Total Knee Arthroplasty (TKA) Flashcards
Who gets a Total Knee Replacement?
People with Osteoarthritis
Causes for Total Knee Replacement?
- Hereditary
- Obesity
What is an ‘Arthroscopy’?
Joint scope to try to smooth out the joint
2 knee deformities?
- Genu Valgum (knock kneed)
- Genu Varum (bow legged)
Total Knee Replacement - 3 components
“Tri-compartmental”
- Proximal tibial
- Distal femur
- Articulating surface of patella
Osteoarthritis symptoms that lead to a Total Knee Replacement?
- Boney spurs
- Thinning articular cartilage
- Joint space narrowing
- Exposed subchondral bone
Why do we want them out of hospital quickly?
In-patient rehab is costly & not usually better for the patient
Usually go home in 2-4 days if no issues
What is the ‘Care Pathway’?
Intervention to get patients from point A to point B in a well-defined period of time
(with drugs, treatment etc…)
TKA post surgery Complications?
- Intercondylar fracture (bone splits)
- Peripheral nerve damage (sliced/crushed)
- Badly positioned implant
- Infection
- Components loosening
- Contractures (tight tissue)
- DVT (Deep Vein Thrombosis)
Symptoms of DVT (deep vein thrombosis)?
- Severe calf pain & redness
- Tender to touch
- Significant swelling
- Positive ‘Homans’ Sign’ (leg pain on dorsiflexion)
What can DVT (deep vein thrombosis) progress to?
PE (Pulmonary Embolism)
- can be fatal if goes into lung
Why are Total Knee Replacements usually done on older people?
Polyethylene wear on tibial & patella components = only 15yr lifespan
Why no pillow under the knee (TKA)?
Increases risk of joint contracture & swelling
Exercises 1 day post op (TKA)?
- Ankle pumps (prevent DVT)
- Deep breathing (collapsed lungs & lung infection risk)
- Coughing
- AAROM
- Isometrics (less stressful, wakes muscles up)
Maximum protection phase goals TKA?
0-4 weeks
- Prevent vascular/pulmonary complications
- Control pain & swelling
- Protect joint (pivot & kneeling damage prosthesis, wear & tear)
- MAINTAIN or improve LE strength
- Regain knee ROM (0-90+)
