– See: – TKR Menu: – Medial Collateral Ligament – Lateral Collateral Ligament – Discussion: – it is not possible to make a definitive assessment of soft tissue deformity or contracture preoperatively, since joint deformity pain & muscle spasm can mask the true condition; … Read more
– See: – Lateral Retinacular Release: – Patella in TKR; – Discussion: – this is one of the most common causes of failed knee replacement; – position of each TKR components will determine success of patellar component: – no patellar prosthesis will track correctly if the … Read more
– Discussion: – the patella should evert with minimal tension on the patella tendon; – methods to facilitate patellar eversion: – patellar resurfacing: – patellar resurfacing can be performed early in the exposure inorder to thin the patella … Read more
– See: Patella in TKR – Discussion: – indications for patellar resurfacing – patellar malalignment – lateral retinacular release – Technique: – start by everting the patella laterally and reflecting the fat pad & synovium from around its periphery; – remove any overhanging osteophytes; – limited patellar fasciectomy should be a part … Read more
– 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
– See: TKR: Soft Tissue Balance and Collateral Ligaments – Discussion: – fixed varus is the most common angular contracture in pts undergoing tkr; – this deformity may be accentuated by the presence of medial tibial plateau or medial femoral condyle osteophytes; – it is essential that … Read more
– 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
– See: – TKR Menu – blood supply to the knee: – standard lateral retinacular release: – Discussion: – at completion of TKR, patellar tracking are critically evaluated to insure stability; – patellar tracking may be improved by removal of patellar osteophytes … Read more
– Theoretical Considerations: – distance from posterior reesction plane to anterior resection plane must equal the internal dimension of femoral component being used; – this cut must be made at a distance from the anterior cut equal to inner anterior-posterior dimension of femoral component used; … Read more
– 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