BACKGROUND Incompletely solved problems in hip and knee arthroplasty present ongoing practice challenges. METHODS Content experts summarized treatment options and preferred treatment methods for 4 incompletely solved problems in hip and knee arthroplasty. RESULTS The problems chosen for discussion in this symposium included 2 soft tissue problems: chronic extensor mechanism deficiency after...

Knee dislocation after total knee arthroplasty (TKA), although rare, is a dangerous injury that can lead to neurovascular compromise and permanent disability. Chronic dislocation after TKA is even less common and is defined as dislocation that is present for 4 weeks or more. There are few reports of its management. Chronic dislocation may be complicated further by concomitant extensor mechanism...

BACKGROUND There is conflicting evidence regarding the merits of patellar resurfacing during total knee arthroplasty, as many of the previous randomized controlled trials have not been adequately powered. METHODS A pragmatic, multicenter, randomized controlled trial was initiated in 1999 in the United Kingdom. Within a partial factorial design, 1715 patients were randomly allocated to receive...

BACKGROUND Thirty thousand knee replacements are performed annually in the UK. There is uncertainty as to the best surgical approach to the knee joint for knee arthroplasty. We planned a randomised controlled trial to compare a standard medial parapatellar arthrotomy with sub-vastus arthrotomy for patients undergoing primary total knee arthroplasty in terms of short and long term knee function....

The management of the stiff knee after total knee arthroplasty is controversial. Manipulation under anesthesia and open lysis of adhesions are techniques that can theoretically address the fibrous scar tissue, but their efficacy has been shown to be variable. We describe the technique of arthroscopic lysis of adhesions for the stiff knee after total knee arthroplasty. The advantages of this tec...