An indispensable step-by-step guide on a full spectrum of open and arthroscopic knee procedures Knee disorders are among the most common musculoskeletal conditions and, as such, constitute four of the top seven orthopaedic procedures. Currently, 720,000 knee replacements are performed annually in the US, with a projected 3.4 million surgeries by 2030. Knee Surgery: Tricks of the Trade edited by renowned knee surgeons and educators James P. Stannard, Andrew Schmidt, and Mauricio Kfuri features contributions from an impressive cadre of distinguished colleagues. The reader-friendly book fills a g.

• Knee Surgery: Tricks of the Trade
• MedOne Access Information
• Title Page
• Copyright
• Contents
• Videos
• Preface
• Acknowledgment
• Contributors
• Section I Trauma
  • 1 Unilateral Lateral Tibial Plateau Fractures
    • 1.1 Description
    • 1.2 Key Principles
    • 1.3 Expectations
    • 1.4 Indications
    • 1.5 Contraindications
    • 1.6 Special Considerations
    • 1.7 Special Instructions, Positioning, and Anesthesia
    • 1.8 Tips, Pearls, and Lessons Learned
      • 1.8.1 Approach
      • 1.8.2 Visualization
      • 1.8.3 Fracture Reduction
      • 1.8.4 Internal Fixation
      • 1.8.5 Closure
    • 1.9 Difficulties Encountered
    • 1.10 Key Procedural Steps
    • 1.11 Bailout, Rescue, Salvage Procedures
    • 1.12 Pitfalls
  • 2 Unicondylar Medial Tibial Plateau Fractures
    • 2.1 Description
    • 2.2 Key Principles
    • 2.3 Expectations
    • 2.4 Indications
    • 2.5 Contraindications
    • 2.6 Special Considerations
    • 2.7 Special Instructions, Positioning, and Anesthesia
    • 2.8 Tips, Pearls, and Lessons Learned
    • 2.9 Difficulties Encountered
    • 2.10 Key Procedural Steps
      • 2.10.1 Straight Medial Approach
      • 2.10.2 Lobenhoffer Posteromedial Approach in the Prone or Supine Position
    • 2.11 Bailout, Rescue, Salvage Procedures
    • 2.12 Pitfalls
  • 3 Bicondylar Tibial Plateau Fractures
    • 3.1 Description
    • 3.2 Key Principles
      • 3.2.1 Alignment
      • 3.2.2 Buttress
      • 3.2.3 Articular Exposure
      • 3.2.4 Compression of Articular Segment
    • 3.3 Expectations
    • 3.4 Indications
    • 3.5 Contraindications
    • 3.6 Special Considerations
    • 3.7 Special Instructions, Position, and Anesthesia
    • 3.8 Tips, Pearls, and Lessons Learned
    • 3.9 Difficulties Encountered
    • 3.10 Key Procedural Steps
    • 3.11 Bailout, Rescue, Salvage Procedures
    • 3.12 Pitfalls
  • 4 Tibial Plateau Fractures in the Coronal Plane
    • 4.1 Description
    • 4.2 Key Principles
    • 4.3 Expectations
    • 4.4 Indications
    • 4.5 Contraindications
    • 4.6 Special Considerations
    • 4.7 Special Instructions, Position, and Anesthesia
    • 4.8 Tips, Pearls, and Lessons Learned
      • 4.8.1 Exposure and Dissection
      • 4.8.2 Reduction Principle
      • 4.8.3 Intraoperative Fluoroscopy and CT Scans
      • 4.8.4 Precontour of the Posterolateral Buttress Plate
      • 4.8.5 Evaluation of the Placement of the Posterolateral Buttressing Plate
    • 4.9 Difficulties Encountered
      • 4.9.1 Reduction of Posterolateral Articular Surface
      • 4.9.2 Fracture Pattern
    • 4.10 Key Procedural Steps
      • 4.10.1 Fracture Reduction and Internal Fixation
      • 4.10.2 Treatment of Associated Injuries
    • 4.11 Bailout, Rescue, Salvage Procedures
    • 4.12 Pitfalls
  • 5 Distal Femur Unicondylar Fracture
    • 5.1 Description
    • 5.2 Key Principles
    • 5.3 Expectations
    • 5.4 Indications
    • 5.5 Contraindications
    • 5.6 Special Considerations
    • 5.7 Special Instructions, Position, and Anesthesia
    • 5.8 Tips, Pearls, and Lessons Learned
      • 5.8.1 Closed Reduction
      • 5.8.2 Open Reduction
    • 5.9 Difficulties Encountered
    • 5.10 Key Procedural Steps
      • 5.10.1 Patient Positioning
      • 5.10.2 Approaches for ORIF
      • 5.10.3 Fixation
    • 5.11 Bailout, Rescue, and Salvage Procedures
    • 5.12 Pitfalls
  • 6 Distal Femur Fractures—Bicondylar
    • 6.1 Description
    • 6.2 Key Principles
    • 6.3 Expectations
    • 6.4 Indications
    • 6.5 Contraindications
    • 6.6 Special Considerations
      • 6.6.1 Geriatric and Osteoporotic Fractures
      • 6.6.2 Open Fractures
