Tibia and Fibula
Foot
The Most Up-to-Date Book on ESWT A Accessory Bones of the Foot Accessory Navicular Achilles Tendinitis Akin Procedure Amputation of Foot and Ankle Anterior Impingement Snydrome of Ankle Arthrodesis of First MTP Joint Avulsion of Base of 5th Metatarsal B Bunionette C Calcaneus Calcaneal Apophysitis Calcaneovalgus Foot Cavovarus Foot Cheilectomy of First MTP Chevron Osteotomy … Read more
TKR: Distal Femoral Sizing Guide
– TKR Menu: AP cutting guide – Determine Appropriate AP Component Size: – most instrument systems incorporate cutting block that is placed on end of femur & rotated to appropriate orientation; – prior to inserting the AP sizing guide, remove any prominent meniscal remnants so that the posterior “fins” of the … Read more
TKR: Consequences of Joint Line Elevation
– See: – Joint Line Position – Patella Infera: – Discussion: – elevation of the joint line occurrs when only very small amount of tibial plateua surface is removed and “space” for the components created by removing portion of the distal … Read more
TKR: Depth of Proximal Tibial Cut
– Discussion: – see: – tibial component – extra-medullary cutting guide; – preparation for proximal tibial cut – posterior slope – this cut is made at right angles to anatomical axis … Read more
TKR: Distal Femoral Cutting Guide
– Discussion: – femoral cutting guide is set for the appropriate right or left valgus angulation of +5 to 7 deg (in the tall thin patient try +5 deg, & in short obese patient try 7 or even +9 deg); – in lateral plane, this cut is perpendicular to anatomic axis … Read more
TKR: Distal Femoral Resection
– See: Femoral Component – Resection of the Distal Femur: – cushing rongeur is used to remove osteophytes in medial & lateral aspects of the femoral condyles as well as the intercondylar space; – this avoids, possible mis-sizing of the femoral component; – femoral IM alignment rod: (discussion) … Read more
TKR: Component Insertion
– Component Insertion: – tibial insertion: – cement is applied to the proximal tibial surface, and the surgeon uses gloved fingers to manually press cement into proximal tibial surface; – subsequently additional cement is applied to the proximal tibial surface; … Read more
TKR: Biomechanics & Prosthetic Design Considerations
– See: – Total Knee Replacement Menu – Axial Alignment – Kinematics of the Knee Joint – Metallurgy: TKR – Rotation of TKR – Unconstrained Prosthesis – Discussion: – inability to achieve precise alignment will ultimately lead to component loosening, the leading cause of TKA failure; – designs with greater conformity between the femoral … Read more
TKR: Bone Defects in Primary Knees
– Discussion: – defects are peripheral or central – peripheral defects offer no peripheral support for tibial component; – central defects with a cortical rim that does not support the tibial componennt act like a peripheral defect; – in OA varus knees defect is peripheral and posteromedial; … Read more