인공관절치환술 TKRA 수술과정 정형외과수술 total knee arthroplasty

문서 내 토픽

1. Surgical Approach

수술 접근법에 대해 설명합니다. 피부 절개, 망막 절개 방법 등을 다루고 있습니다.
2. Bone preparation

골 준비 과정에 대해 설명합니다. 필수적인 절단, 선택적인 절단, 대퇴골 및 경골 절단 등을 다루고 있습니다.
3. Patellofemoral Tracking

슬개대퇴 관절 추적에 대해 설명합니다. 슬개골 절제술, Q각 등을 다루고 있습니다.
4. Component implantation & Wound closure

구성 요소 삽입 및 창상 봉합에 대해 설명합니다. 구성 요소 삽입, 시멘팅, 봉합 등을 다루고 있습니다.

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1. Surgical Approach

The surgical approach is a critical aspect of total knee arthroplasty (TKA) as it can significantly impact the overall success of the procedure. The choice of surgical approach should be based on the surgeon's experience, patient anatomy, and the specific goals of the surgery. Common approaches include the medial parapatellar, lateral parapatellar, and subvastus approaches. Each approach has its own advantages and disadvantages, and the surgeon must carefully consider the patient's individual needs to determine the most appropriate approach. Factors such as exposure, soft tissue handling, and postoperative rehabilitation should be taken into account. Ultimately, the surgical approach should be tailored to the individual patient to optimize outcomes and minimize complications.
2. Bone preparation

Accurate bone preparation is essential for the successful outcome of total knee arthroplasty (TKA). This involves precise osteotomies to remove the diseased or damaged bone and create a stable platform for the implant components. The surgeon must carefully plan the bone cuts to ensure proper alignment, balance, and fit of the prosthetic components. This includes accurately measuring and resecting the distal femur, proximal tibia, and patella to achieve the desired joint line and limb alignment. Proper bone preparation also helps to ensure that the implant components are properly seated and secured, reducing the risk of instability, wear, and loosening over time. Meticulous attention to detail during the bone preparation stage is crucial for the long-term success of the TKA procedure.
3. Patellofemoral Tracking

Patellofemoral tracking is an important consideration in total knee arthroplasty (TKA) as it can significantly impact the patient's functional outcomes and satisfaction. Proper patellofemoral tracking ensures that the patella glides smoothly within the trochlear groove of the femoral component, minimizing the risk of anterior knee pain, instability, and patellar subluxation or dislocation. This requires careful balancing of the soft tissues, including the quadriceps tendon, retinaculum, and patellar tendon, as well as precise positioning and sizing of the femoral and patellar components. Factors such as patellar resurfacing, component design, and surgical technique can all influence patellofemoral tracking. Surgeons must have a thorough understanding of the complex biomechanics of the patellofemoral joint and employ various intraoperative techniques to optimize patellofemoral tracking and minimize the risk of complications. Careful attention to this aspect of TKA is crucial for achieving optimal patient outcomes.
4. Component implantation & Wound closure

The implantation of the prosthetic components and the subsequent wound closure are critical steps in total knee arthroplasty (TKA) that can significantly impact the overall success of the procedure. Proper component implantation involves ensuring accurate sizing, positioning, and alignment of the femoral, tibial, and patellar components to restore the natural joint mechanics and kinematics. This requires meticulous surgical technique, the use of appropriate instrumentation, and intraoperative assessment of component fit and function. Careful attention must also be paid to the soft tissue balancing and tensioning to achieve optimal joint stability and range of motion. The wound closure process is equally important, as it must be performed in a manner that minimizes the risk of postoperative complications, such as infection, hematoma, and wound dehiscence. Proper soft tissue management, suture technique, and the use of appropriate dressings and drains can all contribute to a successful wound closure and a smooth postoperative recovery. Ultimately, the successful implantation of the prosthetic components and the careful closure of the surgical site are essential for achieving the desired clinical outcomes and patient satisfaction in TKA.

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