Orthopaedics Lower Limb: Total Knee Joint Arthroplasty

Question 1

TKJR components

Answer 1

Femoral component, tibial component, plastic spacer (polyethylene). Sometimes a patellar component

Question 2

___% of total knee joints are done because of osteoarthritis

Answer 2

94

Question 3

Operation length and length of stay?

Answer 3

75-90 minutes; mean stay of 5 days in hospital

Question 4

TKJR is a surgery that

Answer 4

replaces an arthritic knee joint with an artificial metal or plastic replacement parts called the prostheses

Question 5

The ACL is always

Answer 5

sacrificed

Question 6

Complications of total knee joint replacement surgery

Answer 6

Patella dislocation
DVT
Infection
Surgical fracture
Post-op swelling and pain
Poor ROM 
knee prosthesis loosening or failing
Excessive wear of the polyethylene

Question 7

Day 1 Post Op?

Answer 7

Mobilised

• Check medical knots on WB status, operation, pain and analgesia
• Checking medical stability
• Assessing AROM
• Can involve standing with 2 assistants. WB as tolerated. Pain controlled by PCA
• Transfers in and out of bed
• Mobilisation in bed
• Possible use of continuous passive motion machine

Question 8

Requirements for discharge

Answer 8

• Pain is controlled
• 90 degrees of knee flexion
• Independently able to go toilet and shower
• Walk 100m and go up and down stairs
• Ride exercycle

Question 9

An incision is made on the

Answer 9

anterior aspect of the knee joint

Question 10

The knee is placed in what kind of position during surgery?

Answer 10

An open pack position and the patella is moved away to expose access to the tibial-femoral joint

Question 11

The PCL may be removed. True or false?

Answer 11

True

Question 12

Disadvantages of minimally invasive surgery

Answer 12

Technically demanding (learning curve), difficulty with alignment and land works, unaccustomed view, implant positioning, gap balancing

Question 13

Pre-operative management

Answer 13

Assessing UL/LL strength, assessing gait including walking aids, teaching transferring skills and crutch walking (stairs as well), reviewing post op exercises. Useful to strengthen quads as people with OA lose 20-40% of quadriceps strength after TKJR

Question 14

Total knee joint replacements has ______ in the last 10 years

Answer 14

doubled