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INSALL & SCOTT SURGERY OF THE KNEE, SIXTH EDITION

Copyright © 2018 by Elsevier, Inc. All rights reserved.

ISBN: 978-0-323-40046-6

Part Vol 1: 9996118703

Part Vol 2: 9996118649

No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions

This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein).

Notices

Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary.

Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility.

With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions.

To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein.

Previous editions copyrighted 2012, 2006, 2001, 1993, and 1984.

Library of Congress Cataloging-in-Publication Data

Names: Scott, W. Norman, editor. | Diduch, David R., editor. | Long, William J. (William John), editor.

Title: Insall & Scott surgery of the knee / editor-in-chief, W. Norman Scott ; associate editors, David R. Diduch, Richard Iorio, William J. Long.

Other titles: Insall and Scott surgery of the knee | Surgery of the knee

Description: Sixth edition. | Philadelphia, PA : Elsevier, [2018] | Includes bibliographical references and index.

Identifiers: LCCN 2016048391 | ISBN 9780323400466 (hardcover : alk. paper)

Subjects: | MESH: Knee–surgery | Ligaments, Articular–injuries | Knee Injuries–surgery | Arthroplasty

Classification: LCC RD561 | NLM WE 870 | DDC 617.5/82059–dc23 LC record available at https://lccn.loc.gov/2016048391

Content Strategist: Dolores Meloni

Content Development Specialist: Janice Gaillard

Publishing Services Manager: Catherine Jackson

Senior Project Manager: Rachel E. McMullen

Design Direction: Amy Buxton

CONTRIBUTORS

Matthew P. Abdel, MD

Associate Professor of Orthopedic Surgery and Senior Associate Consultant Department of Orthopedic Surgery

Mayo Clinic Rochester, Minnesota

Aryeh M. Abeles, MD

Associate Clinical Professor Department of Rheumatology University of Connecticut Farmington, Connecticut

Ronald S. Adler, MD, PhD Professor of Radiology

New York University School of Medicine; Department of Radiology Langone Medical Center

New York, New York

Paolo Adravanti, MD

Chief of Orthopedics Department of Orthopedics Clinic Città di Parma Parma, Italy

Vinay K. Aggarwal, MD Resident Physician

Hospital for Joint Diseases

NYU Langone Medical Center

New York, New York

Eduard Alentorn-Geli, MD, MSc, PhD, FEBOT

Duke Sports Science Institute Department of Orthopedic Surgery Duke University Durham, North Carolina

Azhar A. Ali, MD

Center for Orthopaedic Biomechanics University of Denver Denver, Colorado

Sana Ali, MD

Resident in Diagnostic Radiology Department of Diagnostic Imaging Maimonides Medical Center Brooklyn, New York

Hassan Alosh, MD

Aaron Althaus, MD Fellow

Department of Orthopedic Surgery

Insall Scott Kelly

New York, New York

Annunziato Amendola, MD Department of Orthopedic Surgery Division of Sports Medicine

Duke University Durham, North Carolina

Ned Amendola, MD

Priyadarshi Amit, MS Ortho, DNB

Ortho, MRCSEd

Sicot Fellow

Department of Orthopedics and Traumatology

Fondazione IRCCS Policlinico San Matteo Università degli Studi di Pavia Pavia, Italy; Department of Orthopedics

Max Institute of Medical Sciences

New Delhi, India

Aldo Ampollini, MD

Orthopaedic Surgeon Department of Orthopaedic Surgery

Clinic Città di Parma

Parma, Italy

Allen F. Anderson, MD

Orthopaedic Surgeon

Tennessee Orthopaedic Alliance/The Lipscomb Clinic

Nashville, Tennessee

Christian N. Anderson, MD

Orthopaedic Surgeon

Tennessee Orthopaedic Alliance/The Lipscomb Clinic

Nashville, Tennessee

Thomas P. Andriacchi, MD

Shawn G. Anthony, MD, MBA

Assistant Professor, Sports Medicine

Department of Orthopaedic Surgery

Icahn School of Medicine at Mount Sinai

Mount Sinai Health System

New York, New York

Jason D. Archibald, MD

New England Orthopedic Specialists

Peabody, Massachusetts

Elizabeth A. Arendt, MD

Professor and Vice Chair

Department of Orthopaedic Surgery

University of Minnesota Minneapolis, Minnesota

Jean Noël Argenson, APHM

Institute for Locomotion Department of Orthopaedic Surgery

Sainte-Marguerite Hospital; Professor

Aix-Marseille University

Marseille, France

Yeseniya Aronova, MD

Resident Physician

Department of Anesthesiology, Perioperative Care, and Pain Medicine

New York University Langone Medical Center

New York, New York

Arthur Atchabahian, MD

Professor of Clinical Anesthesiology

Anesthesiology

New York University School of Medicine

New York, New York

Matthew S. Austin, MD

Professor

Department of Orthopaedic Surgery

Rothman Institute at Thomas Jefferson University Hospital Philadelphia, Pennsylvania

Christophe Aveline, MD

Department of Anesthesia and Surgical Intensive Care

Private Hospital Sevigne

Cesson Sevigne, France

Bernard R. Bach, Jr., MD Professor

Orthopaedic Surgery

Division of Sports Medicine

Rush University Medical Center

Chicago, Illinois

Geoffrey S. Baer, MD, PhD

Department of Orthopedic Surgery and Rehabilitation Division of Sports Medicine

University of Wisconsin—Madison

Madison, Wisconsin

Giovanni Balato, MD

Department of Public Health School of Medicine

Federico II University

Naples, Italy

Diane L. Dahm, MD

Professor of Orthopedics, Mayo Clinic College of Medicine Department of Orthopedic Surgery Mayo Clinic Rochester, Minnesota

Timothy A. Damron, MD

Vice-Chairman and David G. Murray Endowed Professor of Orthopedic Surgery

Department of Orthopedic Surgery SUNY Upstate Medical University Syracuse, New York

