OrthopaedicPrinciples.com

Integrating Principles and Evidence

Integrating Principles and Evidence

-Knee Arthroplasty

Restricted Kinematic Alignment in TKR

Courtesy: Dr Makridis Konstantinos, Dr Ashok Shyam, Ortho TV Robotic-Assisted Total Knee Arthroplasty: Kinematic and Restricted Kinematic Alignment (rKA) Fundamental Biomechanics of Knee Kinematics Primary Cylindrical Flexion Axis: The transverse axis of the distal and posterior femoral condyles guides the flexion-extension arc. Asymmetric Native Rollback: During deep flexion, the medial femoral condyle exhibits minimal anteroposterior […]

Kinematic Alignment Pros and Cons

Courtesy: Dr Krishna Kiran, Dr Ashok Shyam, Ortho TV Knee Kinematics and Total Knee Arthroplasty Alignment Philosophies Native Knee Kinematic Anatomy Asymmetric Joint Morphology: Medial and lateral femoral condyles and tibial plateaus are asymmetric. Meniscal Constraints: The medial meniscus is firmly anchored to the deep medial collateral ligament (MCL). The lateral meniscus is mobile, sliding […]

Two Stage Revision, the Gold Standard for Infected TKR

Courtesy: Dr Hemant Wakankar, Dr Ashok Shyam, Ortho TV Two-Stage Revision for Periprosthetic Joint Infection (PJI) Core Concept & Rationale Primary Concern: Recurrent infection remains the main driver for choosing two-stage revision. Gold Standard: Two-stage exchange arthroplasty remains the benchmark for chronic PJI eradication. Microbiological Prerequisite: Discontinue all systemic antibiotics for at least 2 weeks […]

Femoral Revision – Monobloc & Modular Stems in TKR

Courtesy: Dr Vijay Bose, Dr Ashok Shyam, Ortho TV Revision Total Hip Arthroplasty: Monoblock vs. Modular Tapered Fluted Stems Historical Perspective & The Transatlantic Divide The American Philosophy (1980s–1990s): Popularized by Charles Engh and William Harris Jr., advocating extensively porous-coated cylindrical cobalt-chromium stems (e.g., AML). The European Philosophy: Heinz Wagner introduced the Wagner stem in […]

Intra Op and Post Op Cocktail in TKR

Dr David Mayman, Dr Ashok Shyam, Ortho TV Perioperative and Intraoperative Pain Management in Total Knee Arthroplasty Anesthesia Modalities: Neuraxial Dominance Nearly 100% of patients receive neuraxial anesthesia (spinal or epidural) unless clear medical contraindications exist. Contraindications: Extensive lumbar spine instrumented fusion, severe uncorrected coagulopathy, or pulmonary hypertension (which may necessitate controlled general anesthesia). Clinical […]

Indications and ContraIndications of Unicompartmental Knee Replacement

Courtesy: Mr Fahad Hossain, Walsall NHS Healthcare, UK Overview Both unicompartmental knee arthroplasty and high tibial osteotomy preserve bone stock and native soft tissues when compared to total knee arthroplasty. Both procedures provide more physiological knee kinematics and improved native proprioception relative to total knee arthroplasty. General Indications High Tibial Osteotomy Preferred in patients younger […]