The Knee Joint

This book is devoted to all surgical aspects of knee pathology, with the exclusion of bone traumatology. It summarizes
current concepts and recent techniques, from most recent innovations in biology and regenerative medicine to complex
reconstruction involving prosthetic knee surgery. Operative techniques are clearly reported in a didactic fashion,
using figures, tables and algorithms. Worldwide leaders in the field of knee surgery participated in this book in order
to summarize the North American, European and Asian culture in a single volume. The first part of the book concerns
meniscal and ligament injuries. It seeks to clarify the pathophysiology, the natural history and the therapeutic
strategies in various tears of the anterior cruciate ligament, of the posterior cruciate ligament and also in complex
multiligamentous injuries. The second part is about patellofemoral pathology. It helps the reader to analyze and
understand isolated anterior knee pain, patellar instability, and isolated patellofemoral arthrosis. The
pathophysiology as well as the clinical and radiological components and the various treatment options are detailed for
each clinical situation, from isolated soft-tissue procedures to deepening trochleoplasty, resurfacing or
patellofemoral prosthesis. Finally, the third part of the book is devoted to the degenerative knee. The various
techniques of osteotomies around the knee, their results and biomechanical principles are clearly analyzed. Every
aspect of prosthetic knee surgery is detailed, covering all aspects of uni-and tricompartmental prostheses. Specific
sections are devoted to design, surgical approaches and navigation. Difficult cases in primary TKA as well as
strategies and technical problems in revision TKA are addressed in a separate section of the book. This textbook should
help and answer any questions that arise from the knee specialist, from the training resident to the skilled surgeon.
Its ambition is to assist the surgeon in understanding the pathophysiology and elaborating the strategic choices and
indications available. In addition, it will provide practical assistance in the planning and realization of the
described surgical procedures on a regular basis.

Table of Contents
Foreword ........................................................................................ XXI
I Th e Traumatic Knee ..................................................................... 1
Basic Sciences ............................................................................................ 3
1. Th e menisci: anatomy, healing response, and biomechanics
A. Amendola, D. E. Bonasia....................................................................................... 5
2. Th e cruciate ligaments: anatomy, biology, and biomechanics
S. Scheffl
er .............................................................................................................. 11
3. Th e anatomy and biomechanics of the medial collateral ligament
and posteromedial corner of the knee
A. A. Amis, J. R. Robinson ........................................................................................ 23
4. Th e lateral collateral ligament and posterolateral corner
C. J. Griffi th, C. A. Wijdicks, R. F. LaPrade ............................................................... 31
5. Basic science of ligament healing
H. Tohyama, K. Yasuda ............................................................................................. 43
Clinical Basis ............................................................................................. 51
6. Clinical basis: epidemiology, risk factors,
mechanisms of injury, and prevention
of ligament injuries of the knee
T. E. Hewett, B. T. Zazulak, T. Krosshaug, R. Bahr ................................................... 53
7. MRI evaluation of knee ligaments
H. G. Potter, D. B. Sneag, L. R. Chong ....................................................................... 71
8. Classifi cation of knee laxities
S. R. Piedade, E. Servien, F. Lavoie, P. Neyret ........................................................... 85
9. Scoring the knee
B. E. Heyworth, R. H. Brophy, R. G. Marx ................................................................ 95
Th e Menisci ............................................................................................... 107
10. Arthroscopic meniscectomy
J. C. Panisset, J. L. Prudhon ...................................................................................... 109
11. Meniscal sutures
P. Wilmes, D. Pape, R. Seil .........................................................................................
125
12. Meniscal allograft transplantation
P. Verdonk, P. Vansintjan, R. Verdonk ....................................................................... 139
Th e ACL ..................................................................................................... 149