Chase S. Dean, MD

Steadman Philippon Research Institute Vail, Colorado

Jospeh P. DeAngelia, MD, MBA

Carl J. Shapiro Department of Orthopaedics

Beth Israel Deaconess Medical Center Boston, Massachusetts

David DeJour, MD Orthopedic Surgeon Lyon, France

Craig J. Della Valle, MD Professor and Chief Division of Adult Reconstruction Department of Orthopaedic Surgery

Rush University Medical Center Chicago, Illinois

Edward M. DelSole, MD

Resident Physician

Department of Orthopaedic Surgery

New York University Langone Medical Center/Hospital for Joint Diseases New York, New York

Douglas A. Dennis, MD Colorado Joint Replacement; Adjunct Professor of Bioengineering Department of Mechanical and Materials Engineering University of Denver Denver, Colorado; Adjunct Professor Department of Biomedical Engineering University of Tennessee Knoxville Tennessee; Assistant Clinical Professor Department of Orthopaedics University of Colorado School of Medicine Aurora, Colorado

Edward J. Derrick, MD

Ajit J. Deshmukh, MD

Assistant Professor Orthopaedic Surgery

New York University Langone Medical Center/New York University Hospital for Joint Diseases; Assistant Chief Department of Orthopaedics

Surgery

VA New York Harbor Healthcare System

New York, New York

Ian D. Dickey, MD, P Eng (HON) FRCSC

St. Luke’s/Presbyterian Hospital Denver, Colorado

Sorosch Didehvar, MD

Department of Anesthesiology

New York University Langone Medical Center

New York, New York

David R. Diduch, MD, MS

Alfred R. Shands Professor of Orthopaedic Surgery

Vice Chairman, Department of Orthopaedic Surgery

Head Orthopaedic Team Physician

University of Virginia Charlottesville, Virginia

Lisa V. Doan, MD

Assistant Professor

Department of Anesthesiology, Perioperative Care, and Pain Medicine

New York University School of Medicine

New York, New York

Christopher A.F. Dodd, FRCS

Consultant Orthopaedic Surgeon Nuffield Orthopaedic Centre

Oxford University Hospitals NHS Trust Oxford, Great Britain

Shawna Dorman, MD

Assistant Professor of Anesthesiology and Assistant Director of Ambulatory Surgery

Department of Anesthesiology

New York University Langone Hospital for Joint Diseases

New York, New York

James C. Dreese, MD

Kostas Economopoulos, MD

The Orthopedic Clinic Association, PC Phoenix, Arizona

Michele N. Edison, BS, MD

Department of Radiology

Florida Hospital;

Assistant Professor

University of Central Florida College of Medicine Orlando, Florida

Nima Eftekhary, MD

Resident Physician

Orthopaedic Surgery

New York University Hospital for Joint Diseases

New York, New York

Brandon J. Erickson, MD

Orthopaedic Surgery Resident Department of Orthopaedic Surgery

Rush University Chicago, Illinois

Jean-Pierre Estèbe, MD, PhD

Department of Anesthesiology, Intensive Care, and Pain Medicine

University Hospital of Rennes Rennes, France

Cody L. Evans, BS, MD

Resident Physician

Orthopaedic Surgery

University of Virginia Charlottesville, Virginia

Gregory C. Fanelli, MD

Orthopaedic Surgeon

GHS Orthopaedics

Danville, Pennsylvania

Jack Farr, MD

OrthoIndy Cartilage Restoration Center

Professor of Orthopaedic Surgery

Indiana University Medical Center Indianapolis, Indiana

Andrew Feldman, MD

Assistant Professor

Department of Orthopaedic Surgery

New York University Hospital for Joint Diseases

New York, New York

Jonathon T. Finoff, MD

John Fisher, MD

Institute of Medical and Biological Engineering

School of Mechanical Engineering

University of Leeds Leeds, United Kingdom

Ghislaine M. Isidore, MD

Clinical Assistant Professor of Anesthesiology

Anesthesiology, Perioperative Care and Pain Medicine

New York University Langone Medical Center New York, New York

Pia Jæger, MD, PhD

Doctor Department of Anaesthesia, Centre of Head and Orthopeadics

Rigshospitalet Copenhagen, Denmark

Andre M. Jakoi, MD Fellow

Department of Orthopaedic Surgery University of Southern California Los Angeles, California

James G. Jarvis, MD, FRCSC

Associate Professor of Surgery University of Ottawa; Division of Orthopaedic Surgery Children’s Hospital of Eastern Ontario Ottawa, Ontario, Canada

Jason M. Jennings, MD, DPT

Colorado Joint Replacement Porter Adventist Hospital Denver, Colorado

Louise M. Jennings, PhD

Associate Professor of Medical Engineering Institute of Medical and Biological Engineering School of Mechanical Engineering University of Leeds Leeds, United Kingdom

William A. Jiranek, MD Professor and Chief of Adult Reconstruction Dept. of Orthopaedic Surgery

Virginia Commonwealth University School of Medicine Richmond, Virginia

Charles E. Johnston II, MD

Assistant Chief of Staff (Emeritus) Texas Scottish Rite Hospital for Children; Professor

Department of Orthopedic Surgery

University of Texas Southwestern Medical School Dallas, Texas

Justin B. Jones, MD Fellow

Adult Reconstruction

Isall Scott Kelly Institute

New York, New York

V. Karthik Jonna, MD

Daniel J. Kaplan, BA

Research Fellow

Orthopaedic Surgery

New York University Langone Medical Center

New York, New York

Jonathan Katz, MD

Department of Orthopaedic Surgery

Medical University of South Carolina Charleston, South Carolina

Erdan Kayupov, MSE

Research Fellow

Orthopaedic Surgery

Rush University Medical Center Chicago, Illinois

Saurabh Khakharia, MD

Arif Khan, MD

Harpal S. Khanuja, MD

Associate Professor Chief of Adult Reconstruction

Department of Orthopaedic Surgery

The Johns Hopkins University; Chair

Department of Orthopaedic Surgery

Johns Hopkins Bayview Medical Center Baltimore, Maryland

Nayoung Kim, BS Rothman Institute Philadelphia, Pennsylvania

Raymond H. Kim, MD

Colorado Joint Replacement; Adjunct Associate Professor of Bioengineering Department of Mechanical and Materials Engineering University of Denver Denver, Colorado; Clinical Associate Professor Department of Orthopedic Surgery

