Download Complications in Knee and Shoulder Surgery: Management and by Trong B. Nguyen, Peter R. Kurzweil (auth.), Robert J. PDF
By Trong B. Nguyen, Peter R. Kurzweil (auth.), Robert J. Meislin, Jeffrey Halbrecht (eds.)
Any surgical intervention has capability dangers and problems. a few issues are avoidable and a few usually are not. Arthrofibrosis or stiffness may well happen within the better of palms, and an infection may possibly floor postoperatively even within the such a lot sterile working room. How one offers with issues actually exams the ability of the doctor. protecting calm and focussed at the concerns in the course of an intraoperative hassle should be facilitated by way of having an algorithmic approach.
Complications in Knee and Shoulder surgical procedure is designed as a reference device and a roadmap for the activities medication orthopedist to lessen issues in knee and shoulder surgical procedure. through figuring out the useful anatomy in danger, right surgical manage, right apparatus, and correct sufferer choice, a preventative method of problems may be instituted.
The authors of those chapters are leaders in orthopedic activities drugs and show their innovations for facing intraoperative problems, expanding the surgeon’s knowledge of power issues and offering recommendation to prevent and deal with those difficulties successfully and quickly should still they arise.
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Additional info for Complications in Knee and Shoulder Surgery: Management and Treatment Options for the Sports Medicine Orthopedist
When performing a concomitant ACL reconstruction, this strategy has merit. But in isolated medial transplanatation, undermining the medial ACL footprint for graft placement seems unwise. Tunnel Establishment Medially, the bone plug technique is most commonly employed, and requires making two tunnels. The posterior tunnel is the most challenging because it requires anatomic positioning for ideal graft placement. Most a Fig. 8 Medial meniscal horn anatomy in reference to ACL tibial insertion (Reproduced with permission from Sekiya JK.
For example, a failed graft in an arthritic knee need not be revised with yet another transplant, and ligamentous instability or malalignment should be addressed prior to revision transplantation in an appropriate candidate. Identification of the cause of failure is critical. Technically, the steps for revision are the same as those in primary reconstruction, with the overt exception of possible bone stock compromise. A critical point to recognize is the need for adequate exposure if performing a lateral meniscal allograft in a trough.
However, there are limitations with this technique, including the need for an adequate capsulotomy and posteromedial exposure, in addition to the potential for difficulty with graft passage of the anterior plug from posterior to anterior. If the graft is passed from back to front, the plugs ought to be fashioned such that the anterior bone plug is pared down or chamfered with a rongeur to facilitate passage. B. R. Rudzki Fig. 11 Prepared medial meniscal allograft with guide suture to maintain orientation (arrows) If difficulty is encountered in attempting anterior bone plug passage, consider using a disposable cannula or extending the anterior incision.