13. Diagnostic and surgical decision ACL tears
B. T. Kean, R. T. Burks ..............................................................................................
151
14. Natural history of ACL tears: from rupture to osteoarthritis
M. J. Matava, R. W. Wright, E. D. Ellis ..................................................................... 163
XVI The Knee Joint
15. Graft choice in ACL reconstruction
D. E. Bonasia, A. Amendola....................................................................................... 173
16. Tunnels, graft positioning, and isometry in ACL reconstruction
A. Williams, N. Devic ................................................................................................
183
17. Technique in ACL reconstruction: hamstring reconstruction
D. Longino, N. Clerk, P. J. Fowler, J. R. Giffi n ........................................................... 195
18. Technique in ACL reconstruction: patellar tendon
D. R. McAllister, T. Y. Wu ..........................................................................................
203
19. Place of navigation in anterior cruciate ligament reconstruction
G. Messerli, J. M??rey ........................................................................................... 217
20. Single or double bundle?
B. Sonnery-Cottet .....................................................................................................
227
21. Anatomic double-bundle ACL reconstruction: how I do it?
K.
Yasuda .................................................................................................................
. 235
22. Results of ACL reconstruction
J. Iwasa, Y. Shima, L. Engebretsen ............................................................................ 245
23. Arthrofi brosis after anterior cruciate ligament reconstruction
P. Chambat, R. Vargas, J. Desnoyer........................................................................... 263
24. ACL rehabilitation
M. A. Shaff er, G. N. Williams .................................................................................... 269
25. ACL rupture in children: anatomical and biological bases, outcome
of ACL defi cient knee in childhood: strategy, operative technique, results,
and complications.
F. Chotel, J. Henry, J. B?ard .................................................................................... 291
26. Combined injuries of the anterior cruciate ligament
and posterolateral corner
S. P. Robinson, W. Shen, F. H. Fu ............................................................................... 325
27. Failure in ACL reconstruction: etiology, treatment, and results
N. Th omas, J. Carmichael ......................................................................................... 343
Th e PCL ...................................................................................................... 355
28. Defi nition and diagnosis of posterior cruciate ligament injury
and algorithm of treatment
J.
M??rey ...............................................................................................................
357
29. Natural history of PCL ruptures
S. Akhavan, R. D. Parker ........................................................................................... 369
30. Th e PCL: diff erent options in PCL reconstruction:
choice of the graft? One or two bundles?
J. H?er, S. Shafi zadeh .............................................................................................
377
31. Graft tunnel positioning during PCL reconstruction
A. A. Amis, A. Edwards, S. Apsingi ........................................................................... 387
32. Techniques in posterior cruciate ligament reconstruction:
an arthroscopic approach
B. Forsythe, R. Mascarenhas, M. W. Pombo, C. D. Harner ........................................ 395
33. Arthroscopic reconstruction of the posterior cruciate ligament
using double-bundle and tibial-inlay technique
S.- J.
Kim ..................................................................................................................
405
34. Technique in PCL reconstruction: mini posterior approach
R. Badet, P. Verdonk, S. Rocha Piedade ..................................................................... 411
Table of Contents XVII
35. Results of PCL reconstruction
F. Margheritini, M. Aboelnour, P.P. Mariani .............................................................. 417
36. Combined injuries to the posterior cruciate ligament
and medial collateral ligament of the knee
B. Forsythe, R. Mascarenhas, M. W. Pombo, C. D. Harner ........................................ 421
37. PCL injury associated with a posterolateral tear
K. Corten, J. Bellemans .............................................................................................
427
Bicruciate injuries and dislocations .......................................................... 441
38. Th e multiple-ligament injured knee
G. C. Fanelli, C. J. Edson ..........................................................................................
443
39. Surgical treatment of cartilage tear: principles and results
F. U. Veith, J. M??rey ............................................................................................
457
40. Technique of mosaicplasty
A. Miniaci, L. D. Farrow ........................................................................................... 483
41. Allograft osteoarticular resurfacing
M. J. DeFranco, A. G. McNickle, B. J. Cole................................................................ 497
42. Technique of chondrocytes implantation
S. Zaff agnini, E. Kon, G. Filardo, G. Giordano, M. Delcogliano,
G. M. Marcheggiani Muccioli, M. Marcacci ............................................................... 505
43. Regenerative medicine for cartilage
T. Laumonier, J. M??rey ........................................................................................ 511
Patello-femoral joint ................................................................................. 517
44. Th e biomechanics of the patella
R. P. Grelsamer, J. Gould ...........................................................................................
519
45. Imaging of patellofemoral joint
Y.