Joan C. Edwards School of Medicine at Marshall University Huntington, West Virginia

Sung-Hwan Kim, MD

Assistant Professor

Department of Othopaedic Surgery

Arthroscopy and Joint Research Institute

Yonsei University College of Medicine; Assistant Professor

Department of Orthopaedic Surgery

Gangnam Severance Hospital

Seoul, Republic of Korea

Sung-Jae Kim, MD, PhD

Emeritus Professor

Department of Orthopaedic Surgery

Yonsei University College of Medicine; Director

Department of Orthopaedic Surgery

Gangdong Yonsesarang Hospital Seoul, Republic of Korea

Yair D. Kissin, MD

Kevin Klingele, MD Chief

Department of Orthopaedic Surgery

Nationwide Children’s Hospital Columbus, Ohio

Kevin R. Knox, MD

Indiana Hand to Shoulder Center Indianapolis, Indiana

Mininder S. Kocher, MD, MPH Professor of Orthopaedic Surgery

Harvard Medical School; Associate Director

Division of Sports Medicine

Boston Children’s Hospital Boston, Massachusettes

Richard D. Komistek, BSME, MSME, PhD

Fred M. Roddy Professor Biomedical Engineering, Co-Center Director Center for Musculoskeletal Research University of Tennessee Knoxville, Tennessee

Dennis E. Kramer, MD

Assistant Professor of Orthopaedic Surgery

Orthopedic Center

Boston Childrens Hospital Boston, Massachusetts

Mark J. Kransdorf, MD

Consultant

Diagnostic Radiology

Mayo Clinic, Phoenix, Arizona; Professor of Radiology

Mayo Clinic College of Medicine Rochester, Minnesota

Tomas J. Kucera, MD

Christopher M. Kuenze, PhD, ATC

Assistant Professor Department of Kinesiology

Michigan State University East Lansing, Michigan

Vinícius Canello Kuhn, MD

Orthopedic Surgeon Instituto de Ortopedia e Traumatologia de Passo Fundo Passo Fundo, Brazil

Shinichi Kuriyama, MD Professor and Chairman Department of Orthopedic Surgery Kyoto Univeristy Kyoto, Japan

Anne Kuwabara, BA Department of Physical Medicine and Rehabilitation

The Johns Hopkins University Baltimore, Maryland

Paul F. Lachiewicz, MD Consulting Professor Department of Orthopaedic Surgery Duke University, Orthopaedic Surgeon Veterans Administration Medical Center Durham, North Carolina; Orthopaedic Surgeon Chapel Hill Orthopedics Surgery & Sports Medicine Chapel Hill, North Carolina

Michael T. LaCour, BS Graduate Research Assistant Mechanical, Aerospace, and Biomedical Engineering University of Tennessee Knoxville, Tennessee

Claudette Lajam, MD Assistant Professor of Orthopaedic Surgery Department of Orthopaedics New York University Langone Medical Center New York, New York

Alfredo Lamberti, MD

Orthopaedics, Adult Reconstruction IFCA Institute Florence, Italy

Jason E. Lang, MD Attending Surgeon Blue Ridge Bone and Joint Asheville, North Carolina

Joshua R. Langford, MD Division of Orthopaedic Trauma and Complex Adult Reconstruction Department of Orthopaedic Surgery

Orlando Regional Medical Center Orlando, Florida

Robert F. LaPrade, MD, PhD

The Steadman Clinic; The Steadman Philippon Research Institute Vail, Colorado

Nicholas J. Lash, MD Clinical Fellow

Department of Orthopaedics

University of British Columbia Vancouver, British Columbia, Canada

Sherlin Lavianlivi, MD

MSK Fellow/Radiologist Department of Radiology Maimonides Medical Center Brooklyn, New York

Gary Lawera, BS, CMPE

Chief Operating Officer University of Toledo Physicians, LLC Toledo, Ohio

Peter J. Laz, MD

Center for Orthopaedic Biomechanics University of Denver Denver, Colorado

Cheng-Ting Lee, MD Anesthesiology Resident Columbia University Medical Center New York, New York

Gabriel Levi, MD

Richard G. Levine, MD

Dieter Lindskog, MD Associate Professor

Department of Orthopaedics and Rehabilitation

Yale University School of Medicine New Haven, Connecticut

Davidm R. Lionberger, MD

Frank A. Liporace, MD

Division of Orthopaedic Trauma and Complex Adult Reconstruction Department of Orthopaedic Surgery

Jersey City Medical Center

Jersey City, New Jersey

Sanford M. Littwin, MD

Associate Professor of Anesthesiology, Clinical Director Operating Rooms

UPP Department of Anesthesiology

UPMC Presbyterian and Montefiore Hospitals

Pittsburgh, Pennsylvania

Phillip Locker, MD

Adolph V. Lombardi, MD

William J. Long, BSc, MD, FRCSC Director,

Attending Orthopaedic Surgeon Insall Scott Kelly Institute, St. Francis Hospital, Lenox Hill Hospital, Hospital for Joint Diseases New York, New York

Jess H. Lonner, MD

Attending Orthopaedic Surgeon Rothman Institute; Associate Professor

Department of Orthopaedic Surgery

Thomas Jefferson University Philadelphia, Pennsylvania

Walter R. Lowe, MD

Sébastien Lustig, MD, PhD

Albert Trillat Center Orthopedic Surgery

Lyon North University Hospital Lyon, France

Thomas Luyckx, MD, PhD

Full Professor of Orthopedics and Traumatology

Chair, Department of Orthopedics and Traumatology

Ghent University

Ghent, Belgium

Dana Lycans, MD

Resident

Department of Orthopaedic Surgery

Marshall University Huntington, West Virginia

Steven Lyons, MD

Florida Orthopedic Institute

Tampa, Florida

Samuel D. Madoff, MD

Department of Radiology

New England Baptist Hospital Boston, Massachusetts

Robert A. Magnussen, MD, MPH

Associate Professor Department of Orthopaedics

The Ohio State University Columbus, Ohio

Suzanne A. Maher, PhD

Associate Scientist, Associate Director Department of Biomechanics, Associate Director

