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Basic Technique of Total Knee Arthroplasty

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Deformity Correction in Total Knee Arthroplasty

Abstract

With rapid advancement in technology and materials in total knee arthroplasty (TKA), long-term survival and function of the total knee are increasingly more dependent on optimum surgical technique. Adherence to basic surgical principles ensures a successful outcome. Surgical technique in TKA is akin to a game of chess where every move has predictable and logical consequences. Hence, every step of the surgical technique needs to be well thought of before execution. The aim of the authors, like most surgeons, is to ensure a well-aligned, well-balanced and well-fixed TKA. Ligament balancing is an integral part of TKA, and soft-tissue release should follow a functional and anatomic rationale to achieve correct alignment and ligament balance throughout the range of flexion and extension. Any deviation from this principle may lead to stiffness, imbalance or instability during TKA.

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References

  1. Namba RS, Inacio MC, Paxton EW, Ake CF, Wang C, Gross TP, Marinac-Dabic D, Sedrakyan A. Risk of revision for fixed versus mobile-bearing primary total knee replacements. J Bone Joint Surg Am. 2012;94:1929–35.

    Article  PubMed  Google Scholar 

  2. Cheng CH, Cheng YT, Chen JS. A learning curve of total knee arthroplasty (TKA) based on surgical volume analysis. Arch Gerontol Geriatr. 2011;53:e5–9.

    Article  PubMed  Google Scholar 

  3. Dalury DF, Pomeroy DL, Gorab RS, Adams MJ. Why are total knee arthroplasties being revised? J Arthroplasty. 2013;28(8 Suppl):120–1.

    Article  PubMed  Google Scholar 

  4. Mullaji AB, Marawar SV, Simha M, Jindal G. Cruciate ligaments in arthritic knees: a histologic study with radiologic correlation. J Arthroplasty. 2008;23:567–72.

    Article  PubMed  Google Scholar 

  5. Albert A, Forthomme JP, Vandenhooft A, Van Eeckhout P, Feoli F. Are lesions of the posterior cruciate ligament predictable before knee arthroplasty? A histological study of 434 ligaments in osteoarthritic knees. Acta Orthop Belg. 2008;74:652–8.

    PubMed  Google Scholar 

  6. Stubbs G, Dahlstrom J, Papantoniou P, Cherian M. Correlation between macroscopic changes of arthrosis and the posterior cruciate ligament histology in the osteoarthritic knee. ANZ J Surg. 2005;75:1036–40.

    Article  PubMed  Google Scholar 

  7. Mullaji AB, Marawar SV, Luthra M. Tibial articular cartilage wear in varus osteoarthritic knees: correlation with anterior cruciate ligament integrity and severity of deformity. J Arthroplasty. 2008;23:128–35.

    Article  PubMed  Google Scholar 

  8. Seon JK, Park JK, Shin YJ, Seo HY, Lee KB, Song EK. Comparisons of kinematics and range of motion in high-flexion total knee arthroplasty: cruciate retaining vs. substituting designs. Knee Surg Sports Traumatol Arthrosc. 2011;19:2016–22.

    Article  PubMed  Google Scholar 

  9. Luo SX, Zhao JM, Su W, Li XF, Dong GF. Posterior cruciate substituting versus posterior cruciate retaining total knee arthroplasty prostheses: a meta-analysis. Knee. 2012;19:246–52.

    Article  PubMed  Google Scholar 

  10. Harato K, Bourne RB, Victor J, Snyder M, Hart J, Ries MD. Midterm comparison of posterior cruciate-retaining versus -substituting total knee arthroplasty using the Genesis II prosthesis. A multicenter prospective randomized clinical trial. Knee. 2008;15:217–21.

    Article  PubMed  Google Scholar 

  11. Yoon JR, Jeong HI, Oh KJ, Yang JH. In vivo gap analysis in various knee flexion angles during navigation-assisted total knee arthroplasty. J Arthroplasty. 2013;28(10):1796–800.

    Article  PubMed  Google Scholar 

  12. Graban M, Swartz JE. Kaizen and continuous improvement. In: Graban M, Swartz JE, editors. Healthcare Kaizen: engaging front-line staff in sustainable continuous improvements. New York: Productivity Press; 2012. p. 3–27.

    Google Scholar 

  13. Mullaji A, Shetty GM. Computer-assisted total knee arthroplasty for arthritis with extra-articular deformity. J Arthroplasty. 2009;24:1164–9.

    Article  PubMed  Google Scholar 

  14. Mullaji AB, Shetty GM. Correction of varus deformity during TKA with reduction osteotomy. Clin Orthop Relat Res. 2014;472(1):126–32.

    Article  PubMed  Google Scholar 

  15. Mullaji AB, Shetty GM, Kanna R, Vadapalli RC. The influence of preoperative deformity on valgus correction angle: an analysis of 503 total knee arthroplasties. J Arthroplasty. 2013;28:20–7.

    Article  PubMed  Google Scholar 

  16. Mullaji AB, Marawar SV, Mittal V. A comparison of coronal plane axial femoral relationships in Asian patients with varus osteoarthritic knees and healthy knees. J Arthroplasty. 2009;24:861–7.

    Article  PubMed  Google Scholar 

  17. Mullaji AB, Sharma AK, Marawar SV, Kohli AF. Tibial torsion in non-arthritic Indian adults: a computer tomography study of 100 limbs. Indian J Orthop. 2008;42:309–13.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Shetty GM, Mullaji A. The humble toothbrush – a simple and inexpensive tool for bone surface preparation in cemented total knee arthroplasty. J Maharashtra Orthop Assoc. 2011;6:1–4.

    Google Scholar 

  19. Mullaji A, Marawar S, Sharma A. Correcting varus deformity. J Arthroplasty. 2007;22(4 Suppl 1):15–9.

    Article  PubMed  Google Scholar 

  20. Mullaji A, Kanna R, Shetty GM, Chavda V, Singh DP. Efficacy of periarticular injection of bupivacaine, fentanyl, and methylprednisolone in total knee arthroplasty: a prospective, randomized trial. J Arthroplasty. 2010;25:851–7.

    Article  PubMed  Google Scholar 

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Appendix Surgical Technique Workflow Chart for TKA

Appendix Surgical Technique Workflow Chart for TKA

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Mullaji, A.B., Shetty, G.M. (2014). Basic Technique of Total Knee Arthroplasty. In: Deformity Correction in Total Knee Arthroplasty. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-0566-9_2

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  • DOI: https://doi.org/10.1007/978-1-4939-0566-9_2

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-0565-2

  • Online ISBN: 978-1-4939-0566-9

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