      • 6.6.3 Chondral Damage or Loss
    • 6.7 Special Instructions, Position, and Anesthesia
    • 6.8 Tips, Pearls, and Lessons Learned
      • 6.8.1 Preoperative Plan
      • 6.8.2 Surgical Exposures
      • 6.8.3 Common Reduction Instruments
      • 6.8.4 Reduction Aids that Facilitate the Reduction
      • 6.8.5 Implants
      • 6.8.6 Reduction Tips
      • 6.8.7 Fixation Tips
    • 6.9 Difficulties Encountered
    • 6.10 Key Procedural Steps
      • 6.10.1 Choosing the Correct Surgical Exposure
      • 6.10.2 Articular Reduction and Fixation
      • 6.10.3 Metadiaphyseal Reduction
      • 6.10.4 Fixation Strategy
      • 6.10.5 Closure
    • 6.11 Bailout, Rescue, Salvage Procedures
    • 6.12 Pitfalls
  • 7 Distal Femur Fracture in the Coronal Plane—Hoffa Fracture
    • 7.1 Description
    • 7.2 Key Principles
    • 7.3 Expectations
    • 7.4 Indications
    • 7.5 Contraindications
    • 7.6 Special Considerations
    • 7.7 Special Instructions, Positioning, and Anesthesia
    • 7.8 Tips, Pearls, and Lessons Learned
      • 7.8.1 Posterolateral Approach
      • 7.8.2 Anterolateral Approach
      • 7.8.3 Medial Approaches
    • 7.9 Difficulties Encountered
    • 7.10 Key Procedural Steps
    • 7.11 Bailout, Rescue, and Salvage Procedures
    • 7.12 Pitfalls
  • 8 Distal Femur Periprosthetic Fracture—Internal Fixation with Plate
    • 8.1 Description
    • 8.2 Key Principles
    • 8.3 Expectations
    • 8.4 Indications
    • 8.5 Contraindications
    • 8.6 Special Considerations
    • 8.7 Special Instructions, Position,and Anesthesia
    • 8.8 Tips, Pearls, and Lessons Learned
    • 8.9 Difficulties Encountered
    • 8.10 Key Procedural Steps
    • 8.11 Bailout, Rescue, and Salvage Procedures
    • 8.12 Pitfalls
  • 9 Retrograde Nailing of Distal Femur Periprosthetic Fractures
    • 9.1 Description
    • 9.2 Key Principles
    • 9.3 Expectations
    • 9.4 Indications
    • 9.5 Contraindications
    • 9.6 Special Considerations
    • 9.7 Special Instructions, Positioning, and Anesthesia
    • 9.8 Tips, Pearls, and Lessons Learned
    • 9.9 Difficulties Encountered
    • 9.10 Key Procedural Steps
    • 9.11 Bailout, Rescue, and Salvage Procedures
    • 9.12 Pitfalls
  • 10 Nail-Plate Combination and Double Plating for Complex Distal Femur Fractures (Native or Periprosthetic)
    • 10.1 Description
    • 10.2 Key Principles
    • 10.3 Expectations
    • 10.4 Indications
    • 10.5 Contraindications
    • 10.6 Special Considerations
    • 10.7 Special Instructions, Positioning, and Anesthesia
    • 10.8 Tips, Pearls, and Lessons Learned
    • 10.9 Difficulties Encountered
    • 10.10 Key Procedural Steps
    • 10.11 Bailout, Rescue, and Salvage Procedures
    • 10.12 Pitfalls
  • 11 Distal Femur Periprosthetic Fracture: ORIF and Revision Arthroplasty
    • 11.1 Description
    • 11.2 Key Principles
    • 11.3 Expectations
    • 11.4 Indications
    • 11.5 Contraindications
    • 11.6 Special Considerations
    • 11.7 Special Instructions, Positioning, and Anesthesia
    • 11.8 Tips, Pearls, and Lessons Learned
    • 11.9 Difficulties Encountered
    • 11.10 Key Procedural Steps
    • 11.11 Bailout, Rescue, and Salvage Procedures
    • 11.12 Pitfalls
  • 12 Patellar Fracture—Simple Transverse Pattern
    • 12.1 Description
    • 12.2 Key Principles
    • 12.3 Expectations
    • 12.4 Indications and Contraindications
      • 12.4.1 Nonoperative Treatment
      • 12.4.2 Operative Treatment
    • 12.5 Special Considerations
    • 12.6 Special Instructions, Position, and Anesthesia
    • 12.7 Tips, Pearls, and Lessons Learned
    • 12.8 Difficulties Encountered
    • 12.9 Key Procedural Steps
    • 12.10 Bailout, Rescue, and Salvage Procedures
    • 12.11 Pitfalls
      • 12.11.1 Indication for Treatment Issue
      • 12.11.2 Technical Consideration
  • 13 Patellar Fractures—Comminuted Pattern
    • 13.1 Description
    • 13.2 Key Principles
    • 13.3 Expectations
    • 13.4 Indications
    • 13.5 Contraindications
    • 13.6 Special Considerations
    • 13.7 Special Instructions, Positioning, and Anesthesia
    • 13.8 Tips, Pearls, and Lessons Learned
    • 13.9 Difficulties Encountered
    • 13.10 Key Procedural Steps
    • 13.11 Bailout, Rescue, and Salvage Procedures
