Transcript Knee Replacement Surgery

Knee replacement surgery
Typical patient has severe knee osteoarthritis.
Knee prosthesis. Steel femoral component.
Polyethylene tibial articulating surface. Steel
tibial base plate with stem. Polyethylene
patellar articulating surface.
http://www.zimmer.com/z/ctl/op/global/action/1/id/8138/template/PC
http://www.orthop.washington.edu/PatientCare/OurServices/HipandKnee/Articles/Kne
eArthritis.aspx
Top left: Tibial stem and
femoral cam take the
place of the PCL (which is
removed during the
procedure) in preventing
excessive forward
movement of the femur
on the tibia. This is called
a posterior-stabilized
design.
Total knee arthroplasty video
Clear video of key points of procedure from beginning
to end. Anterior (not minimally invasive) approach.
Note longitudinal cut into medial part of quadriceps
tendon to allow lateral displacement and reflection of
patella. Underlying (cartilage-covered) portion of
patella removed by “freehand” sawing at 2:40. View of
distal femur at 3:25 is possible because knee is
dislocated. Quadriceps tendon is sutured around 9:40.
Orientation: left knee, top of frame = superior, left of frame = medial.
Terms: knee arthroplasty, varus deformity, bovie, valgus.
Minimally invasive surgery videos
Video 1: Good explanation of minimally-invasive vs.
traditional surgery. Good radiographs and explanations
of normal, arthritic, and post-replacement knees. No
gore. See 4:40-13:10 (8:30 total).
Video 2: In the OR. Shows portions of minimally
invasive procedure. 3:35-4:12, 4:57-6:25, 6:54-7:14,
7:54-8:30. Note how femoral cutting jig is mounted on
medial, not anterior, aspect of femur.