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16 Cards in this Set
- Front
- Back
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In general, if a patient has a painful TKA with good ROM and normal x-rays, what is the expected outcome of revision? Why?
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Generally quite poor
Outcomes of revisions are better if patient has preoperative pain and limited ROM |
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If there are multiple prior incisions about the knee, which should be used for surgery? Why?
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Choose the most lateral
Blood supply goes from medial to lateral |
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When preforming polyethylene exchange alone, which possible complication may occur?
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Potential locking mechanism failure
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What component is generally loose in a revision situation?
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Tibial component
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What is a general landmark for establishing the location of the joint line?
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1.5 cm above fibular head
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What is the maximum acceptable joint line change?
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8 mm
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What should be done for massive bone loss encountered during reconstruction?
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Use structural allograft
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In what three ways cant eh extensor mechanism be best protected during surgery?
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Quadriceps (rectus) snip
Tubercle osteotomy V-Y quadricepsplasty |
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What two salvage procedures are available for a disrupted extensor mechanism?
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Semitendinosus autorgraft
Augment with allograft |
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What common clinical problem may persist despite extensor reconstruction?
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Extensor lag
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What three salvage procedures are available for a disrupted extensor mechanism?
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Posterior tibial tendon allograft
Advance MCL CCK (constrained condylar knee) |
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How do constrained non hinged TKAs work?
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Large central post substitutes for MCL/LCL
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What are the three indications for their use?
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MCL attenuation
LCL deficiency Flexion gap laxity (because it has a tall post) |
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Why is the use of a constrained non hinged knee controversial if MCL totally absent?
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Risk for post breakage
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What are the three surgical indications for use of constrained hinged rotating TKA?
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All ligaments gone
Knee resection Hyperextension instability (E>G> polio) |
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If using a constrained total knee, what else should always be used?
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Intramedullary device
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