clinicopathological condition.
The ensuing anatomic defect, namely, loss of articular cartilage in the extension gap with no corresponding loss of articular cartilage in the ?exion gap, results in a 6-mm to 8-mm disparity between the extension and ?exion gaps. For this reason, medial osteoarthritis also may be considered an extension gap disease (Figure 12.1). The joint surface asymmetry also accounts for the varus alignment and lateral tibial thrust commonly associated with medial unicompartmental osteoarthritis.
At this stage in the disease process, the medial meniscus is either partially torn or completely compromised and tension is compromised in the anterior cruciate (ACL) and medial collateral (MCL) ligaments.5 To compensate for the varus deformity, a sclerotic layer of bone, or medial tibial buttress is formed. As varus angulation increases, the medial tibial buttress hypertrophies to resist the increasing varus stresses. Although this may appear to be a rather inef?cient solution, this layer of sclerotic bone allows the medial compartment to withstand joint loading and to support weight, permitting continued ambulation for 10 to 19 years after initiation of the disease.
Eventually, however, patients experience weight-bearing pain as a result of the plastic deformation of bone at the articular surface, instability because of ligamentous laxity, and mechanical symptoms due to meniscal damage.5 The clinical presentation of this early, unicompartmental form of osteoarthritis must be differentiated from that of patients with more advanced forms of the disease. The pain associated with the tricompartmental form of the disease often is so debilitating that activities of daily living are severely restricted, independence is lost, and ambulatory aids, such as crutches, a walker, or wheelchair, are required. For these patients, total knee arthroplasty (TKA) is the most appropriate surgical option to relieve pain and to restore some degree of independence."
Preface
6
Table of contents
7
Contributors
10
Section I The Shoulder and Elbow
15
1 Mini-Incision Bankart Repair for Shoulder Instability
16
Anatomy and Biomechanics
16
Clinical Features
17
Patient History
17
Physical Examination
18
Radiographic Features
23
Treatment
24
Nonoperative Treatment
24
Operative Treatment
24
References
31
2 Mini-Open Rotator Cuff Repair
34
Surgical Technique
36
Postoperative Protocol/Rehabilitation
41
Results
42
Summary
43
References
43
3 Mini-Incision Fixation of Proximal Humeral Four-Part Fractures
45
Historical Perspective
46
Anatomic Considerations
47
Indications for Percutaneous Pinning
47
Patient Evaluation
48
Surgical Procedure
49
Patient Positioning
49
Percutaneous Reduction
50
Instrumentation
52
Postoperative Management
54
Results
54
Complications
55
Conclusion
56
References
56
4 Minimally Invasive Approach for Shoulder Arthroplasty
58
Techniques
58
Surgical Approaches
59
Concealed Axillary Approach
59
Mini-Incision Approach
60
Four-Part Proximal Humerus Fractures:
64
Avascular Necrosis
70
Glenohumeral Arthritis
72
Glenoid Exposure in Total Shoulder Arthroplasty
76
Postoperative Care
77
Conclusion
82
References
82
5 Mini-Incision Medial Collateral Ligament Reconstruction of the Elbow
84
Biomechanics and Anatomy
84
History and Physical Examination
86
Imaging
89
Surgical Technique: The Docking Procedure
91
Postoperative Mangement
99
Results
100
Summary
100
References
100
6 Mini-Incision Distal Biceps Tendon Repair
103
Etiology
103
History and Physical Examination
104
Surgical Indication
105
Technique
106
Rehabilitation
111
Complications
111
Summary
112
References
112
Section II The Hip
114
7 A Technique for the Anterolateral Approach to MIS Total Hip Replacement
115
Surgical Technique
115
Exposure
116
Preparation of the Acetabulum
123
Preparation of the Femur
125
Conclusion
132
8 The Anterior Approach for Total Hip Replacement: Background and Operative Technique
133
Surgical Technique
136
References
152
9 Posterolateral Minimal Incision for Total Hip Replacement: Techniqueand Early Results
153
Surgical Technique
153
Patient Positioning and Landmarks
154
Patient Exposure
156
Postoperative Protocol
169
Summary
169
References
170
10 Minimally Invasive Total Hip Arthroplasty Using the Two-Incision Approach
171
Surgical Technique
171
Summary
190
References
191
11 Minimally Invasive Metal-on-Metal Resurfacing Arthroplasty of the Hip
192
Indications
192
Surgical Technique: Anterolateral Approach
193
Placement of Incision
193
Deep Exposure
194
Exposing the Acetabulum
196
Femoral Resurfacing