    • 13.12 Pitfalls
  • 14 Patellar Tendon Repair with Ipsilateral Semitendinosus Autograft Augmentation
    • 14.1 Description
    • 14.2 Key Principles
    • 14.3 Expectations
    • 14.4 Indications
    • 14.5 Contraindications
    • 14.6 Special Considerations
    • 14.7 Special Instructions, Position, and Anesthesia
    • 14.8 Tips, Pearls, and Lessons Learned
    • 14.9 Difficulties Encountered
    • 14.10 Key Procedural Steps
    • 14.11 Bailout, Rescue, Salvage Procedures
    • 14.12 Pitfalls
  • 15 Quadriceps Tendon Rupture
    • 15.1 Description
    • 15.2 Key Principles
    • 15.3 Expectations
    • 15.4 Indications
    • 15.5 Contraindications
    • 15.6 Special Considerations
    • 15.7 Special Instructions, Positioning, and Anesthesia
    • 15.8 Tips, Pearls, and Lessons Learned
    • 15.9 Difficulties Encountered
    • 15.10 Key Procedural Steps
      • 15.10.1 Preparation
      • 15.10.2 Incision and Exposure
      • 15.10.3 Tendon Repair
    • 15.11 Bailout, Rescue, and Salvage Procedures
    • 15.12 Pitfalls
  • 16 Knee Dislocation—Acute Management
    • 16.1 Description
    • 16.2 Key Principles
    • 16.3 Expectations
    • 16.4 Indications for External Fixation
    • 16.5 Contraindications to External Fixation
    • 16.6 Special Considerations
      • 16.6.1 Intimal Tears Resulting in Vascular Occlusion
      • 16.6.2 External Fixation in the Polytrauma and/or Obese Patient
    • 16.7 Special Instructions, Position, and Anesthesia
      • 16.7.1 Reduction
      • 16.7.2 Vascular Exam
      • 16.7.3 Serial Examinations
      • 16.7.4 External Fixation
    • 16.8 Tips, Pearls, and Lessons Learned
      • 16.8.1 External Fixation—Pin Placement
      • 16.8.2 External Fixation for Open Dislocations
      • 16.8.3 Tips
    • 16.9 Difficulties Encountered
    • 16.10 Key Procedural Steps
      • 16.10.1 External Fixation
    • 16.11 Bailout, Rescue, Salvage Procedures
    • 16.12 Pitfalls
  • 17 Correction of a Periarticular Knee Deformity with External Fixation
    • 17.1 Description
    • 17.2 Key Principles
    • 17.3 Expectations
    • 17.4 Indications
    • 17.5 Contraindications
    • 17.6 Special Considerations
    • 17.7 Special Instructions, Position, and Anesthesia
      • 17.7.1 Preoperative Evaluation
      • 17.7.2 Positioning
      • 17.7.3 Anesthesia
      • 17.7.4 Postoperative Deformity Correction
    • 17.8 Tips, Pearls, and Lessons Learned
    • 17.9 Difficulties Encountered
    • 17.10 Key Procedural Steps
    • 17.11 Bailout, Rescue, Salvage Procedures
    • 17.12 Pitfalls
  • 18 Floating Knee Injuries
    • 18.1 Description
    • 18.2 Key Principles
    • 18.3 Expectations
    • 18.4 Indications
    • 18.5 Contraindications
    • 18.6 Special Considerations
    • 18.7 Special Instructions, Positioning, and Anesthesia
    • 18.8 Tips, Pearls, and Lessons Learned
      • 18.8.1 Alignment References
      • 18.8.2 Type I Injuries
      • 18.8.3 Type IIA and IIB Injuries
      • 18.8.4 Type IIC Injuries
    • 18.9 Key Procedural Steps
    • 18.10 Bailout, Rescue, Salvage Procedures
    • 18.11 Pitfalls
  • 19 Open Knee Fractures: The Use of Rotational Flaps
    • 19.1 Description
    • 19.2 Key Principles
    • 19.3 Expectations
    • 19.4 Indications
    • 19.5 Contraindications
    • 19.6 Special Considerations
    • 19.7 Special Instructions, Position, and Anesthesia
    • 19.8 Tips, Pearls, and Lessons Learned
    • 19.9 Difficulties Encountered
    • 19.10 Key Procedural Steps
      • 19.10.1 Medial Gastrocnemius Flap
      • 19.10.2 Lateral Gastrocnemius Flap
      • 19.10.3 Aftercare
    • 19.11 Bailout, Rescue, Salvage Procedures
    • 19.12 Pitfalls
  • 20 Tibial Plateau Revision Surgery
    • 20.1 Description
    • 20.2 Key Principles
    • 20.3 Expectations
    • 20.4 Indications
    • 20.5 Contraindications
    • 20.6 Special Considerations
    • 20.7 Special Instructions, Positioning, and Anesthesia
    • 20.8 Tips, Pearls, and Lessons Learned
    • 20.9 Difficulties Encountered
    • 20.10 Key Procedural Steps
      • 20.10.1 Unicondylar Angulation
      • 20.10.2 Widened Tibial Plateau
    • 20.11 Bailout, Rescue, and Salvage Procedures
    • 20.12 Pitfalls
• Section II Sports Medicine
