医学
射线照相术
软组织
神经血管束
植入
关节置换术
畸形
体格检查
外科
冠状面
口腔正畸科
作者
Michael Tanzer,Asim M. Makhdom
出处
期刊:Journal of the American Academy of Orthopaedic Surgeons
[American Academy of Orthopaedic Surgeons]
日期:2016-04-01
卷期号:24 (4): 220-230
被引量:39
标识
DOI:10.5435/jaaos-d-14-00332
摘要
Preoperative planning is of paramount importance in primary total knee arthroplasty. A thorough preoperative analysis helps the surgeon envision the operation, anticipate any potential issues, and minimize the risk of premature implant failure. Obtaining a thorough history is critical for appropriate patient selection. The physical examination should evaluate the integrity of the soft tissues, the neurovascular status, range of motion, limb deformity, and the status of the collateral ligaments to help determine the soft-tissue balancing and constraint strategy required. Standard radiographs, with a known magnification, should be obtained for preoperative total knee arthroplasty templating. Routine standing AP, lateral, and skyline radiographs of the knee can help the surgeon plan the bone cuts and tibial slope as well as the implant size and position at the time of surgery. In certain circumstances, such as severe coronal deformities, bone deficiencies, and/or extra-articular deformities, additional measures are frequently necessary to successfully reconstruct the knee. Constrained implants, metal augments, and bone graft must be part of the surgeon's armamentarium.
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