Ortho Oracle - orthopaedic operative atlas

TKR following HTO

– See:       – Total Knee Replacement:       – High Tibial Osteotomy: – TKR following HTO:     – expected problems following an HTO may include:           – patellar infera           – peripatellar scarring (and inability to evert the patella);       … Read more

TKR: Deep Exposure

      – Discussion:      – need to reflect capsule medially & laterally from upper 1 cm of proximal tibia;     – performed circumferentially using either elevator or osteotome;     – this capsular reflection relieves minor contractures and provides access for retractors to protect the posterior structures;      – any rim osteophytes from the … Read more

Instability following TKR:

– Discussion:     – may result from unequal flexion and extension gaps; (instability in extension or flexion due to MCL or LCL incompetence);     – varus subluxation in extension or flexion due to unequal gaps;     – in the report by Fehring TK, et al, the authors evaluated the causes of revision … Read more

TKR in Rheumatoid Arthritis

– See: Rheumatoid Arthritis Long-term results of total condylar knee arthroplasty in rheumatoid arthritis. Total knee arthroplasty in rheumatoid arthritis. A comparison of the polycentric and total condylar prostheses. Total condylar knee replacement in patients who have rheumatoid arthritis. A ten-year follow-up study. Use of a total condylar knee prosthesis for treatment of osteoarthritis and … Read more

TKR Osteolysis

– See:      – THR osteolysis      – TKR Menu:   Osteolysis after total knee arthroplasty without cement. Osteolysis After TKA: Influence of Tibial Baseplate Surface Finish and Sterilization of Polyethylene Insert Findings at 5-10 years Postoperatively.  Complications After Total Knee Arthroplasty: How to Manage Patients with Osteolysis

TKR: Flexion Gap

– Definition:     – see instability following TKR     – is space between the posterior coronal cut on the distal femur & transverse cut on proximal tibia, while knee is in flexion;     – effect of resection of PCL (see posterior stabilized prosthesis);     – in report by Kadoya, et al, effect of PCL resection … Read more

TKR: Femoral Component

– See:      – TKR Menu      – Distal Femoral Resection       – Femoral IM Alignment Rod       – Distal Femoral Sizing Guide (and Rotational Alignment)      – Anterior, Posterior, and Chamfer Cuts       – Femoral Component Notching – Design Considerations:      – PCL Retaining Prosthesis      – Posterior Stabilized Prosthesis      – left & … Read more

TKR: Femoral IM Alignment Rod

          – See: TKR Menu                – Distal Femoral Resection                 – Distal Femoral Sizing Guide (and Rotational Alignment)                 – Anterior, Posterior, and Chamfer Cuts – Location of Entry Hole:       – ideally the starting point is slightly medial and posterior to the center of the notch;     – generally the drill needs to be inserted 1 … Read more