Tissue Engineering Regeneration and Repair Program Hospital for Special Surgery New York, New York; Associate Professor of Applied Biomechanics in Orthopaedic Surgery, Adjunct Professor of Biomedical Engineering Department of Biomedical Engineering

Weill Cornell Medical College Cornell University Ithica, New York

Mohamed R. Mahfouz, MS, PhD Professor of Biomedical Engineering Mechanical Aerospace and Biomedical Engineering University of Tennessee Knoxville, Tennessee

Amun Makani, MD

Attending Surgeon Department of Orthopaedic Surgery Watson Clinic Lakeland, Florida

Eric C. Makhni, MD Department of Sports Medicine Henry Ford Health Center Detroit, Michigan

Parul R. Maniar, MD Consultant Ophthalmologist Nook Clinic, Santacruz (W) Mumbai, India

Rajesh N. Maniar, MS, MCh Orth (UK), DNB Head Department of Orthopaedics & Joint Reconstruction

Lilavati Hospital & Research Centre; Consultant and Joint Replacement Surgeon Department of Orthopaedics & Joint Reconstruction

Breach Candy Hospital Mumbai, India

Patrick G. Marinello, MD

Resident Orthopaedic Surgery Cleveland Clinic Foundation Cleveland, Ohio

Milica Markovic, MD

Assistant Professor

Department of Anesthesiology

Weill Cornell Medical College

New York Presbyterian Hospital

New York, New York

J. Bohannon Mason, MD

Bassam A. Masri, MD, FRCSC

Professor and Chairman Department of Orthopaedics

University of British Columbia Vancouver, British Columbia, Canada

Henry Masur, MD

Chief

Critical Care Medicine Department Clinical Center, National Institutes of Health

Bethesda, Maryland

Kevin R. Math, MD

Associate Professor of Radiology

Hospital for Special Surgery

New York, New York

Kenneth B. Mathis, MD

Shuichi Matsuda, MD, PhD

Professor and Chairman Department of Orthopedic Surgery

Kyoto University

Kyoto, Japan

Tomoyuki Matsumoto, MD, PhD Assistant Professor Department of Orthopaedic Surgery

Kobe University Graduate School of Medicine

Kobe, Japan

Chan-Nyein Maung, MD

Clinical Instructor of Anesthesiology Department of Anesthesiology, Perioperative Care, and Pain Medicine

New York University Langone Medical Center

New York, New York

Kristen E. McClure, MD

Brian J. McGrory, MD, MS

Clinical Professor

Department of Orthopaedic Surgery

Tufts University School of Medicine

Boston, Massachusetts; Co-Director

Maine Joint Replacement Institute

Portland, Maine

David C. McNabb, MD

Colorado Joint Replacement

Porter Adventist Hospital

Denver, Colorado

Brad Meccia, BS

University of Tennessee, Knoxville

Knoxville, Tennessee

Michael B. Mechlin, MD

Assistant Professor of Radiology

New York University School of Medicine

New York, New York

Patrick A. Meere, MD, CM

Clinical Associate Professor

Orthopaedic Surgery

New York University Langone Hospital for Joint Diseases

New York, New York

R. Michael Meneghini, MD

Associate Professor

Orthopaedic Surgery

Indiana University School of Medicine; Director of Lower Extremity Adult Reconstruction Fellowship

Indiana University School of Medicine

Indianapolis, Indiana; Director of Joint Replacement

IU Health Saxony Hospital Fishers, Indiana

John J. Mercuri, MD, MA

Chief Resident Department of Orthopaedic Surgery Hospital for Joint Diseases

New York University Langone Medical Center

New York, New York

Maximilian A. Meyer, MD

Department of Sports Medicine

Rush University Medical Center

Chicago, Illinois

Cory Messerschmidt, MD

Department of Orthopaedic Surgery

Medical University of South Carolina Charleston, South Carolina

Matthew D. Milewski, MD

Assistant Professor Department of Orthopaedic Surgery Connecticut Children’s Medical Center— Elite Sports Medicine Farmington, Connecticut

Mark D. Miller, MD

S. Ward Casscells Professor Department of Orthopaedics University of Virginia Charlottesville, Virginia

Patrick J. Milord, MD, MBA Interventional Pain Management Fellow Department of Anesthesiology, Perioperative Care and Pain Medicine

New York University Langone Medical Center

New York, New York

Claude T. Moorman III, MD

Duke Sports Science Institute Department of Orthopedic Surgery Duke University Durham, North Carolina

Vincent M. Moretti, MD Rothman Institute Philadelphia, Pennsylvania

William B. Morrison, MD Professor Department of Radiology

Thomas Jefferson University Director Division of Musculoskeletal and General Diagnostic Radiology

Thomas Jefferson University Hospital Philadelphia, Pennsylvania

James R. Mullen, MD Orthopedic Resident Northwell Health

New Hyde Park, NY

Hirotsugu Muratsu, MD Department of Orthopaedic Surgery Steel Memorial Hirohata Hospital Himeji, Japan

David Murray, MD Professor of Orthopaedic Surgery Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences

University of Oxford; Consultant and Orthopaedic Surgeon Nuffield Orthopaedic Centre

Oxford University Hospitals NHS Trust Oxford, Great Britain

Volker Musahl, MD Associate Professor Department of Orthopaedic Surgery University of Pittsburgh Pittsburgh, Pennsylvania

Zan A. Naseer, BS New York Medical College

New York, New York

Amit Nathani, MD, MS Resident Department of Orthopaedic Surgery University of Michigan Ann Arbor, Michigan

Milad Nazemzadeh, MD

Clinical Assistant, Professor of Anesthesiology Department of Anesthesiology, Perioperative Care, and Pain Medicine

New York University Langone Medical Center

New York, New York

Michael D. Neel, MD Department of Orthopaedic Surgery St Jude Children’s Research Hospital Memphis, West Virginia

