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Calipered Kinematically aligned Total Knee Arthroplasty. Theory, Surgical Techniques and Perspectives

  • Book

  • October 2021
  • Elsevier Health Science
  • ID: 5315092
Calipered kinematic alignment was proposed by Dr. Stephen M. Howell to enable the accurate and individualized placement of total knee components coincident within ? 0.5 mm of the patient's pre-arthritic alignment. The aim was to restore the patient's native joint kinematics and thereby address the well documented 20% dissatisfaction when total knee replacement is performed using traditional, or mechanical alignment techniques.

With Dr. Stefano A. Bini and Dr. G. Daxton Steele as co-editors, Dr. Howell has curated an international team of expert surgeons and engineers to discuss various aspects of the calipered knee alignment technique in short, concise, and well-illustrated chapters. Each author provides clear, practical guidance for adopting and implementing calipered kinematic alignment covering manual, patient-specific, navigated, and robotic techniques. Chapters on component design tailored explicitly for kinematic alignment and showing the close relationship between knee biomechanics and the kinematically aligned TKA help the surgeon manage complex challenges associated with deformity and post-operative complications.

Following the introduction of the calipered kinematic alignment technique for total knee arthroplasty, many international studies have shown consistently better patient satisfaction than the traditional mechanical alignment technique. Better function and high long-term implant survival have catalyzed a paradigm shift in total knee replacement philosophy that is being embraced by orthopedic surgeons and innovative implant companies around the world with excellent results.

Calipered Kinematically Aligned Knee Arthroplasty is the definitive textbook on the subject and features:

- Thorough explanations of how the calipered kinematic alignment technique for total knee arthroplasty accurately sets total knee components coincident with the patient's pre-arthritic alignment and coaligned with the three rotational axes of the native knee.

- A personalized approach to total knee surgery designed to reconstitute the patient's native biomechanics in contrast with mechanical alignment that place all patients in the same standard alignment regardless of their constitutional anatomy.

- Detailed and well-illustrated descriptions of manual, navigated, robotic and patient-specific guide techniques that confirm kinematic alignment with a caliper.

- Clinical photos, radiographs, and line art throughout the book as well as helpful online technique videos.

- Key focus topics such as managing complex deformities, the expected post-operative recovery, and future trends in kinematic alignment.

- The shared experience and knowledge of international pioneers in the field.

- An emphasis on a personalized surgical philosophy which enables same-day discharge, reduces pain and opioid use, and promotes quicker recovery, better function, and a more natural feeling knee.

Table of Contents

Chapter 1: A Word of Caution

Chapter 2: The Principles behind Mechanical Alignment

Chapter 3: Have We Been Shooting at the Wrong Target? Chapter 4: Philosophy and Principles of Kinetic Alignment

Chapter 5: Philosophy and Principles of KA - Q&A

Chapter 6: Surgical Technique: Standard Instrumentation

Chapter 7: Surgical Technique: Custom Jigs

Chapter 8: Handling Instability

Chapter 9: Surgical Technique: Using Navigation Assisted Techniques

Chapter 10: Surgical Technique: Using Robot Assisted Surgery

Chapter 11: Surgical Technique: Tibia First

Chapter 12: Surgical Technique: Kinematic Light

Chapter 13: Post-Operative Rehabilitation and Clinical Evaluation of the KA TKA

Chapter 14: Kinematic Alignment in the Complex Knee

Chapter 15: Revising a KA Knee: Surgical Considerations

Chapter 16: Revising a MA Aligned Knee into KA: Early Experience and Indications

Chapter 17: Kinematic Alignment: Q&A on Surgical Techniques

Chapter 18: Future Trends in KA

Chapter 19: Literature Review and Highlights of Key Findings

Authors

Stephen M. Howell Stephen M. Howell, MD is a board-certified orthopedic surgeon practicing in Sacramento and Lodi. He joined Adventist Health Lodi Memorial with more than three decades of experience as a clinician, researcher, and innovator in total knee replacement (TKR), anterior cruciate ligament (ACL) reconstruction, and meniscal surgery. Dr. Howell's clinical practice focuses on the treatment of degenerative processes and sports-related injuries to the knee. He performs more than 500 TKRs and 100 ACL reconstructions per year. Dr. Howell also created the kinematic alignment method, which caused a paradigm shift in TKR. His published experience demonstrates that patients report less pain, a quicker recovery, better pain relief, better function, better flexion, and a more natural feeling knee when treated with this method. Dr. Howell is also an Adjunct Professor of Biomedical Engineering at the University of California, Davis. He has published more than 140 scientific articles in peer-reviewed journals. Stefano A. Bini Stefano Bini, MD received his BA from Stanford University, his MD from Columbia University and completed Residency training at UCSF. He completed a Fellowship at the Rizzoli Orthopaedic Institute in Italy and obtained a second MD from the University of Florence. Prior to joining the faculty at UCSF, Dr. Bini worked at Kaiser Permanente as a joint replacement surgeon. Active in professional associations and academia, Stefano currently serves as the Chair of the International Committee for the AAHKS and sits on the Biomedical Engineering Committee for the AAOS. He is the Associate Editor of Arthroplasty Today and is a reviewer for 4 major orthopaedic journals. Over the past decade, Dr. Bini has organized over a dozen conferences and learning labs nationally and internationally, presented over 110 scientific papers and has authored 23 research papers, which focus on leveraging large databases to define best practice in adult reconstruction surgery. G. Daxton Steele G. Daxton Steele, MD is a highly skilled orthopaedic surgeon specializing in total joint surgery with The Andrews Institute, an affiliate of Baptist Health Care. Dr. Steele is an industry consultant and helped develop the first FDA approved technique for kinematic alignment.