Carrillon ..............................................................................................................
.. 525
46. Anterior knee pain and patellar instability: diagnosis and treatment
K. F. Almqvist, E. A. Arendt ...................................................................................... 533
47. Patellar stabilization for episodic patellar instability
K. Raiszadeh, D. C. Fithian, L. D. Latt ...................................................................... 539
48. Deepening trochleoplasty for patellofemoral instability
D. Dejour, P.
Byn ....................................................................................................... 549
II Th e Degenerative Knee ............................................................... 559
Osteoarthritis of the patello-femoral joint ............................................... 561
49. Patellofemoral osteoarthritis: pathophysiologie, treatment,
and results
H. Vandenneucker, K. Didden, J. Bellemans ............................................................. 563
50. Patellofemoral replacement
J. H.
Newman ........................................................................................................... 573
Indications in osteoarthritis of the femoro-tibial joint ............................ 583
51. Is there a place for arthroscopy in the degenerative knee?
P. Djian, G. Bellier, B. Moyen, X. Ayral, J. P. Bonvarlet .............................................. 585
52. Surgical indications in medial knee osteoarthritis
F. Lavoie, S. Lustig, E. Servien, S. R. Piedade, P. Neyret ............................................ 591
XVIII The Knee Joint
Osteotomy around the knee ...................................................................... 601
53. Biomechanics, basis, and indications of osteotomies around the knee
P. Hernigou, S. Zilber, A. Poignard, R. Jalil, P. Filippini, M. Mukisi Mukasa ............. 603
54. Technique of closing wedge HTO
D. Kohn, D.
Pape ....................................................................................................... 611
55. Technique of open wedge HTO
P. Lobenhoff er, J. D. Agneskirchner ........................................................................... 621
56. Results of HTO in medial OA of the knee
A. Amendola, D. E. Bonasia....................................................................................... 633
57. Osteotomies in the valgus knee
G. Puddu, L. Panarella ..............................................................................................
643
58. Medial closing wedge varus osteotomy of the distal femur
R. J. van Heerwaarden ............................................................................................. 653
Unicondylar knee arthroplasty ................................................................. 661
59. Technical considerations, results,
and complications of mobile-bearing UKA
R. W. McCalden ........................................................................................................
663
60. Fixed bearing unicompartmental knee prosthesis:
results, complications, and technical considerations
G. Deschamps, C. Bussi?e, S. Donell ........................................................................ 669
61. Indications of unicompartmental knee arthroplasty
C. L. Barnes, R. D. Scott ............................................................................................
685
62. Lateral Unicompartmental Knee Replacement
J. H.
Newman ........................................................................................................... 689
III Primary Total Knee Arthroplasty ............................................... 695
Design and concept in TKA ....................................................................... 697
63. Th e history of total knee arthroplasty
A. S. Ranawat, A, S. Ranawat, C. S. Ranawat .......................................................... 699
64. Posterostabilized TKA: advantages and disadvantages
S. Parratte, J.-M. Aubaniac, J.-N. A. Argenson ......................................................... 709
65. Conservation of posterior cruciate ligament
in fi xed-bearing total knee replacement
J.Y. Nordin, Guepar Group ....................................................................................... 721
66. Deep dish TKA: advantages and disadvantages
P.-F. Leyvraz, V. Leclercq ...........................................................................................
729
67. Bicruciate retaining TKA: the future?
J. Bellemans, K. Corten, J. Vanlauwe, H. Vandenneucker ......................................... 735
68. Mobile-bearing total knee arthroplasty:
advantages and disadvantages
R. H. Kim, D. A. Dennis ............................................................................................ 741
69. Fixed-bearing total knee arthoplasty:
advantages and disadvantages
D. Kohn, M. Kusma ...................................................................................................
755
70. Cement fi xation for total knee arthroplasty
J. D. Jackson, M. W. Pagnano.................................................................................... 759
Table of Contents XIX
Surgical techniques ................................................................................... 765
71. Pre-operative imaging techniques
in primary total knee replacement: role for computed tomography
P. Beaufi
ls ..................................................................................................................
