Total knee arthroplasty has been a very successful treatment for end-stage arthritis of the knee for the past twenty-five years. The basic design of the original total condylar knee replacement has changed little since the early to middle 1970s. However, with the increasing longevity of the population and the performance of total knee arthroplasty in younger patients, revision procedures on the knee are becoming commonplace.
This text is intended to help the surgeon to understand and to effectively resolve the problems associated with a failed total knee prosthesis. The editors, in the preface, refer to the text as "an indispensable reference for the practicing orthopaedic surgeon or senior level resident who has a need for practical, `how-to' information on the approach to revision total knee arthroplasty." This is indeed a lofty claim.
The text consists of thirty-two chapters and is quite comprehensive, with sections on basic science, evaluation of pain at the site of a total knee prosthesis, revision of an aseptically loose total knee prosthesis, operative treatment of infection at the site of the prosthesis, complications, and salvage of a failed total knee replacement. The authors are leaders in the field of total knee arthroplasty. The text is well organized and easy to read; it contains numerous detailed illustrations and many color photographs, most of which were made at the time of operative intervention.
The section on the treatment of pain at the site of the prosthesis is particularly helpful. The operative techniques are clearly described and very easy to comprehend.
There is some redundancy between chapters and authors; however, this serves to further emphasize important points. As with any text that has multiple authors, the style of writing varies from chapter to chapter; however, this further underscores the diversity of the approaches that the authors use to manage these challenging patients.
The editors and authors are to be congratulated on achieving their ambitious goal of providing an indispensable reference for those who perform revision total knee arthroplasty. This is a very useful text for orthopaedic surgeons who deal with reconstructive problems of the knee in adults.
Charles R. Clark, M.D.
Deputy Editor for Adult Reconstruction
The Journal of Bone and Joint Surgery
Needham, Massachusetts