Tag Archives: TKA

Orthopedics, Print Release

PUBLISHED: Total Knee Arthroplasty

Total Knee Arthroplasty
Thomas S. Thornhill, MD; David J. Lee, MD
Brigham and Women’s Hospital

Total knee replacement is one of the most common orthopaedic procedures performed in the United States. The most common indication for total knee replacement is osteoarthritis. Clinical signs of knee osteoarthritis include pain with walking, difficulty ranging the knee, knee instability, varus deformity, bony enlargement, extension lag, and flexion contracture. Radiologic evidence for osteoarthritis of the knee includes the presence of osteophytes, joint space narrowing, subchondral sclerosis, subchondral cysts, and malalignment.

Before considering total knee replacement, patients typically undergo a trial of less invasive treatments, including lifestyle modification, pharmacologic therapy, and injections. If these methods fail to produce satisfactory improvement in the patient’s symptoms, one should consider the benefits and risks of total knee replacement in conjunction with their surgeon. Outcomes following total knee replacement are excellent, with patients reporting greatly reduced pain, improved mobility, and improved quality of life. However, patients must be aware that there are serious risks that accompany any surgery, which include infection, pulmonary embolism, deep vein thrombosis, nerve damage, and need for further procedures.

Orthopedic Trauma, Orthopedics, Print Release

Right Distal Tibial Oblique Fracture Open Reduction and Internal Fixation (ORIF) with Medial Neutralization Non-locking Plate

Right Distal Tibial Oblique Fracture Open Reduction and Internal Fixation (ORIF) with Medial Neutralization Non-locking Plate
Andrew M. Hresko, MD; Edward Kenneth Rodriguez, MD, PhD
Beth Israel Deaconess Medical Center

Diaphyseal tibial fractures are common injuries that are most often treated with intramedullary nailing. However, certain patient factors may necessitate alternative treatment strategies such as open reduction internal fixation (ORIF) with plates and screws. Presence of a total knee arthroplasty (TKA) in the injured extremity is one such factor. TKA is a common operation that is only increasing in popularity, and management of tibia fractures distal to TKA may be a frequently encountered clinical scenario.

This video presents a technique for ORIF of a distal diaphyseal tibia fracture distal to a TKA that precludes intramedullary nail fixation. The fracture is fixed with lag screws and secured with an anatomically-contoured distal tibia locking-compression plate (LCP) in neutralization mode.

Orthopedics, Print Release

PUBLISHED: Mako Robotic-Arm Assisted Total Knee Arthroplasty

Mako Robotic-Arm Assisted Total Knee Arthroplasty
Jeffrey S. Zarin, MD; Gustavo Barrazueta, MD
Tufts Medical Center

Total knee arthroplasty (TKA) has been around for decades and serves as a very successful procedure to alleviate pain and restore function in a knee with advanced degenerative joint disease. Over the years, there have been many advancements in surgical technique and even more so in implant design. One such technological breakthrough in TKA is the use of robotic-arm assistance for enhanced preoperative planning and intraoperative guidance with dynamic joint balancing and bone preparation.

In this video article, Dr. Zarin demonstrates the operative technique he uses in performing a posterior stabilizing TKA in a varus deformity degenerative knee using Mako robotic-arm assistance.

Announcement, Orthopedics, Preprint Release

PREPRINT RELEASE: Mako Robotic Arm Assisted Total Knee Arthroplasty

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Mako Robotic Arm Assisted Total Knee Arthroplasty
Tufts Medical Center
Jeffrey S. Zarin, MD
Chief, Division of Arthroplasty

In this case a 66-year-old patient presents with arthritis predominantly in the medial compartment. Dr. Jeffrey Zarin explains how to use the Mako robot to precisely plan and perform a total knee arthroplasty surgery on this patient. Preoperatively, he uses a CT scan to create a model of the patient in order to determine the appropriate implant size, and intraoperatively, he utilizes the Mako robot to assist in ligament and gap balancing, perform the osteotomies, and make precise corrections.
Announcement, Orthopedics, Print Release

PUBLISHED: Posterior Cruciate-Retaining Total Knee Arthroplasty

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0062Posterior Cruciate-Retaining Total Knee Arthroplasty
Richard Scott, MD
Professor of Orthopaedic Surgery, Emeritus
Harvard Medical School

Abstract: Total knee arthroplasty has evolved into a very successful procedure to relieve pain and restore function in the arthritic knee with advanced structural damage. Optimal results are dependent on the restoration of alignment and ligament stability. Operative techniques involve either preservation of the posterior cruciate ligament or substitution of its function through increased prosthetic constraint. The vast majority of knees do not require cruciate substitution to establish appropriate stability and function. This video outlines the operative technique used by the author for posterior cruciate-retaining total knee arthroplasty in a patient with a preoperative varus deformity.