  • 21 Quadriceps Autograft: All-Inside Anterior Cruciate Ligament Reconstruction
    • 21.1 Description
    • 21.2 Key Principles
    • 21.3 Expectations
    • 21.4 Indications
    • 21.5 Contraindications
    • 21.6 Special Considerations
    • 21.7 Special Instructions, Position, and Anesthesia
    • 21.8 Tips, Pearls, and Lessons Learned
    • 21.9 Difficulties Encountered
    • 21.10 Key Procedural Steps
    • 21.11 Bailout, Rescue, Salvage Procedures
    • 21.12 Pitfalls
  • 22 Anterior Cruciate Ligament Reconstruction: Hamstrings Autograft
    • 22.1 Description
    • 22.2 Key Principles
    • 22.3 Expectations
    • 22.4 Indications
    • 22.5 Contraindications
    • 22.6 Special Considerations
    • 22.7 Special Instructions, Position, and Anesthesia
    • 22.8 Tips, Pearls, and Lessons Learned
    • 22.9 Difficulties Encountered
    • 22.10 Key Procedural Steps
      • 22.10.1 Tendon Harvesting
      • 22.10.2 Graft Preparation
      • 22.10.3 Portals
      • 22.10.4 Femoral Tunnel Preparation
      • 22.10.5 Tibial Tunnel
      • 22.10.6 ACL Graft Passage
      • 22.10.7 Femoral Fixation
      • 22.10.8 Graft Prestressing
      • 22.10.9 Tibial Tunnel Graft Tension and Fixation
      • 22.10.10 Final Checking and Wound Closure
      • 22.10.11 Postoperative Care
    • 22.11 Bailout, Rescue, Salvage Procedures
    • 22.12 Pitfalls
  • 23 Anterior Cruciate Reconstruction—Patellar Tendon Autograft
    • 23.1 Description
    • 23.2 Key Principles
    • 23.3 Expectations
    • 23.4 Indications
    • 23.5 Contraindications
    • 23.6 Special Considerations
    • 23.7 Special Instructions, Positioning, and Anesthesia
    • 23.8 Tips, Pearls, and Lessons Learned
    • 23.9 Difficulties Encountered
    • 23.10 Key Procedural Steps
    • 23.11 Bailout, Rescue, and Salvage Procedures
    • 23.12 Pitfalls
  • 24 Anterior Cruciate Ligament Reconstruction—Pediatric Patient
    • 24.1 Description
    • 24.2 Key Principles
    • 24.3 Expectations
    • 24.4 Indications
    • 24.5 Contraindications
    • 24.6 Special Considerations
    • 24.7 Special Instructions, Positioning, and Anesthesia
    • 24.8 Tips, Pearls, and Lessons Learned
    • 24.9 Difficulties Encountered
    • 24.10 Key Procedural Steps
    • 24.11 Bailout, Rescue, Salvage Procedures
    • 24.12 Pitfalls
  • 25 Anterior Cruciate Ligament—Tibial Avulsion
    • 25.1 Description
    • 25.2 Key Principles
    • 25.3 Expectations
    • 25.4 Indications
    • 25.5 Contraindications
    • 25.6 Special Considerations
    • 25.7 Special Instructions, Position, and Anesthesia
    • 25.8 Tips, Pearls, and Lessons Learned
    • 25.9 Difficulties Encountered
    • 25.10 Key Procedural Steps
      • 25.10.1 Arthroscopic Technique
      • 25.10.2 Open Reduction Internal Fixation
      • 25.10.3 Suture Fixation
      • 25.10.4 Screw Fixation
      • 25.10.5 Hybrid Fixation
    • 25.11 Bailout, Rescue, Salvage Procedures
    • 25.12 Pitfalls
  • 26 Posterior Cruciate Ligament Reconstruction: Achilles Tendon Allograft
    • 26.1 Description
    • 26.2 Key Principles
    • 26.3 Expectations
    • 26.4 Indications
    • 26.5 Contraindications
    • 26.6 Special Considerations
    • 26.7 Special Instructions, Position, and Anesthesia
    • 26.8 Tips, Pearls, and Lessons Learned
      • 26.8.1 Tibial Inlay
      • 26.8.2 Transtibial PCL
    • 26.9 Difficulties Encountered
    • 26.10 Key Procedural Steps
      • 26.10.1 Common Steps—Femoral Socket Preparation
      • 26.10.2 Transtibial Tibia Socket Preparation
      • 26.10.3 Inlay Tibial Preparation
    • 26.11 Bailout, Rescue, and Salvage Procedures
    • 26.12 Pitfalls
  • 27 Posterior Cruciate Ligament (PCL) Reconstruction—Autograft
    • 27.1 Introduction
    • 27.2 Description
    • 27.3 Key Principles
    • 27.4 Surgical Indications
    • 27.5 Contraindications
    • 27.6 Special Considerations
      • 27.6.1 Quadriceps Tendon-Bone Autograft Harvest
      • 27.6.2 Hamstring Tendon Autograft
    • 27.7 Special Instructions, Position, and Anesthesia
    • 27.8 Tips, Pearls and Lessons Learned
    • 27.9 Difficulties Encountered
    • 27.10 Key Procedural Steps
      • 27.10.1 Diagnostic Knee Arthroscopy and Tunnel Preparation
      • 27.10.2 Drilling the Femoral Tunnel (Inside Out)
