wk9 TKJR/TKA Flashcards
Indication for TKJR/ TKA
- Pain
- Minimum age - 50years old
- Significant joint space narrowing - bone to bone
- Avascular necrosis
Rate of TKA in the last 10 years in NZ
It has been doubled up from 3000 to more than 6000 in the last Decade
94% for OA
3 Main components of TKA
- Femoral Component
- Plastic Spacer
- Tibial component
brief description of TKA
- ACL is always sacrificed
- PCL may be removed
- Patella may be resurfaced
Some general failures of TKA
- polyethylene wear
- infection
- mal-alignment
- ligament instability
Mobile Bearing VS Fixed Bearing
0
disadvantages of Minimally invasive surgery
difficult alignment
diffcult landmarks
gap imbalancing
Total procedure
75-90 mins
hospital stay
5 days
Discharging requirements
- Pain controlled
- Flex the knee 90 degree
- Independently Mobile (toilet & shower)
- Walk 100m and do stairs
- ride exercycle
How long does swelling last following TKA
3 months
Huge Swelling reduces ROM
-
what are physio post Rehab following TKA?
- Mobilisation on day 1 post op
- Knee flexion 90 degree by end of hospital stay (5days)
- knee flexion 115 by end of 3 months
- Quad strength exercise
- CPM started within first 24 hrs. - dependent on surgeon
What is CPM?
A machine that is used for moving knee joint passively within specified range. It may reduce for forceful manipulation done by surgeon during general anesthesia.
evidence for CPM
No evidence on improving AROM, Pain, Function, QOL
High correlation between 6MWT and Quad strength
True False
True- can use in the clinical setting
Complications
- patella dislocation
- DVT
- Infection
- Surgical Fracture
- Post op swelling and Pain ++
- Poor Rom
survival rate in NZ
97% at 6 years
Factors affecting TKJR outcome
- co-morbidities
- Age
- BMI
- Quad strength (50-60% decreased in 1month postop
- ROM
- Pre op pain and function
- Gender
