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Indications for UKR Surgery

  • Unicompartmental pain / Osteoarthritis (OA)

Indications for PFJ Surgery

  • Patellofemoral joint pain / OA

Indications for TKR Surgery

  • Pain on mobilising
  • Restricted range of movement
  • Tibial and/or femoral OA
  • Functional Restrictions
  • Progression from a UKR

Possible complications of Surgery:

  • Infection
  • Bleeding
  • Nerve damage
  • Deep Vein Thrombosis
  • Pulmonary embolism
  • Persistent/ Recurrent Pain
  • Failure of prosthesis
  • Patello-femoral instability and other complications
  • Peri-prosthetic fractures, especially of the femur (supracondylar)
  • Neurological complications: peroneal nerve palsy / altered sensation post-op

More Information

Surgical Techniques
TKR e.g. PFC, Triathlon, Vanguard, Genus II
• The most common form of total knee replacement is the unconstrained
• The femoral and tibial components are not joined together therefore the stability of the knee comes from patients own ligamentous support
 
Constrained TKR e.g. SMILES
• These tend to be used in patients with poor ligamentous stability and/or severe joint deformity
• The femoral and tibial components are joined together with a hinge to give stability that would otherwise have been provided by patients own ligaments.
• Due to its constrained nature normally patients will be restricted to achieve knee flexion to 90° with this prosthesis, but not always the case.
 
UKR
• Medial or lateral compartment replaced, therefore one femoral condyle metal component and one tibial metal component, with or without a patella component. This replacement often has a plastic spacer attached to the metal tray of the tibial component which can be replaced if worn.
• Offers normal knee kinematics • Bone stock preserved and much less surgical dissection
 
PFJR
• Front of trochlea groove removed and resurfaced with metal component. Posterior surface of patella may also be resurfaced
• Bone stock preserved and much less surgical dissection Will often allow hyperextension
 

Patients will be referred for follow-up physiotherapy in accordance with treating physiotherapist’s clinical reasoning. Reasons for referral to outpatient physiotherapy could include: difficulty achieving ROM, poor quadriceps function, functional deficit compared to pre-op mobility levels, deterioration of neurovascular status i.e. foot-drop and difficulty with independent HEP.

 
 

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