Charles L. Nelson, MD Chief of Adult Reconstruction Associate Professor of Orthopaedic Surgery University of Pennsylvania Philadelphia, Pennsylvania

Nathan A. Netravali, MD

Michael P. Nett, MD

Orthopedic Surgeon, Coordinator of Quality and Clinical Arthroplasty Department of Orthopedic Surgery North Shore Long Island Jewish Orthopedic Institute @ Southside Hospital Bay Shore, New York

Phillipe Neyret, MD, PhD Head of Department Orthopaedic Surgery and Traumatology Hospices Civils de Lyon—Centre Albert Trillat Lyon, Rhône, France

Jesse Ng, MD Clinical Assistant Professor of Anesthesiology

Carl W. Nissen, MD

Physician

Elite Sports Medicine

Connecticut Children’s Medical Center; Professor Department of Orthopaedics University of Connecticut Farmington, Connecticut

Philip C. Noble, BE, MES, PhD

Frank R. Noyes, MD President and Medical Director Noyes Knee Institute Cincinnati, Ohio

Mary I. O’Connor, MD Director and Professor Center for Musculoskeletal Care at Yale School of Medicine and Yale—New Haven Hospital Yale School of Medicine New Haven, Connecticut

Khalid Odeh, BA

Russell M. Odono, MD Orthopaedic Surgeon Department of Orthopaedic Surgery

Insall Scott Kelly Institute New York, New York

Louis Okafor, MD Department of Orthopaedic Surgery

The Johns Hopkins University Baltimore, Maryland

Andrew B. Old, AB, MD Fellow

Orthopaedics and Adult Reconstruction

New York University New York, New York

Ali Oliashirazi, MD

Chairman Department of Orthopaedic Surgery

Marshall University Huntington, West Virginia

Matthieu Ollivier, APHM Institute for Locomotion Department of Orthopaedic Surgery

Sainte-Marguerite Hospital; Professor

Aix-Marseille University Marseille, France

Mark W. Pagnano, MD

Chairman and Professor of Orthopedic Surgery

Department of Orthopedic Surgery

Mayo Clinic Rochester, Minnesota

Susan Craig Scott, MD

Clinical Assistant Professor Department of Orthopaedic Surgery

Hansjorg Wyss Department of Plastic Surgery

New York University School of Medicine; Surgeon Department of Hand Surgery

NYU Hospital for Joint Diseases; Assistant Attending Department of Orthopedics

Bellevue Hospital Center; Consulting Physician

Departments of Surgery and Orthopedic Surgery

Department of Veterans Affairs

New York Harbor Healthcare System

New York, New York

W. Norman Scott, MD, FACS

Clinical Professor of Orthopaedic Surgery

New York University Langone Medical Center

Hospital for Joint Diseases; Joan C. Edwards School of Medicine

Marshall University

Founding Director

Insall Scott Kelly Institute for Orthaepedic Sports Medicine

New York, New York

Giles R. Scuderi, MD

Vice President

Orthopedic Service Line Northwell Health; Fellowship Director Adult Knee Reconstruction Lenox Hill Hospital

New York, New York; Associate Clinical Professor of Orthopedic Surgery

Hofstra Northwell School of Medicine Hempstead, New York

Elvire Servien, MD, PhD Professor

Department of Orthopedic Surgery

Erik P. Severson, MD

Minnesota Center for Orthopaedics Crosby/Aitkin, Minnesota

Nicholas A. Sgaglione, MD

Professor and Chair

Department of Orthopaedic Surgery Northwell Health, New Hyde Park, New York

Peter F. Sharkey, MD

Rothman Institute Philadelphia, Pennsylvania

Adrija Sharma, PhD

Research Assistant Professor

Mechanical Aerospace and Biomedical Engineering University of Tennessee Knoxville, Tennessee

Kevin G. Shea, MD

Orthopedic Surgeon Department of Sports Medicine

St. Luke’s Boise, Idaho; Associate Professor

Department of Orthopaedics

University of Utah Salt Lake City, Utah

Courtney E. Sherman, MD

Assistant Professor of Orthopedics Department of Orthopedics

Mayo Clinic Jacksonville Jacksonville, Florida

Jodi Sherman, MD

Assistant Professor of Anesthesiology

Yale University, School of Medicine New Haven, Connecticut

Seth L. Sherman, MD

Attending Orthopaedic Surgeon Department of Orthopaedic Surgery University of Missouri Columbia, Missouri

Michael S. Shin, MD

Rafael J. Sierra, MD

Associate Professor of Orthopedics Department of Orthopedic Surgery College of Medicine

Mayo Clinic Rochester, Minnesota

Tushar Singhi, MD

Associate Professor Department of Orthopedics

Padamshree D Y Patil Medical College Navi Mumbai, India

David L. Skaggs, MD, MMM

Children’s Orthopaedic Center Children’s Hospital Los Angeles Los Angeles, California

Harris S. Slone, MD

Assistant Professor

Department of Orthopaedics

Medical University of South Carolina Charleston, South Carolina

James D. Slover, MD, MS

Associate Professor

Adult Reconstruction Division

Department of Orthopaedic Surgery

Hospital for Joint Diseases

New York University Langone Medical Center

New York, New York

Nathaniel R. Smilowitz, MD

Professor of Medicine and Surgery

Leon H. Charney Division of Cardiology

New York University School of Medicine

New York, New York

Daniel C. Smith, MD

Adult Reconstruction Fellow Department of Orthopaedic Surgery

New York University Langone Hospital for Joint Diseases

New York, New York

Gideon P. Smith, MD PhD

Director of Connective Tissue Diseases

Department of Dermatology

Mass General Hospital of Harvard University

Boston, Massachusetts

Gary E. Solomon, MD

Associate Professor Department of Medicine

New York University Langone School of Medicine

New York, New York

Jeffrey T. Spang, MD

Assistant Professor Department of Orthopaedics

University of North Carolina Chapel Hill, North Carolina

Kurt P. Spindler, BS, MD

Vice Chairman of Research Director Orthopaedic Clinical Outcomes

Academic Director

Cleveland Clinic Sports Health Orthopaedic and Rheumatologic Institute

Cleveland Clinic Cleveland, Ohio; Adjoint Professor Department of Orthopaedics

Vanderbilt University Medical Center Nashville, Tennessee

Bryan D. Springer, MD

Attending Orthopaedic Surgeon

OrthoCarolina Hip and Knee Center

Charlotte, North Carolina

It is fair to say that the Insall & Scott Surgery of the Knee series has served as the definitive chronicle to the evolution of modern reconstructive surgery of the knee. So it is with the Sixth Edition of this comprehensive textbook that we, as interested readers, are once again privileged to avail ourselves of this carefully curated knowledge from today’s leaders in knee surgery. It is a vibrant time to be a knee surgeon as intellectual excitement permeates our field and opportunities to alleviate pain and improve function for our patients continue to expand.

