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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
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.
Orthopedic experts in their field have carefully chosen what they consider to be the key papers in their respective domains. Every paper is carefully described and evaluated by its strengths, weaknesses and its contribution to the field. Papers have been chosen by number of citations, academic importance, articles that have changed our whole way of thinking or that have simply stood the test of time.
The incidence of total hip arthroplasty is increasing in number because of successful outcomes. Although technically challenging, once mastered a hip replacement is one of the most gratifying surgeries for both patient and surgeon. This book covers some of the most important aspects of hip replacement surgery. These include preoperative planning, anesthesia, classification systems, management of proximal femur fractures, anterior approach, complications, and rehabilitation aspects of hip arthroplasty. The book is intended for arthroplasty surgeons, anesthetists, and physical therapists who will find the book useful in parts and as a whole if they deal with arthroplasty cases on a regular basis. Experience-based narration of various subjects by authors ensures that first-hand experience is passed on to readers in a simple, easy-to-understand manner.
The must-have book for candidates preparing for the oral component of the FRCS (Tr and Orth).
An in-depth understanding of a comprehensive approach to the management of radius fractures and their complications. The authors -- world renowned experts in the field -- present practical, clinical information from their extensive experience in the treatment of these fractures. Topics include the authors' classification as well as decision- making and tactics in the conservative and operative management of all types of radius fractures. Topics covered include: bending fractures of the metaphysis, shearing and compression fractures of the joint surface, avulsion fractures, radio-carpal fracture and dislocation, combined fractures, high velocity injury and malunions. In addition, chapters deal with surgical techniques and approach as well as with complications. With over 500 illustrations, this is the definitive volume on these challenging fractures, their complete treatment, and the management of complications.
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.
The purpose of this book was to offer an overview of recent insights into the current state of arthroplasty. The tremendous long term success of Sir Charnley's total hip arthroplasty has encouraged many researchers to treat pain, improve function and create solutions for higher quality of life. Indeed and as described in a special chapter of this book, arthroplasty is an emerging field in the joints of upper extremity and spine. However, there are inborn complications in any foreign design brought to the human body. First, in the chapter on infections we endeavor to provide a comprehensive, up-to-date analysis and description of the management of this difficult problem. Second, the immune system is faced with a strange material coming in huge amounts of micro-particles from the tribology code. Therefore, great attention to the problem of aseptic loosening has been addressed in special chapters on loosening and on materials currently available for arthroplasty.