By S. A. V. Swanson (auth.), M. A. R. Freeman M.D. F.R.C.S. (eds.)
Early in its improvement, the subject material of any box of surgical procedure is simply too ill-defined and reviews are too fluid for the construction of a ebook at the topic to be attainable. overdue in its improvement, controversy is at an finish, and even though it remains to be attainable to supply a textbook, it really is too overdue to provide a publication that would stimulate dialogue and crystallise rules. This ebook has that target, it being the Editor's view that the sector of the surgical operation of arthritis of the knee had reached a suitable intermediate level in 1978 whilst this article was once written. 3 vast matters stand out as being wanting solution earlier than the optimal kind of surgical operation for a given knee might be outlined extra convincingly than is feasible at this time: to start with: What symptomatic and actual gains of the knee are to be recorded pre- and post-operatively, upon the foundation of which comparisons will be made among the implications received through various surgeons or with varied tech niques. The answer of this factor calls for common contract not just upon what gains of the knee can be recorded yet, crucially, upon how those good points may still therefore be provided on the way to characterise a selected staff of knees.
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Extra resources for Arthritis of the Knee: Clinical Features and Surgical Management
1. : Friction, lubrication and wear. The scientific basis of joint replacement. R. ), p. 46. R. FREEMAN The London Hospital, London El 2AD, England This Chapter is not concerned with the pathogenesis of rheumatoid arthritis (RA) and osteoarthritis (OA) nor with the pathology of these diseases at the cellular level, both topics that have been reviewed extensively elsewhere. The initial causes of these diseases and the associated events at the cellular level have been excluded, since at present they have little or no bearing upon the surgical treatment of these two conditions at the knee.
If the femur is thought of as flexing across the top of a fixed tibia without antero-posterior movement, the point on the femur to which the posterior cruciate ligament is attached would therefore tend to move first forwards and then upwards. Such movement cannot of course occur because the posterior cruciate ligament is inelastic for practical purposes: instead the femur must move bodily first backwards and then downwards relative to the tibia, the latter movement being permitted by (and presumably accounting for) the backward and downward slope of the tibial articular surfaces (Fig.
This process is expensive, and imposes some restriction on the shapes that can be made at an acceptable cost, but direct moulding to shape in this material has not so far been practicable because of its flow characteristics. , 1974). Polyformaldehyde is currently used in at least one design of hip prosthesis (CHRISTIANSEN, 1974). Ceramics are being used in some hip prostheses (BOUTIN, 1974), and are claimed to be less reactive 28 - Biomechanics than metallic alloys and to give a lower wear rate of polyethylene.