      • 27.10.3 Graft Passage and Fixation
    • 27.11 Bailout, Rescue, Salvage Procedures
    • 27.12 Pitfalls
  • 28 Posterior Cruciate Ligament—Tibial Avulsion
    • 28.1 Description
    • 28.2 Key Principles
    • 28.3 Expectations
    • 28.4 Indications
    • 28.5 Contraindications
    • 28.6 Special Considerations
    • 28.7 Special Instructions, Positioning, and Anesthesia
      • 28.7.1 Open Surgical Technique
      • 28.7.2 Arthroscopic Technique
    • 28.8 Tips, Pearls, and Lessons Learned
      • 28.8.1 Open Surgical Technique
      • 28.8.2 Arthroscopic Technique
    • 28.9 Difficulties Encountered
    • 28.10 Key Procedural Steps
    • 28.11 Bailout, Rescue, and Salvage Procedures
  • 29 Posteromedial Corner Knee Reconstruction
    • 29.1 Description
    • 29.2 Key Principles
    • 29.3 Expectations
    • 29.4 Indications
    • 29.5 Contraindications
    • 29.6 Special Considerations
    • 29.7 Special Instructions, Position, and Anesthesia
    • 29.8 Tips, Pearls, and Lessons Learned
    • 29.9 Difficulties Encountered
    • 29.10 Key Procedural Steps
    • 29.11 Bailout, Rescue, and Salvage Procedures
    • 29.12 Pitfalls
  • 30 Posterolateral Corner Reconstruction
    • 30.1 Description
    • 30.2 Key Principles
    • 30.3 Expectations
    • 30.4 Indications
    • 30.5 Contraindications
    • 30.6 Special Considerations
    • 30.7 Special Instructions, Position, and Anesthesia
    • 30.8 Tips, Pearls, and Lessons Learned
    • 30.9 Difficulties Encountered
    • 30.10 Key Procedural Steps
    • 30.11 Bailout, Rescue, and Salvage Procedures
    • 30.12 Pitfalls
  • 31 Knee Dislocation: Reconstruction
    • 31.1 Description
    • 31.2 Key Principles
    • 31.3 Expectations
    • 31.4 Indications
    • 31.5 Contraindications
    • 31.6 Special Considerations
    • 31.7 Special Instructions, Positioning, and Anesthesia
    • 31.8 Tips, Pearls, Lessons Learned
      • 31.8.1 Posteromedial Safety Incision (PMSI)
      • 31.8.2 PCL Tibial Tunnel
      • 31.8.3 PCL Femoral Tunnel
      • 31.8.4 Single- and Double-Bundle PCL Reconstruction
      • 31.8.5 Transtibial ACL Reconstruction
      • 31.8.6 Mechanical Graft Tensioning
      • 31.8.7 Posterolateral Reconstruction (PLR)
      • 31.8.8 Posteromedial Reconstruction (PMR)
    • 31.9 Difficulties Encountered
      • 31.9.1 Fractures
      • 31.9.2 External Fixation
    • 31.10 Key Procedural Steps
      • 31.10.1 Posterior Cruciate Ligament Reconstruction (PCLR)
      • 31.10.2 Anterior Cruciate Ligament (ACL) Reconstruction
      • 31.10.3 Fibular Head-Based Posterolateral Reconstruction
      • 31.10.4 Two-Tailed Posterolateral Reconstruction
      • 31.10.5 Posteromedial Reconstruction (Posteromedial Capsular Shift)
      • 31.10.6 Posteromedial Reconstruction (Free Graft)
    • 31.11 Bailout, Rescue, and Salvage Procedures
    • 31.12 Pitfalls
  • 32 Patellofemoral Instability—Medial Patellofemoral Ligament Reconstruction
    • 32.1 Description
    • 32.2 Key Principles
    • 32.3 Expectations
    • 32.4 Indications
    • 32.5 Contraindications
    • 32.6 Special Considerations
    • 32.7 Special Instructions, Position, and Anesthesia
    • 32.8 Tips, Pearls, and Lessons Learned
    • 32.9 Difficulties Encountered
    • 32.10 Key Procedural Steps
    • 32.11 Bailout, Rescue, and Salvage Procedures
    • 32.12 Pitfalls
  • 33 Proximal Realignment: Lateral Retinaculum Lengthening
    • 33.1 Description
    • 33.2 Key Principles
    • 33.3 Expectations
    • 33.4 Indications
    • 33.5 Contraindications
    • 33.6 Special Considerations
    • 33.7 Special Instructions, Position, and Anesthesia
    • 33.8 Tips, Pearls, and Lessons Learned
      • 33.8.1 Hemostasis
      • 33.8.2 Medial and Lateral Balance
    • 33.9 Pitfalls
      • 33.9.1 Identification of the Layers
      • 33.9.2 Hemostasis
      • 33.9.3 Medial and Lateral Balance
    • 33.10 Difficulties Encountered
    • 33.11 Key Procedural Steps
    • 33.12 Bailout, Rescue, and Salvage Procedures
  • 34 Recurrent Patellofemoral Dislocation—Distal Realignment
    • 34.1 Description
    • 34.2 Key Principles in Tibial Tubercle Osteotomy for Recurrent Patellofemoral Dislocation
    • 34.3 Expectations
    • 34.4 Indications