As an orthopedic community we are indebted to the foresight of John Insall and W. Norman Scott to recognize in the early 1980s the coming sea-change in the efficacy of knee surgery and to initiate the process that captured that collective knowledge in written form. Knee surgery has progressed dramatically over the past four decades from a lastresort option reserved for the markedly disabled to a largely elective surgical option that definitively improves the quality of life for patients with a spectrum of problems involving the bone, cartilage, or ligaments of the knee. Within the field of knee replacement, Dr. Insall helped carefully push the boundaries of patient age and activity that now allow us to successfully treat a wide spectrum of patients with knee arthroplasty. Within the field of ligament reconstruction, Dr. Scott brought to light what was possible at the highest levels of sport after cruciate ligament reconstruction. Together Drs. Insall & Scott shared a vision of improving patient care and advancing the understanding of reconstructive knee surgery for which we all have reaped benefit.

The Sixth Edition continues the long and academically rich history associated with this text that began in 1984. This series was so thoughtfully conceived that every surgeon performing total knee arthroplasty today could improve their fundamental understanding of contemporary knee replacement surgery by reading Dr. Insall’s chapter on surgical technique and instrumentation from the First Edition. Subsequent versions of the textbook have preserved the fundamental spirit of the original

which was to be at once comprehensive yet still accessible and relevant for the practicing orthopedic surgeon. The editor of the Sixth Edition has wisely chosen from amongst today’s experts in contemporary knee surgery and the individual chapters are written in keeping with that spirit of comprehensive yet accessible and relevant. With national and international experts authoring each chapter the depth and breadth of realworld experience is evident throughout each of the chapters in this text.

The Sixth Edition of Insall & Scott Surgery of the Knee incorporates a broad international perspective that recognizes the rich contributions that surgeons from around the globe make to the field of knee surgery. Technology has fostered broader connections amongst orthopedic surgeons in disparate parts of the world and has quickened the pace of discovery and translation of new ideas into clinical practice. The Sixth Edition incorporates such technology and includes robust, high-quality illustrations, video demonstrations, and advanced electronic media resources that aid the process of education for the interested reader. The combination of text, illustration, and video material has been carefully balanced and clearly hits the mark for educational excellence.

I invite you to enjoy this textbook as more than just a source for knowledge about knee surgery. Insall & Scott’s Surgery of the Knee also captures the energy, enthusiasm, and intellectual curiosity of today’s most creative, innovative, and industrious knee surgeons. I hope that excitement is evident to you as a reader and inspires you to continually improve your individual skills and to support our collective-efforts to improve knee surgery for patients in our communities, patients nationwide, and patients world-wide.

Mark W. Pagnano, MD Professor and Chairman Department of Orthopaedic Surgery Mayo Clinic Rochester, Minnesota

FOREWORD

When the late Dr. John Insall wrote the preface of the First Edition of Insall & Scott Surgery of the Knee in 1984, he already had a vision of a comprehensive evolutionary textbook related exclusively to knee pathology and surgery. Some 33 years later this book is now in its Sixth Edition due to the continued efforts and innovations brought by Dr. Insall’s original partner and friend Dr. W. Norman Scott. This book is not only covering all aspects of knee surgery such as ligament reconstruction, meniscus disease, cartilage repair, fractures about the knee, and knee arthroplasty, but also is considering the clinical, anatomical, biomechanical, and imaging evaluation of the knee joint. This book is also considering the patient himself in terms of demographic differences, expectations of the surgery, and perioperative management such as postoperative pain control.

The computer world has overwhelmed the field of continuous medical education and the Sixth Edition of Insall & Scott Surgery of the Knee has beautifully taken up the challenge of providing, both for the young and committed orthopedic surgeons, an evolving video technique section to maintain the status of the book as current as possible. This Sixth Edition also expands the world-wide contributions from the United States, Europe, and Asia, focusing on all aspects of clinical examinations, MRI imaging, knee anatomy, sports medicine, and reconstructive knee surgical techniques. Dr. Insall’s decision in the First Edition was to reach out of the walls of his own hospital in New York City in order to include additional expertise. This Sixth Edition of Insall & Scott Surgery of the Knee further expands the horizon across the oceans, East, and West, with more than 20 chapters from International contributors.

Understanding the biomechanics of the knee starts with a correct comprehension of the anatomy and Rayesh Maniar from India describes the features of the Asian knee. The field of articular cartilage repair has now reached the time of maturity, consensus, while controversies will continue to be beneficial in the pursuit of progress. Lars Peterson from Sweden provides an international overview and results with autologous chondrocyte implantation techniques. Dr. Pinczewski from Australia, a pioneer in ACL reconstruction, and Dr. Kim from Korea likewise for PCL reconstruction, demonstrate their own vast experiences. The surgical correction of bony deformity both for the patella-femoral or the tibio-femoral joint has always been a trade-mark of the Lyon school in France, and respectively, Dr. Dejour and Dr. Neyret with their co-authors detail their own specific contribution.

