Title: Total Knee Replacement (TKR) by Dr. Neelam V. Ramana Reddy
1- Total Knee Replacement (TKR)
- Dr Neelam Venktramana Reddy
- www.neelamramanareddy.com
2Overview
01
Anatomy of the knee joint
02
Common conditions leading to TKR
03
Evolution of TKR
04
Total knee replacement
3 4- Medial
- Lateral
- Anterior
- Posterior
- Rotatory
5- Common Conditions That Lead To T K R
01
Osteoarthritis
Primary (idiopathic)
i
Secondary Post traumatic arthritis
ii
02
Rheumatoid Arthritis
6- Far more common than hip OA in Asian population
- Age 80 above 75 years
- Genders Equal in both genders up to 45-55
years. After 55 years - more common in females
7- Risk Factors of Osteoarthritis
- Increasing age
- Obesity
- Females
- Trauma
- Infection
- Repetitive Occupational Trauma
8- Clinical Features Of Osteoarthritis
- Depends upon the stage of involvement
- Pain
- Loss of Function
- Stiffness
- Swelling
- Deformity
- Crepitus
9- Non-pharmacologic therapy
- Patients education
- Use of assistive devices
- Weight loss
- Physical therapy
- Occupational therapy
- Pharmacologic therapy
- NSAIDS
- Glucosamine sulphate
- Intra articular Corticosteroids
- Intra articular Hyaluronic acid
10- Arthroscopy
- Osteotomy
- Knee replacement surgery
11 12- Total knee replacement
- Partial knee replacement
13- Fergussen (1860) resection arthroplasty
- Verneuil performed first interposition
arthroplasty - 1940s- first artificial implants were tried when
molds were fitted in the femoral condyle - 1950s- combined femoral and tibial articular
surface replacement appeared as simple hinges
14- Frank Gunston (1971), developed a metal on
plastic knee replacement. - John Insall (1973), designed what has become the
prototype for current total knee replacements.
This was a prosthesis made of 3 components which
would resurface on all the three surfaces of the
knee the femur, tibia and patella
15- Classification of Implants Design
- Unconstrained
- Cruciate retaining
- Cruciate substituting
- Mobile bearing knees
- Constrained (Hinged)
16- Total Knee Replacement Today
- Large variety is available
- Majority of TKRs today are condylar replacements
which consist of the following - Cobalt-chrome alloy femoral component
- Cobalt-chrome alloy or titanium tibial tray
- UHMWPE tibial bearing component
- UHMWPE patella component
17- Who Is A Candidate For TKR?
- Quality of life severely affected
- Daily pain
- Restriction of ordinary activities
- Evidence of significant radiographic changes of
the knee
18- Old age with more sedentary life style
- Young patients who have limited functions
- Progressive deformity
- Other treatment modalities have failed
- TKRs should be done before things get out of
hands and the patient experiences a severe
decrease in ROM, deformity,
contracture, joint instability or muscle atrophy
19- Evaluation Of Patient Before Surgery
- A Complete Medical History
- Thorough Physical Examination
- Laboratory Work-up
- Anesthesia Assessment
20- Pain relief
- Restoration of normal limb alignment
- Restoration of a functional range of motion
21- Successful Results Depends upon
- Precise surgical technique
- Sound implant design
- Appropriate material
- Patient compliance with rehabilitation
22- Technical Goals Of TKR Surgery
- The restoration of mechanical alignment.
- Preservation (or restoration) of the joint line,
- Balanced Ligaments
- Maintaining or restoring a normal Q angle.
23TKA aims at restoring the mechanical axis of
the lower limb by Sequential soft tissue
releases Correction of bone defects by grafts or
prosthetic augments
24a. Coronal Plane For varus deformities For
valgus deformities b. Sagittal Plane Flexion
contractures Extension contractures
25- Post-Operative Rehabilitation
- Rapid post-operative mobilization
- Range of motion exercises started
- CPM
- Passive extension by placing pillow under foot
- Flexion-by dangling the legs over the side of bed
- Muscle strengthening exercises
- Weight bearing is allowed on first post op day
26 15 Years Experience
22K Satisfied Patients
11K Surgeries
Total Knee Replacement (TKR) By Dr. Neelam
Venktramana Reddy
Dr. N eelam Venkatramana Reddy is one of
the leading Orthopaedic Surgeons in
Hyderabad with extensive experience in the area
of joint replacement for a span of fifteen years.
Book An Appointment Now ! Call us on 040 44 777
777
27www.neelamramanareddy.com