Problem: 1) The busy surgeon is faced with a mounting amount of documentation challenges which interferes with already hardpressed time constraints. (Any surgeon that disputes the increasing amount of documentation is probably not aware of current CMS guidelines). Most surgeons are probably not aware of what CMS requires and does not require (and has not felt … Read more
– See: – TKR Menu – Joint Line Position: – Posterior Stabilized Prosthesis: – Function of Posterior Cruciate Ligament: (see PCL) – as the knee flexes, eccentric postion of the PCL femoral orgin prodecues a tensile force in the ligament; – because of nonconforming low friction articlation, this tensile force is converted into a translatory … Read more
– See: – TKR Menu: – Collateral ligaments: – Medial Collateral Ligament – Lateral Collateral Ligament – Discussion: – more common in females; – in valgus knee, ligament balancing is more difficult to fix; – the anatomic deformity is usually larger in valgus than in varus, and it is on the femoral side; – femur … Read more
– See: – Revision TKR: – TKR Menu – Discussion: – asymmetrical bone loss often occurs in the proximal tibia; – CT scan have shown that once one get more than 1 cm below joint line quality and quantity of the supporting cancellous bone diminishes precipitously; – equally important, attachments of iliotibial band, pes anserinus, … Read more
How We Are Committed to Protecting Your Safety: How We Protect You From Infection How We Protect You From Blood Clots: What you should know before your surgery? your laboratory results your hematocrit should be between 30 and 45% – if your hematocrit drops below 25-26% during your surgery, we may recommend a … Read more
blood draw: A blood drawing technician will draw your blood at 6 AM (will test for your red blood cell level – hematocrit – and possibly chemitry level). Ask your nurse about your hematocrit (should be above 30 and if the hematocrit is below 26 we may recommend a transfusion) vitals … Read more
– See: – PreOp Planning: – TKR Menu – Lateral View: – note if AP size of lateral femoral condyle > medial condyle; – w/ large discrepancy of small degree of Internal Rotation may be necessary to prevent undercutting anterior cortex; – careful preoperative planning, using templates & … Read more
– Discussion: – Should Subcuticular Sutures be Avoided in TKR? – references: – Modality of wound closure after total knee replacement: are staples as safe as sutures? A retrospective study of 181 patients. – Wound complications in joint arthroplasty: comparing traditional and modern methods of skin closure – Staple vs. … Read more
– Management of Complications: – see open debridement and retention of components; – wound complications: (Dennis, ICLS 1997) (see contaminated wound care) – wound complications include prolonged post-operative drainage, superficial soft tissue necrosis, and full thickness soft tissue necrosis; – wound drainage and hematoma: … Read more
– See: TKR Menu: (Function and Activity after TKR) – Natural History of Painful TKR: – references: – Pain and Depression Influence Outcome 5 Years after Knee Replacement Surgery. – Impact of Psychological Distress on Pain and Function Following Knee Arthroplasty – Potential Causes of TKR failure: – early failures: … Read more