Considering the knee as three separate articulations has led to selective compartmental replacement, a tradition in Europe for several decades. Contributions in that field come from the United Kingdom with Chris Dodd; Italy with Paolo Adravanti and Francesco Benazzo; Belgium with Emmanuel Thienpont; and France with Jean-Noel Argenson, Matthieu Ollivier, and Sebastien Parratte. The last three decades in the field of total knee arthroplasty has been fraught with debates, controversies, and most importantly success. The Sixth Edition of Insall & Scott Surgery of the Knee includes PCL retaining or substituting options provided respectively by Ate Wymenga from the Netherlands and Sam Tarabichi from the Middle East. Dr. Schindler from the UK and Dr. Matsumoto from Japan reflect on the debate regarding resurfacing of the patella or not. Both inside and outside the United States we are seeing new interpretations about alignment considerations and surgical options to obtain a mobile and stable knee after the arthroplasty. Johan Bellemans and Jan Victor from Belgium discuss the issues exhaustively. Intraarticular or extraarticular deformities at the time of total knee arthroplasty are world-wide challenges and Shuichi Matsuda from Asia and Andrea Baldini for Europe accurately describe their successful approaches. These surgical techniques are also often applicable to the use of specific technologies such as computer, robotics, or custom guides, and Emmanuel Thienpont details these approaches in an expert fashion.

The Sixth Edition of Insall & Scott Surgery of the Knee maintains this book’s reputation as “The” reference for knee surgery providing the orthopedic surgeon from the United States, Europe, Middle East, or Asia with a considerable number of principles, details, and experiences covering all aspects of knee pathology, evaluation, and surgical treatments. While the spirit of late Dr. John Insall is still evident in the Sixth Edition of Insall and Scott Surgery of the Knee, the considerable and unique contributions of Dr. W. Norman Scott and his section editors in the organization of this book and its video section is now even more evident with the inclusion of so many international innovators and experts throughout the world.

Jean-Noel A. Argenson, MD

Professor and Chairman Department of Orthopedic Surgery The Institute for Locomotion, Aix-Marseille University Marseille, France

It would have been inconceivable 33 years ago when the First Edition of this text book was drafted that the success of knee surgery would lead to a revolutionary approach to health care economics and care delivery. The projected increase of demand for total knee replacement over the next 20 years and the current and projected cost of the procedure have caused the value based health care movement to focus on the treatment of arthritis of the knee. For the first time, Insall & Scott Surgery of the Knee has focused an entire section (Economics, Quality, and Payment Paradigms for Total Knee Arthroplasty) on the value based issues facing knee surgeons in the next decade.

Since the passage of the Patient Protection and Affordable Care Act (PPACA) in 2010 and Medicare Access and CHIPS Reauthorization Act (MACRA) in 2015, the Center for Medicare and Medicaid Services (CMS) has been mandated to transform from a passive consumer to an active purchaser of health care. Orthopaedic surgeons are well positioned to provide leadership and detailed analysis of the processes related to the provision of orthopaedic care. Early and active involvement by orthopaedic surgeons in the development and implementation of care improvement processes in bundled payment systems such as the BPCI, CJR and any future initiatives is critical for the efficacy and sustainability of value-based orthopaedic care pathways. Moreover, orthopaedic surgeons need to be involved in all components of health care delivery that impact the care of their patients in order to preserve access and maintain affordability. In the next 5 years, physicians will be individually held accountable for cost and quality measures affecting their patients. The Merit Based Incentive Payment System (MIPS) will change reimbursement from not just a hospital at risk, quality driven model but also to a physician at risk, quality driven model.

The Bundled Payment for Care Initiative (BPCI) was begun in 2013 by CMS. Under the voluntary BPCI program, organizations entered into payment arrangements that include financial and performance accountability for episodes of care. A successful BPCI requires that quality is maintained and that care is delivered at a lower cost. CJR is a mandatory extension of Model 2 BPCI with hospital quality and Patient Reported Outcome Measures (PROM’s) reporting requirements in addition to financial performance measures. This requires physicians and hospitals to align their interests and in this context, orthopaedic surgeons must assume a leadership role in cost-containment, surgical safety, and quality assurance so that cost-effective care is provided. Because most orthopaedic surgeons practice independently and are not hospital-employed, models of physicianhospital alignment such as physician-hospital organizations or contracted gainsharing arrangements between practices and hospitals may be necessary for bundled pricing to succeed. Under BPCI, hospitals, surgeons, or third parties can share the rewards, but also assume the risk for the bundle. It is forecast that most TKA cases covered under private and public insurance will be compensated under a bundled, quality driven program within the next 5 years.

For patients, cost savings must be associated with maintenance or improvement in quality metrics. However, the manner

in which quality is defined and measured and what processes and outcomes are rewarded can vary. Risk-stratified allowances for nonpreventable complications must be incorporated into bundled pricing agreements to prevent the exclusion of patients with significant comorbidities and the anticipated higher care costs. Bundled pricing depends on economies of scale for success and it may not be appropriate for smaller orthopaedic groups or hospitals, where one costly patient could impact the success of the entire program. Furthermore, significant investment in infrastructure is required to develop programs to improve the quality and coordination of care, to manage quality data, and to distribute payments. Perhaps, smaller groups of surgeons can be joined together under advanced alternative payment models in the future so that all patients can benefit from bundled, value-based care.

In the current unsustainable healthcare environment, hospitals and administrators are facing increased pressure to optimize the value equation by decreasing the risk of complications. The ethical implications of reducing provider (physician and hospital) complication rates following joint replacement is compelling. Additionally, public transparency concerning provider complication rates would help patients make more informed decisions as to where to have their TJA performed. Nevertheless, it is morally incumbent on providers and policy makers to aggressively explore options for lowering cost while maintaining access and improving quality. Patients, physicians, and health care administrators must begin to see themselves acting not just as individuals involved in the decision to undergo TKA, but rather, as part of a system that administers health care within a larger societal context. It is simply unsustainable for surgeons and hospitals to perform elective surgery in higher risk patients with modifiable risk factors without increasing efforts to reduce them. Risk modification is a component of a larger, new era of medicine in which all stakeholders ought to accept some share of responsibility to create a safer, more costefficient health system. As TKA surgery shows, true shared decision making which involves patients, their physicians, the hospital, and the payers in a paradigm where interventions are provided only after modifiable risk factors have been addressed, can be an effective tool for delivering high quality, ethical health care at a reasonable price with a minimum of complications. We hope the information provided within the Sixth Edition of Insall & Scott Surgery of the Knee will help make this transition easier for all knee surgeons and the patients they care for.

