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TKA Indications

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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

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  1. 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

  2. TOTAL KNEE REPLACEMENTWhen? • Pain • Function • LOM • Level of disability

  3. TOTAL KNEE REPLACEMENTHow? • Fixation • Cement • Cementless • Incision – approach • Limited – minimal • Prosthetic choice

  4. TKAThings to consider • Patient’s age • Occupation and activity level • Surgeon ability • Patient desires

  5. TKATYPES • Unicompartmental • Tricompartmental - Posterior cruciate retaining - Posterior cruciate substituting • Hinge

  6. UNICOMPARTMENTAL • Medial-lateral Single comp. Disease Good ligaments Limited activity • Patellofemoral Only PF disease No patellar maltracking Few candidates

  7. TKATYPES Tricompartmental • Non modular • Modular • Rotating platform

  8. TOTAL KNEE ARTHROPLASTYSurgery • 1-2 hr surgery • 3-5 days hospitalization • More discomfort than hip • Rehabilitation a bit harder

  9. for TOTAL KNEE ARTHROPLASTYAnesthesia • Regional or general • Femoral n. block (continuous)Sciatic n. block • postop analgesia

  10. TOAL KNEE ARTHROPLASTYRecovery • 4-6 wks walker / 2 crutches • Wait for wound healing to FWB • Physical therapy advisable

  11. TOTAL KNEE ARTHROPLASTYExpectations • 95% satisfaction • Slightly less than THA • 20+ yrs longevity • Ability to walk distances • Bike, horseback riding: yes • Skiing, running, jumping: no

  12. 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

  13. TOTAL JOINT REPLACEMENTHIP AND KNEEConclusions • Pain relieving and function improving procedures • Predictable results

  14. TOTAL JOINT REPLACEMENTHIP AND KNEEWho Should Do It? • Proper training • Over 50/yr

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