    • 34.5 Contraindications
    • 34.6 Special Considerations
    • 34.7 Special Instructions, Positioning, and Anesthesia
    • 34.8 Tips, Pearl, and Lessons Learned
    • 34.9 Difficulties Encountered
    • 34.10 Key Procedural Steps
    • 34.11 Bailout, Rescue, and Salvage Procedures
    • 34.12 Pitfalls
  • 35 Meniscal Tears and Principles of Partial Meniscectomy
    • 35.1 Description
    • 35.2 Key Principles
    • 35.3 Expectations
    • 35.4 Indications
    • 35.5 Contraindications
    • 35.6 Special Considerations
    • 35.7 Special Instructions, Position, and Anesthesia
    • 35.8 Tips, Pearls, and Lessons Learned
    • 35.9 Difficulties Encountered
    • 35.10 Key Procedural Steps
    • 35.11 Bailout, Rescue, Salvage Procedures
    • 35.12 Pitfalls
  • 36 Meniscus Repair
    • 36.1 Description
    • 36.2 Key Principles
    • 36.3 Expectations
    • 36.4 Indications
    • 36.5 Contraindications
    • 36.6 Special Considerations
    • 36.7 Special Instructions, Position, and Anesthesia
      • 36.7.1 Medial Meniscus Inside-Out Technique
      • 36.7.2 Lateral Meniscus Inside-Out Technique
      • 36.7.3 Biologic Augmentation
    • 36.8 Tips, Pearls, and Lessons Learned
    • 36.9 Difficulties Encountered
    • 36.10 Key Procedural Steps
    • 36.11 Bailout, Rescue, and Salvage Procedures
    • 36.12 Pitfalls
  • 37 Meniscus Repair—Root Tears
    • 37.1 Description
    • 37.2 Key Principles
    • 37.3 Expectations
    • 37.4 Indications
    • 37.5 Contraindications
    • 37.6 Special Considerations
    • 37.7 Special Instructions, Position, and Anesthesia
    • 37.8 Tips, Pearls, and Lessons Learned
    • 37.9 Difficulties Encountered
    • 37.10 Key Procedural Steps: Lateral Root Tear
    • 37.11 Key Procedural Steps: Medial Root Tear
    • 37.12 Bailout, Rescue, and Salvage Procedures
    • 37.13 Pitfalls
  • 38 Meniscal Allograft Transplantation (Medial and Lateral)
    • 38.1 Description
    • 38.2 Key Principles
    • 38.3 Surgical Indications
    • 38.4 Contraindications
    • 38.5 Special Considerations
      • 38.5.1 Medial Meniscal Graft Preparation
      • 38.5.2 Lateral Meniscal Graft Preparation
    • 38.6 Special Instructions, Position and Anesthesia
    • 38.7 Tips, Pearls, and Lessons Learned
    • 38.8 Difficulties Encountered
    • 38.9 Key Procedural Steps
      • 38.9.1 Medial Meniscal Allograft Transplant
      • 38.9.2 Lateral Meniscal Allograft Transplant
    • 38.10 Bailout, Rescue, and Salvage Procedures
    • 38.11 Pitfalls
  • 39 Anterolateral Ligament Reconstruction
    • 39.1 Description
    • 39.2 Key Principles
    • 39.3 Expectations
    • 39.4 Indications
    • 39.5 Contraindications
    • 39.6 Special Considerations
    • 39.7 Special Instructions, Position, and Anesthesia
    • 39.8 Tips, Pearls, and Lessons Learned
    • 39.9 Difficulties Encountered
    • 39.10 Key Procedural Steps
    • 39.11 Bailout, Rescue, and Salvage Procedures
    • 39.12 Pitfalls
• Section III Adult Reconstruction
  • 40 Opening Wedge High Tibia Osteotomy—Varus Knee
    • 40.1 Description
    • 40.2 Key Principles
    • 40.3 Expectations
    • 40.4 Indications
    • 40.5 Contraindications
    • 40.6 Special Considerations
    • 40.7 Special Instructions, Position, and Anesthesia
    • 40.7.1 Patient Positioning and Preliminary Steps
    • 40.8 Tips, Pearls, and Lessons Learned
      • 40.8.1 Lateral Hinge
      • 40.8.2 Overcorrection
      • 40.8.3 Unintended Increase of Tibial Slope
    • 40.9 Difficulties Encountered
    • 40.10 Key Procedural Steps
      • 40.10.1 Surgical Exposure
      • 40.10.2 MCL Release
      • 40.10.3 Guidewire Placement
      • 40.10.4 Osteotomy
      • 40.10.5 Opening of the Osteotomy
      • 40.10.6 “Fine-tuning” the Correction
      • 40.10.7 Fixation of the Osteotomy
    • 40.11 Bailout, Rescue, and Salvage Procedures
      • 40.11.1 Hinge Fractures
      • 40.11.2 Arterial Bleeding
      • 40.11.3 Pseudarthrosis
    • 40.12 Pitfalls
      • 40.12.1 Lateral Hinge
      • 40.12.2 Overcorrection
      • 40.12.3 Unintended Increase of Tibial Slope
  • 41 Lateral Closing-Wedge High Tibia Osteotomy (LCWHTO) in Varus Knee
    • 41.1 Description
    • 41.2 Key Principles
    • 41.3 Expectations
    • 41.4 Indications
