PLANNING YOUR NEXT REVISION - STEP BY STEP
At a Glance
Section titled āAt a Glanceā| Metadata | Details |
|---|---|
| Publication Date | 2018-02-21 |
| Authors | Douglas E. Padgett |
| Institutions | Hospital for Special Surgery |
Abstract
Section titled āAbstractāUnderstand the nature of the problem. Revision TKR is a major undertaking and should be focused on problem solving. Know the problem!- Pain is not a diagnosis. Review history of problem. Think of possibilities: Infection, loosening, instability, stiffness, malalignment, poor kinematics. Ensure an adequate workup - History, Exam; Imaging: Radiographs: consider long alignment films, MR for soft tissue issues: Clunk, recurrent hemarthroses; CT scan: Remains gold standard for rotational alignment. Labs: CBC, ESR, C-reactive protein. Aspiration: Cell count, Culture. Assessment of where the patient is currently! Synthesise a working diagnosis and formulate a provisional plan. Revise āpart of kneeā: you better know what9s in there! Revise āall of kneeā. How will you get there? Think old incisions How will get the parts out? What tools do you need? High speed burrs / diamond tip wheel /long thin saw blades; Osteotomes; Implant specific tools. Once everything is out: What do you have left? Soft tissue defects, Bone defects. How to ārebuildā: Constraint for soft tissue defects, Stems for mechanical stability, Cones / augments / bone graft for osseous defects; Fixation: Cement, Cementless.
Tech Support
Section titled āTech SupportāOriginal Source
Section titled āOriginal Sourceā- DOI: None