TKR following HTO
– See: – Total Knee Replacement: – High Tibial Osteotomy: – TKR following HTO: – expected problems following an HTO may include: – patellar infera – peripatellar scarring (and inability to evert the patella); … Read more
Tibia and Fibula
Instability following TKR:
– Discussion: – may result from unequal flexion and extension gaps; (instability in extension or flexion due to MCL or LCL incompetence); – varus subluxation in extension or flexion due to unequal gaps; – in the report by Fehring TK, et al, the authors evaluated the causes of revision … Read more
TKR: Lateral Retinacular Release
– See: – TKR Menu – blood supply to the knee: – standard lateral retinacular release: – Discussion: – at completion of TKR, patellar tracking are critically evaluated to insure stability; – patellar tracking may be improved by removal of patellar osteophytes … Read more
TKR: Deep Exposure
– Discussion: – need to reflect capsule medially & laterally from upper 1 cm of proximal tibia; – performed circumferentially using either elevator or osteotome; – this capsular reflection relieves minor contractures and provides access for retractors to protect the posterior structures; – any rim osteophytes from the … Read more
TKR: Flexion Gap
– Definition: – see instability following TKR – is space between the posterior coronal cut on the distal femur & transverse cut on proximal tibia, while knee is in flexion; – effect of resection of PCL (see posterior stabilized prosthesis); – in report by Kadoya, et al, effect of PCL resection … Read more
TKR: Femoral Component
– See: – TKR Menu – Distal Femoral Resection – Femoral IM Alignment Rod – Distal Femoral Sizing Guide (and Rotational Alignment) – Anterior, Posterior, and Chamfer Cuts – Femoral Component Notching – Design Considerations: – PCL Retaining Prosthesis – Posterior Stabilized Prosthesis – left & … Read more
TKR Femoral Cuts: Anterior, Posterior, Chamfer Cuts
– Theoretical Considerations: – distance from posterior reesction plane to anterior resection plane must equal the internal dimension of femoral component being used; – this cut must be made at a distance from the anterior cut equal to inner anterior-posterior dimension of femoral component used; … Read more
TKR: Effects of Component Rotation
– Discussion: – if there is free movement at hip, subtalar & mid-tarsal joints rotation at the knee is not essential for restricted function of prosthetic joint; – in contrast, an arthrodesed ipsilateral hip is a relative contra indication to knee replacement, for it prevents rotation of thigh as … Read more
Pediatric Supination – Inversion Ankle Fracture:
– Discussion: – most common type of pediatric ankle fracture; – involves adduction injury to a supinated foot; – Classification: – type I: (involves fibula); – separation of distal fibular epiphysis (SH I or II frx); – epiphyseal separation involves distal fibula … Read more
Supination Plantar Flexion Injuries:
– Discussion: – w/ foot in full supination, ankle is submitted to plantar flexion force; – most often causes a SH type II frx (less often SH I) of distal tibia; – fibular fracture may or may not be present; – Radiograph: – on lateral x-ray look for … Read more