    • 41.5 Contraindications
    • 41.6 Special Considerations
    • 41.7 Special Instructions, Position, and Anesthesia
    • 41.8 Tips, Pearls, and Lessons Learned
    • 41.9 Difficulties Encountered
    • 41.10 Key Procedural Steps
    • 41.11 Bailout, Rescue, and Salvage Procedures
    • 41.12 Pitfalls
  • 42 Opening Wedge Distal Femur Osteotomy—Valgus Knee
    • 42.1 Description
    • 42.2 Key Principles
    • 42.3 Expectations
    • 42.4 Indications
    • 42.5 Contraindications
    • 42.6 Special Considerations
    • 42.7 Special Instructions, Position, and Anesthesia
    • 42.8 Tips, Pearls, and Lessons Learned
    • 42.9 Difficulties Encountered
    • 42.10 Key Procedural Steps
    • 42.11 Bailout, Rescue, and Salvage Procedures
    • 42.12 Pitfalls
  • 43 Closing Wedge Femur Osteotomy—Valgus Knee
    • 43.1 Description
    • 43.2 Key Principles
    • 43.3 Expectations
    • 43.4 Indications
    • 43.5 Contraindications
    • 43.6 Special Considerations
    • 43.7 Special Instructions, Position, and Anesthesia
    • 43.8 Tips, Pearls, and Lessons Learned
    • 43.9 Difficulties Encountered
    • 43.10 Key Procedural Steps
    • 43.11 Bailout, Rescue, and Salvage Procedures
    • 43.12 Pitfalls
  • 44 Unicompartmental Knee Replacement—Medial Compartment
    • 44.1 Description
    • 44.2 Key Principles
    • 44.3 Expectations
    • 44.4 Indications
    • 44.5 Contraindications
    • 44.6 Special Considerations
    • 44.7 Special Instructions, Position, and Anesthesia
    • 44.8 Tips, Pearls, and Lessons Learned
    • 44.9 Difficulties Encountered
    • 44.10 Key Procedural Steps
      • 44.10.1 Exposure
      • 44.10.2 Tibial Preparation
      • 44.10.3 Femoral Preparation
      • 44.10.4 Balance, Trialing, and Insertion
      • 44.10.5 Postoperative Management
    • 44.11 Bailout, Rescue, and Salvage Procedures
    • 44.12 Pitfalls
  • 45 Unicompartmental Arthroplasty—Lateral Compartment
    • 45.1 Description
    • 45.2 Key Principles
    • 45.3 Expectations
    • 45.4 Indications
    • 45.5 Contraindications
    • 45.6 Special Considerations
    • 45.7 Special Instructions, Position, and Anesthesia
    • 45.8 Tips, Pearls, and Lessons Learned
    • 45.9 Difficulties Encountered
    • 45.10 Key Procedural Steps
      • 45.10.1 Surgical Approach
      • 45.10.2 Femoral Preparation
      • 45.10.3 Tibial Preparation
      • 45.10.4 Soft Tissue Balancing and Trialing
      • 45.10.5 Component Insertion
      • 45.10.6 Postoperative Care
    • 45.11 Bailout, Rescue, and Salvage Procedures
    • 45.12 Pitfalls
  • 46 Unicompartmental Knee Replacement—Patellofemoral Compartment
    • 46.1 Description
    • 46.2 Key Principles
    • 46.3 Expectations
    • 46.4 Indications
    • 46.5 Contraindications
    • 46.6 Special Considerations
    • 46.7 Special Instructions, Position, and Anesthesia
    • 46.8 Tips, Pearls, and Lessons Learned
    • 46.9 Difficulties Encountered
    • 46.10 Key Procedural Steps
      • 46.10.1 Choosing a Prosthesis
      • 46.10.2 Operative Approach
      • 46.10.3 Femoral Component Positioning
      • 46.10.4 Patellar Resection and Positioning
      • 46.10.5 Trial Component Evaluation
      • 46.10.6 Cementation and Closure
    • 46.11 Bailout, Rescue, and Salvage Procedures
    • 46.12 Pitfalls
  • 47 Cruciate-Retaining Total Knee Arthroplasty
    • 47.1 Description
    • 47.2 Key Principles
    • 47.3 Expectations
    • 47.4 Indications
    • 47.5 Contraindications
    • 47.6 Special Considerations
    • 47.7 Special Instructions, Position, and Anesthesia
    • 47.8 Tips, Pearls, and Lessons Learned
    • 47.9 Difficulties Encountered
      • 47.9.1 Intramedullary Alignment Guides
      • 47.9.2 Visualization
      • 47.9.3 Patellar Maltracking
      • 47.9.4 Flexion-Extension Imbalance
      • 47.9.5 Tibial Slope
      • 47.9.6 Asymmetric Femoral Bone Resection
      • 47.9.7 Varus-Valgus Laxity
    • 47.10 Key Procedural Steps
    • 47.11 Bailout, Rescue, and Salvage Procedures
    • 47.12 Pitfalls
  • 48 Primary Total Knee Replacement: Posterior Stabilized
    • 48.1 Description
    • 48.2 Key Principles
    • 48.3 Expectations
    • 48.4 Indications
    • 48.5 Contraindications
    • 48.6 Special Considerations
