R Hube1, H O Mayr, T Kalteis, G Matziolis. 1. OCM-Klinik München, Steiner Str. 6, 81369, München, Deutschland. robert.hube@ocm-muenchen.de
Abstract
OBJECTIVE: Surgical technique in total knee arthroplasty (TKA) to combine the femur first and tibia first techniques in order to reduce surgical mistakes regarding rotation and alignment. INDICATIONS: Symptomatic arthritis of the knee. CONTRAINDICATIONS: General contraindications for TKA. SURGICAL TECHNIQUE: Osseous preparation starting with a distal femur cut. Then the proximal tibia cut is accomplished and the knee is balanced in extension after checking for correct alignment. Bone-referenced positioning of the femoral cutting block for further preparation of the femur. Finally, the rotation of the femur is checked in 90° of flexion by means of ligament tension. If required, the rotation is checked and the flexion gap balanced, respectively. POSTOPERATIVE MANAGEMENT: Mobilization with weight bearing and range of motion as tolerated. RESULTS: In a prospective study, 267 knees (160 women, 107 men, average age of 69.3 [46-89] years) were followed up preoperatively and after 6 weeks. The clinical results were based on the American Knee Society score. The scores were 48.9 (32-68) preoperatively and 86.5 (75-100) at follow-up. Radiologically 92.1% of the knees showed a malposition <3°.
OBJECTIVE: Surgical technique in total knee arthroplasty (TKA) to combine the femur first and tibia first techniques in order to reduce surgical mistakes regarding rotation and alignment. INDICATIONS: Symptomatic arthritis of the knee. CONTRAINDICATIONS: General contraindications for TKA. SURGICAL TECHNIQUE: Osseous preparation starting with a distal femur cut. Then the proximal tibia cut is accomplished and the knee is balanced in extension after checking for correct alignment. Bone-referenced positioning of the femoral cutting block for further preparation of the femur. Finally, the rotation of the femur is checked in 90° of flexion by means of ligament tension. If required, the rotation is checked and the flexion gap balanced, respectively. POSTOPERATIVE MANAGEMENT: Mobilization with weight bearing and range of motion as tolerated. RESULTS: In a prospective study, 267 knees (160 women, 107 men, average age of 69.3 [46-89] years) were followed up preoperatively and after 6 weeks. The clinical results were based on the American Knee Society score. The scores were 48.9 (32-68) preoperatively and 86.5 (75-100) at follow-up. Radiologically 92.1% of the knees showed a malposition <3°.
Authors: John N Insall; Giles R Scuderi; Richard D Komistek; Kevin Math; Douglas A Dennis; Dylan T Anderson Journal: Clin Orthop Relat Res Date: 2002-10 Impact factor: 4.176
Authors: Tilman Pfitzner; Philippe Moewis; Patrick Stein; Heide Boeth; Adam Trepczynski; Philipp von Roth; Georg N Duda Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-06-27 Impact factor: 4.342