04 Articular Cartilage 3 Flashcards Preview

7212 Pathophysiology > 04 Articular Cartilage 3 > Flashcards

Flashcards in 04 Articular Cartilage 3 Deck (28):
1

purpose of a knee TKA

end stage salvage procedure

2

What is the current trend for TKA for unilateral compartment problems?

unicompartmental arthroplasties

3

Which compartment most commonly gets the unicompartmental arthroplasty?

medial compartment

4

What must also likely be done for a unicompartmental arthroplasty to line everything up right?

tibial osteoplasty

5

total knee components

tibial
femoral
patellar

6

tibial component

- usu. some type of polypropylene (softer portion)
- drilled into medullary canal

7

femoral component

- must shape the femur
- meticulous procedure to make sure everything is sized correctly

8

patellar component

- if it's ok, they'll leave it alone
- otherwise, they do patellar resurfacing

9

surgical incisions for the TKA: traditional

large anterior quad incision (20-30 cm)

10

surgical incisions for TKA: MIS

muscle sparing TKA
- mini
- Q-S

11

MIS: mini

quad snip
12-14 cm

12

MIS: Q-S

quadriceps sparing
7-10 cm

13

Where are the MIS incisions on the leg?

usually on the medial side

14

types of TKA

- posterior stabilization
- cruciate retaining
- cruciate sacrificing

15

types of TKA: posterior stabilization

- buttress in the back that has posterior stability to prevent tibia from moving front and back
- built into components

16

types of TKA: cruciate retaining

keep the ligaments

17

types of TKA: cruciate sacrificing

remove the ligaments

18

TKA fixation types

- bone cement
- press fit
- hybrid

19

TKA fixation: hybrid

may do cemented on the tibia and press fit on the femur

20

Why is the trend to do the TKA earlier?

better quality of life for the 15-20 years rather than a continual functional decline if you try to buy time

21

TKA rehab overall

- decrease pain and effusion
- manual therapy for ROM
- TLS

22

CPM and TKA?

has not been shown to be effective (or cost effective

23

What do TKA rehab protocols vary with?

- patient
- MD
- co-morbidities
- procedure
- type of prosthesis

24

What are complications of the TKA?

- patella tilt (maltracking)
- femur flexed
- skin pressure ulcer
- reoperations

25

Why is a flexed femur a complication?

may cause loosening of the prosthesis

26

reoperations subsequent to TKA

- manipulations
- arthroscopic debridement
- patella instability
- component revisions

27

Why would you need to do component revisions after a TKA?

- infections
- bone not incorporating the way it should (progressive lucent lines)
- loose implants

28

What are indicators of a loose implant on radiograph?

sclerotic bone and cyst formations