Open AccessThe difficult primary total knee arthroplasty
Author(s) -
Andrea Baldini,
Lorenzo Castellani,
F. Traverso,
Amerigo Balatri,
Giovanni Balato,
Vincenzo Franceschini
Publication year - 2015
Publication title -
the bone and joint journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.587
H-Index - 181
eISSN - 2049-4408
pISSN - 2049-4394
DOI - 10.1302/0301-620x.97b10.36920
Subject(s) - medicine , coronal plane , patella , total knee arthroplasty , knee joint , arthroplasty , surgery , osteotomy , orthodontics , radiology
Primary total knee arthroplasty (TKA) is a reliable procedure with reproducible long-term results. Nevertheless, there are conditions related to the type of patient or local conditions of the knee that can make it a difficult procedure. The most common scenarios that make it difficult are discussed in this review. These include patients with many previous operations and incisions, and those with severe coronal deformities, genu recurvatum, a stiff knee, extra-articular deformities and those who have previously undergone osteotomy around the knee and those with chronic dislocation of the patella. Each condition is analysed according to the characteristics of the patient, the pre-operative planning and the reported outcomes. When approaching the difficult primary TKA surgeons should use a systematic approach, which begins with the review of the existing literature for each specific clinical situation.