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
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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