Ch 62 - Total Knee Replacement Flashcards

1
Q

What is the below implant?
What are its components made of?

A

BioMedtrix Canine Total Knee Replacement
- A = Articulated construct
- B = Inverted tibial component. Made of UHMW polyethylene and is undercut to allow cemented fixation
- C = Femoral component, positioned to show non-articulating surface coated with beads for press-fit, cementless fixation. Made of cobalt-chromium alloy

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2
Q

What is the recommendation for patients presenting for a total knee replacement with current TPLO implants or other stifle implants?

A
  • Remove implants atleast 6 weeks prior to TKR
  • Culture of synovium and peri-implant tissue
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3
Q

List two absolute contraindications for TKR

A
  • Infection
  • Loss of effective extensor mechanism
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4
Q

What are the recommendations regarding implantation of the tibial component?

A
  • 90 degrees to the mechanical axis of the tibia in the frontal plane
  • Sagittal slope at 6 degrees
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5
Q

What factors affect optimal balance of the implants?

A
  • Alignment
  • Joint laxity (tension within the periarticular soft tissues)
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6
Q

List potential intra-operative complications

A
  • Inadvertent damage to collateral ligaments of patellar ligament
  • Femoral or tibial fracture
  • Haemorrhage (stifle should be flexed and placed into cranial drawer during the tibial osteotomy while protecting the vascular structures within the popliteal fossa)
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7
Q

List potential post-op complications?

A
  • Implant wear
  • Aseptic loosening
  • Chronic instability
  • Limited range of motion (Arthrofibrosis)
  • Infection
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8
Q

What is the most common organism cultures in infected TKR?
What are the treatment options?

A

Multidrug Resistant Staph

Treatment Options:
- Chronic medical managment
- Surgical debridement with retention of implants
- Revision (remove implants, ABx impregnated spacer for 6-12wk, new implant)
- Arthrodesis
- Amputation

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