Knee Unit-TKA Flashcards
Joint surgery (33 cards)
What is the primary reasons for knee replacements?
- Eliminate severe pain
- Restore ADL function in patients to OA and RA
What are contraindications for a TKA?
- Active sepsis
- Prior knee infection
- Absent quadriceps function
- Significant genu recurvatum
- Severe obesity
What are the most common materials for a TKA?
cobalt chromium or titanium
Can withstand 1,000lbs of pressure
Stabilization of a TKA?
-with or without cement
>If uncemented may have delayed wtb
»_space;Typically toe touch for up to 6 weeks
-Can have unicompartmental TKA
What is a hybrid TKA?
they have uncemented femoral and patella components and cemented tibial components
TKA complications?
- DVT
- Pulmonary embolus (PE)
- Infection
- Patellofemoral problems
- Vascular damage
- Fracture surrounding the prosthesis
- Nerve damage
- Loosening of the prosthesis
Precautions post op for TKA (immediate)
- Weight bearing status determined by physician
- May wear knee immobilizer post op
Precautions for several months post surgery
TKA
- Avoid excessive stress to the knee
- Avoid squatting
- Avoid quick pivoting
- Don’t use pillows under knee in bed
- Avoid low sitting
What does rehabilitation involve?
- Education
- Reconditioning
- *Restoring ROM
- Gait training
PTA needs to be aware of different types of TKA’s and any special precautions
Treatment settings
-Will begin the afternoon of surgery or the next morning
-Usually will be seen BID(2x/day) during the week and QD (1x/day) on weekends
-Usually have short acute care stays
>Discharged to home with home health, to skilled nursing facilities or acute rehab to complete rehabilitation
What is the time frame for a TKA
6-12 weeks
return to activity depends on recovery and MD clearance
Outcome for TKA
-highly successful surgery that should significantly reduce pain and increase function
-minor limitations in ROM post rehab
-TKA can loosen up over time and require revision
>life expectancy of prosthesis 15-20 years
What happened in 1960 in TKA world?
First TKA’s; hinged implants
What happened in 1970 in TKA world?
condylar implants: allowed rotation but only came in two sizes and solid pieces
What happened in 1990 in TKA world?
implants became easier to place and better instrument design. TKA”s became widely accepted. Subvastus and Midvastus technique
What happened in 1998 in TKA world?
Mini-incision TKA
What happened in 2002 in TKA world?
Minimally Invasive Solutions (MIS) quadriceps sparing TKA
What is a classic TKA
large cut ( more than 5 finger widths )made into quadriceps muscle
What is a mini TKA?
relatively small cut ( 1-4 finger widths) made into the quadriceps
What is an MIS TKA?
“Minimal Invasive Solution” Quad Sparing – quadriceps muscle is spared
Does the size of the incision define the procedure?
No, it does NOT
Other Factors Used To Define Minimally Invasive
-Some do define by the length of the incision
-Patella displacement
>Retraction versus eversion
-Knee joint location
The Mini TKA Advantages
Comparing to MIS Quad Sparing
- Approach similar to traditional
- Allows full visualization of distal femur
- Uses existing instruments with only a few changes
- Requires little additional training
- Can address more severe pathology
The Mini TKA Disadvantages
Comparing to MIS Quad Sparing
- More traumatic than MIS-QS
- Deters aggressive rehab
- Additional training/experience needed to address wide range of pathologies
- Quadriceps cut
