Patients are rightfully trying to become more educated about their surgery and recovery. They often obtain (mis)information on the Internet or from friends. They need to be informed about their surgeon’s individual postoperative protocol, and they need to have their…
Many problems or mishaps can be encountered during routine and not-so-routine total knee arthroplasty (TKA). In this chapter, I address several of these and offer potential solutions. Choosing the Correct Incision Wound necrosis after TKA can be a minor inconvenience…
Sepsis occurring after total knee arthroplasty (TKA) is a disastrous complication. I was fortunate in my career in that after more than 6000 primary TKAs, none of my patients had experienced an early deep infection. I have seen late “metastatic”…
Because arthritis of the knee has a significant incidence of bilaterality, both patients and surgeons often consider the possibility of bilateral simultaneous total knee arthroplasty (TKA). I am a strong advocate of this procedure in properly selected patients, and the…
Femoral Deficiency Options available for reconstitution of deficient bone stock on the femoral side include bone grafting, cement alone, cement plus screw augmentation, augmented components, trabecular metal augments and custom components. Bone Grafting Bone grafting is appropriate for all contained…
Total knee arthroplasty (TKA) in patients with rheumatoid arthritis has unique features that are different from those encountered in patients with osteoarthritis. Through the years, I have taken care of a large number of patients with rheumatoid arthritis requiring TKA…
Conversion of osteotomy to total knee arthroplasty (TKA) can be extremely difficult for multiple reasons including the presence of prior incisions, difficult operative exposure, the presence of retained hardware, joint line angle distortion, malunion, nonunion, patella baja, offset tibial shafts,…
A fixed flexion contracture can result from several disease processes, including osteoarthritis, rheumatoid arthritis, and posttraumatic arthritis. Often a common pathway starts with pain and leads to decreased motion and posterior capsular scarring. The scarring promoted by the inflammatory component…
Among the goals of total knee arthroplasty (TKA) are relief of pain and restoration of function. Adequate range of motion is necessary for return to certain activities. For example, to walk normally on level ground, a person needs 70 degrees…
Patellofemoral complications once accounted for as much as 50% of complications after total knee arthroplasty (TKA). These statistics come from arthroplasties performed in the 1980s and early 1990s. With improvements in surgical technique and prosthetic design, the incidence has decreased,…