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TKA Indications. Pain and disfunction severe enough to justify surgery X-ray correlation: joint damage beyond repair by other means Patient good understanding of what to expect from surgery . TOTAL KNEE REPLACEMENT When?. Pain Function LOM Level of disability. TOTAL KNEE REPLACEMENT How?.

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tka indications
TKAIndications
  • Pain and disfunction severe enough to justify surgery
  • X-ray correlation: joint damage beyond repair by other means
  • Patient good understanding of what to expect from surgery
total knee replacement when
TOTAL KNEE REPLACEMENTWhen?
  • Pain
  • Function
  • LOM
  • Level of disability
total knee replacement how
TOTAL KNEE REPLACEMENTHow?
  • Fixation
    • Cement
    • Cementless
  • Incision – approach
    • Limited – minimal
  • Prosthetic choice
tka things to consider
TKAThings to consider
  • Patient’s age
  • Occupation and activity level
  • Surgeon ability
  • Patient desires
tka types
TKATYPES
  • Unicompartmental
  • Tricompartmental

- Posterior cruciate retaining

- Posterior cruciate substituting

  • Hinge
unicompartmental
UNICOMPARTMENTAL
  • Medial-lateral

Single comp. Disease

Good ligaments

Limited activity

  • Patellofemoral

Only PF disease

No patellar maltracking

Few candidates

tka types7
TKATYPES

Tricompartmental

  • Non modular
  • Modular
  • Rotating platform
total knee arthroplasty surgery
TOTAL KNEE ARTHROPLASTYSurgery
  • 1-2 hr surgery
  • 3-5 days hospitalization
  • More discomfort than hip
  • Rehabilitation a bit harder
total knee arthroplasty anesthesia

for

TOTAL KNEE ARTHROPLASTYAnesthesia
  • Regional or general
  • Femoral n. block (continuous)Sciatic n. block
      • postop analgesia
toal knee arthroplasty recovery
TOAL KNEE ARTHROPLASTYRecovery
  • 4-6 wks walker / 2 crutches
  • Wait for wound healing to FWB
  • Physical therapy advisable
total knee arthroplasty expectations
TOTAL KNEE ARTHROPLASTYExpectations
  • 95% satisfaction
  • Slightly less than THA
  • 20+ yrs longevity
  • Ability to walk distances
  • Bike, horseback riding: yes
  • Skiing, running, jumping: no
total joint arthroplasty minimally invasive surgery
TOTAL JOINT ARTHROPLASTYMinimally Invasive Surgery
  • Same surgery, smaller incision
  • Technically more demanding
  • No proofs that recovery is better, faster or less painful
  • No long-term data
total joint replacement hip and knee conclusions
TOTAL JOINT REPLACEMENTHIP AND KNEEConclusions
  • Pain relieving and function improving procedures
  • Predictable results