Total Knee Arthroplasty
Table of Contents
- Following suitable premedication, the patient is taken to the operating room where general anesthesia is induced.
- The patient is placed in the supine position upon a carefully padded operative frame.
- A tourniquet is applied to the upper leg.
- The upper leg is prepped and draped as a sterile field.
- A midline incision is made over the knee.
- The capsule is opened in a medial parapatellar fashion.
- The patella is everted and the patellofemoral ligament is sacrificed.
- Continue exposure by medial release and partial meniscectomies.
- ACL is sacrificed.
- Bony cuts are made in this order: distal femur, then posterior femur, then proximal tibia.
- Trial components inserted.
- Pericapsular injections are done.
- Patella is then prepared.
- Trial components are placed and full flexion and extension are assessed.
- Femoral and tibial surfaces are cleaned and dried, then components are cemented.
- Excess cement is trimmed.
- Ensure that there is no impingement and medial and lateral cortical size are intact and component size is appropriate.
- The synovium is closed with 2-0 continuous Vicryl.
- The capsule is closed with #2 Quill in a double fashion.
- Re-check full extension and gravity flexion with the capsule closed.
- The subcutaneous tissues are closed with 2-0 and 3-0 Vicryl.
- The skin is closed with Monocryl and Dermabond.
- A sterile dressing is applied.
- The patient is awakened from general anesthesia and brought to the post-anesthesia care unit.
- Patient is discharged from the hospital on postoperative day #2.
- The patient is made weight bearing as tolerated.
- Postoperative follow-up visits are scheduled.
- Range of motion and physical therapy are scheduled.