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issues related to surgical exposure, bone loss management and implant selection. 2 In the current article, authors provide a practical guide to approach revision knee surgery. Preoperative evaluation Understanding the cause of the prosthetic
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Introduction Although several surgical approaches to the knee exist, the medial parapatellar approach has been used in 93% of primary total knee replacements (TKRs) performed in England and Wales between 2004 and 2014. 1 This approach
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Facoltà di Scienze Biomediche, Università della Svizzera Italiana, Lugano, Switzerland
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Applied and Translational Research Center, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
Facoltà di Scienze Biomediche, Università della Svizzera Italiana, Lugano, Switzerland
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pain, lower complication rates along with good long-term survivorship and kinematics. 10 , 11 A great effort has been made to introduce and improve the minimally invasive approach for UKA surgery, allowing recovery to be shortened and the
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approach using external fixation is recommended in complex patterns and high-energy trauma, especially in cases of axial instability. Knee-spanning external fixators can be used to approximate the fracture fragments by the process of ligamentotaxis. 1 , 6
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. Approaches in revision Knee exposure in rTKA can be difficult, as dense scarring may penetrate into the deep fascial layers or even the underlying bone and may be accompanied by loss of elasticity or thickening of the capsular envelope. The latter – common
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. The lower success rates related to an open release may be a consequence of the local tissue scare derived from an incision injury. Nowadays arthroscopic approach is the first treatment choice, but open debridement can still be considered for severe
IRCCS Humanitas Research Hospital, Milan, Italy
These authors contributed equally to the article and should both be considered first authors
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IRCCS Humanitas Research Hospital, Milan, Italy
These authors contributed equally to the article and should both be considered first authors
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First Moscow State Medical University – Sechenov University, Moscow, Russia
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IRCCS Humanitas Research Hospital, Milan, Italy
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be achieved through different therapeutic strategies such as lifestyle modifications, exercise therapy, pharmacological therapies and injections of various substances. 2 Pharmacological approaches based for example on non-steroidal anti
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of articular degeneration. Planning Planning is of utmost importance when approaching this challenging surgery. Clinical and radiological evaluations must address a number of issues: diagnosis (to exclude latent infection), approach, axis, bone
Department of Orthopaedic Surgery, University of Cape Town, SA
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of the early 1970s, considerable advances have been made in terms of component design, peri-operative care, alignment strategies, surgical approaches, and, more recently, the use of advanced technologies such as computer navigation and robotic
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) debridement and removal of fibrous tissue, (ii) anatomical reduction, (iii) stability, and (iv) healing enhancement techniques, all achievable using a posterior approach. Other benefits of posterior arthroscopy in repairing posterior meniscal lesions include