    • 48.7 Special Instructions, Position, and Anesthesia
    • 48.8 Tips, Pearls, and Lessons Learned
    • 48.9 Difficulties Encountered
    • 48.10 Key Procedural Steps
    • 48.11 Bailout, Rescue, and Salvage Procedures
    • 48.12 Pitfalls
  • 49 Primary Total Knee Replacement using Navigation
    • 49.1 Description
    • 49.2 Key Principles
    • 49.3 Expectations
    • 49.4 Indications
    • 49.5 Contraindications
    • 49.6 Special Considerations
    • 49.7 Special Instructions, Positioning, and Anesthesia
    • 49.8 Tips, Pearls, and Lessons Learned
    • 49.9 Difficulties Encountered
    • 49.10 Key Procedural Steps
      • 49.10.1 Navigation of the Femorotibial Mechanical Angle
      • 49.10.2 Navigation of the Bone Cuts
      • 49.10.3 Implanting the Prosthetic Trial
      • 49.10.4 Rotation of the Femoral Implant
      • 49.10.5 Ligament Balance
      • 49.10.6 Implanting the Final Prosthesis
    • 49.11 Bailout, Rescue, and Salvage Procedures
    • 49.12 Pitfalls
  • 50 Revision Total Knee Arthroplasty: Femoral and Tibial Components
    • 50.1 Description
    • 50.2 Key Principles
    • 50.3 Expectations
    • 50.4 Indications
    • 50.5 Contraindications
    • 50.6 Special Considerations
    • 50.6.1 Diagnosis
    • 50.7 Special Instructions, Position, Anesthesia
    • 50.8 Tips, Pearls, and Lessons Learned
      • 50.8.1 Have all Prosthetic Options Available
      • 50.8.2 Consider the Possibility of Infection in All Revisions
    • 50.9 Difficulties Encountered
    • 50.10 Key Procedural Steps
      • 50.10.1 Obtain Adequate Exposure
      • 50.10.2 Remove the Implants Carefully with Minimal Bone Loss
      • 50.10.3 Femoral Component Removal
      • 50.10.4 Tibial Component Removal
      • 50.10.5 Debride the Knee, Assess Residual Defects, and Determine the Management Strategy
      • 50.10.6 Preparation of the Femur and Tibia
      • 50.10.7 Apply the Trials and Assess Stability and Kinematics
      • 50.10.8 Deflate the Tourniquet, Achieve Hemostasis, Prepare the Bone Ends, and Cement the Implants
      • 50.10.9 Close the Wound Securely
      • 50.10.10 Wound Healing Must Supersede Rehabilitation
    • 50.11 Bailout, Rescue, and Salvage Procedures
    • 50.12 Pitfalls
  • 51 Revision Total Knee Replacement—Patellar Component
    • 51.1 Description
    • 51.2 Key Principles
    • 51.3 Expectations
    • 51.4 Indications
    • 51.5 Contraindications
    • 51.6 Special Considerations
    • 51.7 Special Instructions, Position, and Anesthesia
    • 51.8 Tips, Pearls, and Lessons Learned
    • 51.9 Difficulties Encountered
    • 51.10 Key Procedural Steps
    • 51.11 Bailout, Rescue, and Salvage Procedures
    • 51.12 Pitfalls
  • 52 Extensor Mechanism Reconstruction—Synthetic Mesh
    • 52.1 Description
    • 52.2 Key Principles
    • 52.3 Expectations
    • 52.4 Indications and Contraindications
    • 52.5 Special Instructions, Position, and Anesthesia
    • 52.6 Tips, Pearls, and Lessons Learned
    • 52.7 Difficulties Encountered
    • 52.8 Key Procedural Steps
    • 52.9 Bailout, Rescue, and Salvage Procedures
    • 52.10 Pitfalls
  • 53 Unipolar Osteochondral Femoral Replacement
    • 53.1 Description
    • 53.2 Key Principles
    • 53.3 Expectations
    • 53.4 Indications
      • 53.4.1 Cartilage Repair
      • 53.4.2 Complex Reconstruction
    • 53.5 Contraindications
    • 53.6 Special Considerations
    • 53.7 Special Instructions, Position, and Anesthesia
    • 53.8 Tips, Pearls, and Lessons Learned
    • 53.9 Difficulties Encountered
    • 53.10 Key Procedural Steps
    • 53.10.1 Dowel Technique
    • 53.10.2 Shell Technique
    • 53.11 Bailout, Rescue, and Salvage Procedures
    • 53.12 Pitfalls
  • 54 Patellofemoral Osteochondral Replacement
    • 54.1 Description
    • 54.2 Key Principles
    • 54.3 Expectations
    • 54.4 Indications
    • 54.5 Contraindications
    • 54.6 Special Considerations
    • 54.7 Special Instructions, Position, and Anesthesia
    • 54.8 Tips, Pearls, and Lessons Learned
    • 54.9 Difficulties Encountered
    • 54.10 Key Procedural Steps
      • 54.10.1 Trochlea
      • 54.10.2 Patella
    • 54.11 Bailout, Rescue, and Salvage Procedures
    • 54.12 Pitfalls
• Index
• Additional MedOne Access Information