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This book reviews the principles and concepts underlying Professor Sir John Charnley’s original work Low Friction Arthroplasty of the Hip: Theory and Practice (Springer, 1979) in the light of more extensive clinical experience with results, incidence and indications for revisions highlighted throughout. The studies, combined with the examination of explanted components carried out with the backing of Universities, indicate the avenues for further research and the development and introduction of new ideas into clinical practice. The time span (1962 – 2015) involved has allowed a number of these very long-term studies not only to be brought to conclusion, but has given the benefit of their clinical application with meaningful results. This is not a sudden diversion into new and speculative areas of hip replacement surgery. It is a carefully collected, documented and executed work of the evolution of the Charnley low-frictional torque arthroplasty of the hip based on sound principles, supported by long-term studies with benefits derived.
The theme of this work is the application of the engmeermg theory of frictional torque to total hip replacement. The author adhered tenaciously to this theory, involving the use of a small-diameter femoral head, throughout the epoch when the large-diame ter, metal-to-metal design dominated the field. During that considerable period general satisfaction with the early results rendered criticisms of the large-diameter head unwelcome. There was a formidable array of counter criticism: the small head would pierce a film of synovial fluid; the small head would wear the socket too rapidly; the small head would always have a high risk of dislocation; detachment of the trochanter, to achieve precise orientation for the small head, was unacceptable. But all these objections have now been largely overcome. Lubrication of high molecular weight polyethylene (HMWP) on metal is now accepted as being mainly by the boundary regime with thick fluid films playing no part. We now know that HMWP can indeed tolerate the very high stresses imposed by the small head and in tribological theory there may even be some advantage in high stress. Dislocation is now known not to be an automatic sequel to the small head.
This open access book describes and illustrates the surgical techniques, implants, and technologies used for the purpose of personalized implantation of hip and knee components. This new and flourishing treatment philosophy offers important benefits over conventional systematic techniques, including component positioning appropriate to individual anatomy, improved surgical reproducibility and prosthetic performance, and a reduction in complications. The techniques described in the book aim to reproduce patients’ native anatomy and physiological joint laxity, thereby improving the prosthetic hip/knee kinematics and functional outcomes in the quest of the forgotten joint. They include kinematically aligned total knee/total hip arthroplasty, partial knee replacement, and hip resurfacing. The relevance of available and emerging technological tools for these personalized approaches is also explained, with coverage of, for example, robotics, computer-assisted surgery, and augmented reality. Contributions from surgeons who are considered world leaders in diverse fields of this novel surgical philosophy make this open access book will invaluable to a wide readership, from trainees at all levels to consultants practicing lower limb surgery
The fifth edition of Orthopaedic Basic Science: Foundations of Clinical Practice is your concise and clinically relevant resource for the diagnosis and treatment of musculoskeletal diseases and conditions. This completely rewritten edition explains the functions and limitations of the science behind the decisions, treatments, and procedures you perform in your practice every day. Use it to build and reinforce your foundation of knowledge for applying advances in scientific discovery to your decision-making in the clinic and the OR.
Highly Commended, BMA Medical Book Awards 2013Orthopaedic problems account for over one-third of all medical and surgical problems. Mercer's Textbook of Orthopaedics and Trauma provides all the information required by the senior trainee or qualified specialist to improve understanding and management of any given condition or disease in this area.Si
This book is the first monograph to examine all aspects of femoroacetabular impingement (FAI), an important disease first described early in the twenty-first century. Comprising 27 chapters and including many color illustrations, the book contains a variety of points of view from more than 50 experts from 11 countries and represents an up-to-date compilation of professional knowledge on FAI. The full range of available surgical treatments is carefully described and evaluated, including arthroscopic treatment, the open and mini-open approaches, periacetabular osteotomy, hip resurfacing arthroplasty, and combined techniques. Differential diagnosis, imaging, postoperative management, and treatment outcome are also discussed in appropriate detail. It is hoped that this book will promote a comprehensive approach to what is a common pathology and thereby encourage further improvement in treatment.
This open access book gathers authoritative contributions concerning multiscale problems in biomechanics, geomechanics, materials science and tribology. It is written in memory of Sergey Grigorievich Psakhie to feature various aspects of his multifaceted research interests, ranging from theoretical physics, computer modeling of materials and material characterization at the atomic scale, to applications in space industry, medicine and geotectonics, and including organizational, psychological and philosophical aspects of scientific research and teaching as well. This book covers new advances relating to orthopedic implants, concerning the physiological, tribological and materials aspects of their behavior; medical and geological applications of permeable fluid-saturated materials; earthquake dynamics together with aspects relating to their managed and gentle release; lubrication, wear and material transfer in natural and artificial joints; material research in manufacturing processes; hard-soft matter interaction, including adhesive and capillary effects; using nanostructures for influencing living cells and for cancer treatment; manufacturing of surfaces with desired properties; self-organization of hierarchical structures during plastic deformation and thermal treatment; mechanics of composites and coatings; and many more. Covering established knowledge as well as new models and methods, this book provides readers with a comprehensive overview of the field, yet also with extensive details on each single topic.
Osteoarthritis is the most common form of arthritis and cause of joint pain in adults. It affects more than 500 million people worldwide. Patients develop osteoarthritis when the structure of the protective cartilage that covers the bones begins to deteriorate. Recent research shows that multiple drugs in development are promising to treat osteoarthritis. Yet, most physicians agree that we still do not have enough effective treatments for this condition. What works for one person might not work for someone else. Consequently, osteoarthritis research is very important because understanding what causes osteoarthritis or why it progresses remains controversial. In fact, although articular cartilage is the primary target of the disease, both subchondral bone and synovium are often actively involved. This book describes the details of both surgical and non-surgical treatment options for osteoarthritis.
Hip replacement operations have become commonplace during the past ten years, but none the less it is well to remember the struggle to overcome the initial difficulties before the achievement of the successful results which are confidently expected today. Certainly, in the 1950s attempts to relieve pain and restore movement to an arthritic hip frequently failed. Such operations which were practised often involved a prolonged period of immobilisation which would now not be tolerated. For progress to be made orthopaedic surgeons had to rely on the loyalty and stoicism of their patients who allowed untried procedures to be carried out on themselves, often without appreciating the possible outcome. These surgical experiments resulted in progress being made, and the failures led to a greater understanding of the problems involved. The importance of collaboration with bio-engineers was also recognised, and the search began for suitable materials with which to make an artificial joint. Progress was made in many centres throughout the world, and surgeons in the United Kingdom were at the forefront in devising original techniques. Although others also produced new models, John Charnley was a pioneer and an innovator who influenced the development of hip relacement more than any other individual. In telling the story of his life this book is inevitably also the story of the operation, but it is not intended to be a scientific evaluation of his work.
This volume in the Core Knowledge in Orthopaedics Series equips you with the key concepts and clinical skills needed to excel in the subspecialty of adult reconstruction and arthroplasty. Inside you'll find concise, clinically focused coverage of the surgical techniques you need to know to obtain optimal patient management outcomes, along with relevant anatomy, biomechanics, limb salvage techniques, imaging, arthroscopy, and more. It's a perfect resource for training...board certification or recertification review...or everyday clinical reference! Apply the guidance in a logical fashion with coverage that progresses from describing commonly seen clinical problems to reviewing less frequently encountered conditions. Follow the most appropriate surgical management approaches. Assimilate the information easily through bulleted text, crisp artwork, clinical charts, tables, algorithms, and annotated key references.