Joseph D. Zuckerman, MD

Richard Iorio, MD

Dr. William and Susan Jaffe Professor of Orthopaedic Surgery

Chief Division of Adult Reconstructive Surgery

Department of Orthopaedic Surgery

New York University Langone Medical Center

Hospital for Joint Diseases

New York, New York

PREFACE

Why write a textbook in 2017? All pertinent information is now at our fingertips, the APP should be sufficient (if it works!) right? Electronic media is all we need or is it? Search engines are often “a mile wide and an inch deep” in detailing medical specifics in general and subspecialty knowledge in particular. Just think of our patients “surfing the net” and becoming fully cognizant of all aspects of knee surgery! Thus the need for a textbook for the lifelong students of the diagnosis and treatment of knee disorders.

Obviously the successes achieved in the field of knee surgery since the 1970s are absolutely incredible. The prefaces for the last five editions of Insall & Scott Surgery of the Knee are included in the Sixth Edition to reflect the historical perspective and to illustrate “how far we’ve (patients and physicians) come.” And if we are to continue succeeding we need to learn by past mistakes to minimize the future ones.

Welcome to the Sixth Edition of Insall & Scott Surgery of the Knee (and yes we do have a companion electronic version).

The Sixth Edition of Insall & Scott Surgery of the Knee has greatly expanded on the Fifth Edition. Reviewing, refreshing and updating the excellent chapters of previous authors were, of course, a must. Almost all of these lead contributors added new authors to assure the viewer would receive the most recent subject information. The Sixth Edition, unlike the Fifth, has two complete volumes, and is accompanied not only by an e-version (at expertconsult.com) but also by an enhanced video section and a glossary. There are 14 sections and more than 78 new chapters!

Dr. Henry Clarke, the section editor for Basic Science has in this section enhanced the multifaceted anatomic perspective. I believe this comprehensive (microscopic, gross, arthroscopic, and radiographic) anatomy section is the best in the knee literature.

Dr. Jenny Bencardino, an orthopedic radiologist has taken over the imaging section of Insall & Scott Surgery of the Knee and has added 4 new chapters with the help of 14 expert radiologists. Similarly, Rick Komistek, PhD has updated the excellent Biomechanics section (Section III) with two new chapters.

One of the two largest sections of the Sixth Edition of Insall & Scott Surgery of the Knee has been organized and completed by associate editor, David Diduch. David has worked with section editors Asheesh Bedi and Geoff Baer to present 53 chapters spanning the basic science, diagnoses, and treatment of cartilage, ligament, and patella femoral conditions. This is an awesome contribution to the education of the innumerable “sports medicine” students throughout the world.

Dr. Andrew Franks, a renowned Professor of Rheumatology and Dermatology has once again modernized and updated the fundamental aspects of diagnosing and treating the most common systemic arthritic conditions that orthopedists will encounter. Topics such as gout and other crystalline arthropathies, psoriatic arthritis, degenerative arthritis, and rheumatoid arthritis are discussed succinctly. Dr. Franks has also devoted a chapter to arthropathies associated with hemophilia and pigmented villondular synovitis and discussed in detail a subject pertinent to all reconstructive orthopedic surgeons, systemic allergic dermatitis in total knee arthroplasty (TKA).

One of orthopedic surgery’s major advances in patient care has been the diminution of postoperative complications and more recently patients’ postoperative discomfort. It is for this reason that we have devoted an entire section to anesthesia for knee surgery. Dr. Arthur Atchabahian has put this section, “Anesthesia for Knee Surgery,” together by stressing different aspects: preoperative evaluation, perioperative management of inpatient and ambulatory procedures, and a section on peripheral nerve blocks. These chapters are well organized, practical, concise, and essential for successful patient care. The orthopedist needs to be cognizant of these pain modality specifics.

Wound problems are the bane of any orthopedic procedures and we are once again honored to have Drs. Susan Scott and Robert Reiffel discuss prevention and treatment of these situations, which left unrecognized or untreated will destroy any knee arthroplasty.

Under the direction of Dr. George Haidukwych, the discussions and treatments of fractures about the knee have been updated with more recent data supporting alternative treatments. This is especially helpful in the treatment of periprosthetic fractures, an increasing problem due to the abundance of replacements in more active patients.

The overlap of treating pediatric, adolescent, and adult knee conditions is often daunting for the nonpediatric orthopedist. Dr. Min Kocher and his contributors in Section XI skillfully updated the eight chapters on pediatric knee problems; these chapters now allow all orthopedists to be current and to undertake treatments or, if necessary, to refer patients appropriately.

The largest section in the book, Sections XII A and XII B, Joint Replacement and Its Alternatives and Revision Complex Knee Arthroplasty, consists of 59 chapters and to my knowledge, is the most comprehensive compendium of an exhaustive discussion on these topics in one textbook. These sections represent an international approach to knee arthroplasty and the authors are pioneers and active clinicians in this discipline. In particular, Dr. Arlen Hanssen’s contributions to the world of knee arthroplasty are legendary, and this section, thankfully, has his fingerprints all over it!

The other contributors in Sections XII A and XII B, too numerous to mention in a Preface, truly comprise the majority of worldwide knee arthroplasty innovators, surgeons, academicians, and teachers to us all. This section is a “must read” for any serious student in the field of knee arthroplasty.

In addition to the obvious importance of design and surgical technique in the world of knee arthroplasty, we as surgeons have continued to strive to make our patients safe, comfortable, happy, and convinced that they experienced both an excellent and cost effective knee arthroplasty procedure.

As section editor, Dr. Rich Iorio has enhanced the Sixth Edition of Insall & Scott Surgery of the Knee by discussing in over 20 chapters the present day approach to perioperative and hospital management of our patients in a comprehensive cost effective paradigm. In today’s complicated and controversial health care environment, these chapters represent the foundation for the future of cost effective and superb care for our patients.

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