767
72. Th e mini-subvastus approach for total knee arthroplasty
J. D. Jackson, M. W. Pagnano.................................................................................... 775
73. Th e degenerative knee ?surgical techniques: 밽ap balancing? C. Stukenborg-Colsman, S. Ostermeier, H. Windhagen ............................................ 783
74. Component orientation and total knee arthroplasty
F. R. Orozco, W. J. Hozack ......................................................................................... 791
75. Rotation of components in total knee arthroplasty
M.
Bonnin .................................................................................................................
797
76. Improving mobility
S. Parratte, A. Ashour, Y. H?on, J.-M. Aubaniac, J.-N. Argenson ........................... 809
77. Medical management before and after TKA
E. J. Graham, R. B. Bourne ....................................................................................... 815
78. Rehabilitation protocol following total knee arthroplasty
B. Quelard, O. Rachet ...............................................................................................
823
Th e Patella in TKA ..................................................................................... 839
79. Why I always resurface the patella in TKA
K. Corten, S. J. MacDonald ....................................................................................... 841
80. Why I do not routinely resurface the patella in TKA
A. J. Bigham, J. L. Howard........................................................................................ 857
Navigation in TKA ..................................................................................... 865
81. Total knee replacement navigation: the diff erent techniques
F. Picard, A. Gregori, A. Deakin................................................................................. 867
82. Why using navigation in total knee arthroplasty?
P. Deprez, J.
Victor .................................................................................................... 879
Results in Primary TKA ............................................................................. 885
83. Results and function of total knee arthroplasty
M. Dunbar, S. Sripada, R. Kjar ................................................................................. 887
Diffi culties in Primary TKA ....................................................................... 895
84. TKA in the stiff knee
J. Vanlauwe, H. Vandenneucker, J. Bellemans ........................................................... 897
85. Th e lateral approach in the valgus knee
R. Zayni, M. Bonnin ..................................................................................................
901
86. TKA in the severe valgus knee: lateral epicondyle sliding osteotomy technique
J. Brilhault, P.
Burdin ................................................................................................ 907
87. Total knee replacement in patients with severe varus deformity
Y. Catonn? E. Sariali, F. Khiami, B. Tillie ................................................................. 915
88. Total knee arthroplasty after failed high tibial osteotomy
M. Bonnin, R. Zayni ..................................................................................................
923
89. Total knee arthroplasty after malunion
T. Ait Si Selmi, D. Carmody, Ph. Neyret .................................................................... 933
XX The Knee Joint
90. Revision total knee arthroplasty after failed unicompartmental knee replacement
J. R.
Laurent .............................................................................................................
941
Failures and Revision in TKA .................................................................... 953
91. Causes of failures in TKA
M.
Bonnin .................................................................................................................
955
92. Th e painful total knee arthroplasty
G. Van Damme, J. Victor ........................................................................................... 969
93. Pre-operative planning for revision TKA
E. J. Graham, S. J. MacDonald.................................................................................. 983
94. Technique of revision: surgical approach
M. Tanzer, S. Burnett ................................................................................................
989
95. Revision TKA: component removal
K. Corten, S. J. MacDonald ....................................................................................... 1003
96. Management of bony defects in revision TKR
M.
Clatworthy ..........................................................................................................
1009
97. Stems in revision TKA
D. J.
Berry .................................................................................................................
1021
98. Technique of revision in TKA: joint line level
C. M. van den Broek, G. G. van Hellemondt, A. B. Wymenga .................................... 1029
99. Technique of revision in total knee arthroplasty: the patella
D. D. R. Naudie, T. H. Bell, J. McAuley ...................................................................... 1039
100. Extensor mechanism allograft ?surgical technique
A. P. Sah, C. J. Della Valle, A. G. Rosenberg .............................................................. 1049
101. Infection in total knee arthroplasty ?prevention
T. Kostamo, S. J. MacDonald .................................................................................... 1057
102. Diagnosis of infection after total knee arthroplasty
C. J. Richards, D. S. Garbuz, B. A. Masri ................................................................... 1063
103. Infection in total knee arthroplasty: treatment
T. M. Mabry, A. D. Hanssen ...................................................................................... 1071