Flashcards in 04 Articular Cartilage 3 Deck (28):
purpose of a knee TKA
end stage salvage procedure
What is the current trend for TKA for unilateral compartment problems?
Which compartment most commonly gets the unicompartmental arthroplasty?
What must also likely be done for a unicompartmental arthroplasty to line everything up right?
total knee components
- usu. some type of polypropylene (softer portion)
- drilled into medullary canal
- must shape the femur
- meticulous procedure to make sure everything is sized correctly
- if it's ok, they'll leave it alone
- otherwise, they do patellar resurfacing
surgical incisions for the TKA: traditional
large anterior quad incision (20-30 cm)
surgical incisions for TKA: MIS
muscle sparing TKA
Where are the MIS incisions on the leg?
usually on the medial side
types of TKA
- posterior stabilization
- cruciate retaining
- cruciate sacrificing
types of TKA: posterior stabilization
- buttress in the back that has posterior stability to prevent tibia from moving front and back
- built into components
types of TKA: cruciate retaining
keep the ligaments
types of TKA: cruciate sacrificing
remove the ligaments
TKA fixation types
- bone cement
- press fit
TKA fixation: hybrid
may do cemented on the tibia and press fit on the femur
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
TKA rehab overall
- decrease pain and effusion
- manual therapy for ROM
CPM and TKA?
has not been shown to be effective (or cost effective
What do TKA rehab protocols vary with?
- type of prosthesis
What are complications of the TKA?
- patella tilt (maltracking)
- femur flexed
- skin pressure ulcer
Why is a flexed femur a complication?
may cause loosening of the prosthesis
reoperations subsequent to TKA
- arthroscopic debridement
- patella instability
- component revisions
Why would you need to do component revisions after a TKA?
- bone not incorporating the way it should (progressive lucent lines)
- loose implants