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Complex Cases in Total Knee Arthroplasty pp 103–115Cite as

Retained Hardware

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Abstract

Post-traumatic arthritis is a common cause of arthritis leading to the total knee arthroplasty procedure. If the original injury was a fracture, often residual hardware remains that necessitates a change in the usual surgical technique. If there is a femoral rod or hardware extending into the femoral canal, then standard intramedullary instruments are not possible, and a different approach is needed. This may involve complete removal of the hardware or partial removal to allow the use of standard instruments. “Smart instruments” are now available and include handheld computer and gyroscope-like devices that allow for hardware to remain in place or custom cutting jigs that are patient-specific and allow for the hardware to remain in place. Consideration on the tibia side is a bit different since it is quite common to use an extramedullary device for the tibial osteotomy. Complete or partial hardware removal may be required for prosthesis placement, and often a change in tibia design can allow prosthesis placement without the need for any hardware removal. The goal here is the less removal the better, and numerous options exist to make this task easier.

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Author information

Authors and Affiliations

  1. North Shore-Long Island Jewish Medical Group, New York, NY, USA

    Fred D. Cushner MD

  2. Department of Orthopedic Surgery, Loma Linda University Medical Center, Loma Linda, CA, USA

    Nirav H. Amin MD

  3. Joint Implant Surgeons, Inc., New Albany, OH, USA

    Antonio G. Manocchio DO & Adolph V. Lombardi Jr. MD

  4. Mount Carmel New Albany Surgical Hospital, Ohio State University Wexner Center, New Albany, OH, USA

    Adolph V. Lombardi Jr. MD

Authors
  1. Fred D. Cushner MD
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  2. Nirav H. Amin MD
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  3. Antonio G. Manocchio DO
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  4. Adolph V. Lombardi Jr. MD
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Corresponding author

Correspondence to Fred D. Cushner MD .

Editor information

Editors and Affiliations

  1. Orthopedic Center of New Jersey, Somerset, New Jersey, USA

    Alfred J. Tria

  2. Northwell Health Orthopedic Institute, New York, New York, USA

    Giles R. Scuderi

  3. Orthopedic Center of New Jersey, Somerset, New Jersey, USA

    Fred D. Cushner

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Cushner, F.D., Amin, N.H., Manocchio, A.G., Lombardi, A.V. (2018). Retained Hardware. In: Tria, A., Scuderi, G., Cushner, F. (eds) Complex Cases in Total Knee Arthroplasty. Springer, Cham. https://doi.org/10.1007/978-3-319-69380-4_5

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  • DOI: https://doi.org/10.1007/978-3-319-69380-4_5

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-69379-8

  • Online ISBN: 978-3-319-69380-4

  • eBook Packages: MedicineMedicine (R0)

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