TOTBİD Dergisi

TOTBİD Dergisi

2015, Cilt 14, Sayı, 2     (Sayfalar: 077-085)

Preoperative planning for revision surgery of total knee arthroplasty

Olcay Güler 1, Mehmet Halis Çerci 2, Mahir Mahiroğulları 1

1 İstanbul Medipol Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı, İstanbul
2 Özel Nisa Hastanesi Ortopedi ve Travmatoloji Kliniği, İstanbul

DOI: 10.14292/totbid.dergisi.2015.11
Görüntüleme: 505
İndirme : 285

The aim of preoperative planning before total knee arthroplasty (TKA) revision surgery should be increasing success and quality of surgery and patient satisfaction. All issues which have possible effects on treatment process should be evaluated in a standardized method and algorithm after detailed history, physical and radiological examination. By these preparations surgeon can give more accurate and quick decisions about the problems during the surgical operation and can foresee results of these decisions. Skin, peripheral vascular circulation, neurological situation, range of motion and stability of articulation should be evaluated while preoperative physical examination. In addition to standart standing knee anteroposterior/lateral, patellofemoral tangential X-rays, hip to ankle standing X-ray examinations should be evaluated while radiological examination. Computed tomography has a special importance especially for rotational malposition of implant components and bone defects adjacent to the implant. Brand, model, size and specificities of existing implants must be known before the revision surgery. Furthermore, the usage of X-rays and templates facilitates the collection of preliminary information about the specificities of the implants to be used while revision surgery. Necessary equipment must be acquired for implant removing and all preparations must be done by keeping in mind the worst scenario. Giving decisions on appropriate implant options and bone grafts, metallic augmentations for bone defect reconstruction, in the light of physical and radiological examination during the preoperative planning, plays an important role in achieving satisfactory results.

Anahtar Kelimeler : total knee replacement; surgical revision; preoperative proceedures; planning methodology