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Total Knee Replacement (TKR) by Dr. Neelam V.Ramana Reddy

Dr. Neelam Venkatramana Reddy is one of the best orthopedic doctor in Hyderabad with extensive experience in the area of joint replacement for a span of fifteen years.<br><br>Visit: www.neelamramanareddy.com

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Total Knee Replacement (TKR) by Dr. Neelam V.Ramana Reddy

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  1. Total Knee Replacement (TKR) DrNeelamVenktramana Reddy www.neelamramanareddy.com

  2. Overview 01 Anatomy of the kneejoint 02 Common conditions leading toTKR 03 Evolution ofTKR 04 Total kneereplacement

  3. Anatomy of the Knee

  4. Knee Stabilizers • Medial • Lateral • Anterior • Posterior • Rotatory

  5. Common Conditions That Lead ToT K R 01 Osteoarthritis Primary (idiopathic) i Secondary Post traumaticarthritis ii 02 RheumatoidArthritis

  6. Knee Arthritis • FarmorecommonthanhipOAinAsianpopulation • Age: 80% above 75years • Genders: Equal in both genders up to 45-55 years. After 55 years • more common infemales

  7. Risk Factors of Osteoarthritis • Increasing age • Obesity • Females • Trauma • Infection • Repetitive OccupationalTrauma

  8. Clinical Features OfOsteoarthritis • Depends upon the stage of involvement • Pain • Loss of Function • Stiffness • Swelling • Deformity • Crepitus

  9. Non Operative Treatment • Non-pharmacologictherapy • Patient’seducation • Use of assistivedevices • Weightloss • Physicaltherapy • Occupationaltherapy • Pharmacologictherapy • NSAIDS • Glucosaminesulphate • Intra articularCorticosteroids • Intra articular Hyaluronicacid

  10. OperativeTreatment • Arthroscopy • Osteotomy • Knee replacementsurgery

  11. Osteotomy

  12. KneeReplacement • Total kneereplacement • Partial kneereplacement

  13. Evolution of TKR • Fergussen (1860) resectionarthroplasty • Verneuilperformed first interpositionarthroplasty • 1940s- first artificial implants were tried whenmoldswere fitted in thefemoral condyle • 1950s- combined femoral and tibialarticular surface replacement appeared as simplehinges

  14. Evolution of TKR (count) • Frank Gunston (1971), developed a metal on plastic kneereplacement. • John Insall (1973), designed what has become the prototypeforcurrenttotalkneereplacements.This was a prosthesis made of 3components which would resurface on all the three surfaces of the knee – the femur, tibia andpatella

  15. Classification of Implants Design • Unconstrained • Cruciateretaining • Cruciatesubstituting • Mobile bearingknees • Constrained(Hinged)

  16. Total Knee Replacement Today • Large variety isavailable • Majority of TKRstoday are condylar replacements which consist of thefollowing: • Cobalt-chrome alloy femoralcomponent • Cobalt-chrome alloy or titanium tibialtray • UHMWPE tibialbearingcomponent • UHMWPE patellacomponent

  17. Who Is A Candidate For TKR? • Quality of life severelyaffected • Dailypain • Restriction of ordinaryactivities • Evidence of significant radiographic changes of the knee

  18. TimeFor Replacement • Old age with moresedentary life style • Young patients who have limitedfunctions • Progressivedeformity • Other treatment modalities havefailed • TKRsshouldbedonebeforethingsgetoutofhandsand the patient experiences a severe decrease in ROM,deformity, contracture, joint instability or muscle atrophy

  19. Evaluation Of Patient Before Surgery • A Complete MedicalHistory • Thorough PhysicalExamination • LaboratoryWork-up • AnesthesiaAssessment

  20. Goal of TKR • Painrelief • Restoration of normal limbalignment • Restoration of a functional rangeofmotion

  21. Successful Results Depends upon: • Precise surgicaltechnique • Sound implantdesign • Appropriatematerial • Patient compliance withrehabilitation

  22. Technical Goals Of TKR Surgery • The restoration of mechanicalalignment. • Preservation (or restoration) of thejoint line, • BalancedLigaments • MaintainingorrestoringanormalQangle.

  23. Mechanical Alignment TKA aims at restoring the mechanical axis of the lower limb by: Sequential soft tissue releases Correction of bone defects by grafts or prosthetic augments

  24. Ligament Balancing • a. CoronalPlane • For varusdeformities’ • For valgusdeformities • b. SagittalPlane • Flexioncontractures • Extensioncontractures

  25. Post-OperativeRehabilitation • Rapidpost-operativemobilization • Range of motion exercisesstarted • CPM • Passive extension by placing pillow underfoot • Flexion-bydanglingthelegsoverthesideofbed • Muscle strengtheningexercises • Weightbearingisallowedonfirstpostopday

  26. 15+ Years Experience 22K+ Satisfied Patients 11K+ Surgeries Total Knee Replacement (TKR) By Dr. NeelamVenktramana Reddy Dr.N eelamVenkatramana Reddy is one of the leadingOrthopaedic Surgeons in Hyderabad with extensive experience in the area of joint replacement for a span of fifteen years. Book An Appointment Now ! Call us on: 040 44 777 777

  27. www.neelamramanareddy.com

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