TOTAL KNEE REPLACEMENT

DR NIRAJ KUMAR, SGRRIMHS DEHRADUN

1. DR. NIRAJ KUMAR , PT
ASSOCIATE PROFESSOR PHYSIOTHERAPY DEPT.
Shri Guru Rai Institute Of Paramedical Sciences ,
Dehradun

2. 1.Anatomy of the knee joint
2.Introduction
3.Definition
4.Indication (Common conditions
leading to TKR)
5.Contraindication
6.Orthopedics Evaluation
7.Management of TKR

3. Anatomy Of The Knee Joint

6. Three bones and three compartment

7. Midial
Lateral
Anterior
Posterior
Rotatory

8. INTRODUCTION

9. Definition

10. OSTEOARTHRITIS
A. Primary (idiopathic)
B. Secondary Post traumatic arthritis
RHEUMATOID ARTHRITIS
TKR DONE WHEN CONSERVATIVE MANAGEMENT
(NSAID & PHYSIO) IS FAILED TO RESTORE THE
MOBILITY AND RELIF THE PAIN THE KNEE JOINT.

12. Contraindication

13. Far more common than hip OA in asian
population
Age: 80% above 75 years
Sex: Equal in both sexes upto 45-55 years
After 55 years more common in
female.

14. Increasing age
Obesity
Female sex
Trauma
Infection
Repetitive occupational trauma

17. 1. Non Operative Treatment
Non pharmacologic therapy
Patient’s education
Use of assistive devices
Weight loss
Physical therapy
Occupational therapy
Pharmacologic therapy
NSAIDS
Glucosamine sulphate
Intra articular Corticoteroids
Intra articular Hyaluronic acid

18. 1. Partial knee replacement
2. Total knee replacement

19.  Fergussen(1860) resection
arthroplasty
 Verneuil performed first
interposition arthroplasty
1940s- first artificial implants were
tried when molds were fitted in the
femoral condyle
1950s- combined femoral and tibial
articular surface replacement
appeared as simple hinges

20. Frank Gunston(1971), developed a
metal on plastic knee replacement.
 John Insall(1973), designed what has
become the prototype for current total
knee replacements. This was a
prosthesis made of three components
which would resurface all three
surfaces of the knee - the femur, tibia
and patella

24. Large variety is available
Majority of TKR today are condylar
replacements which consist of the following
Cobalt-chrome alloy femoral component
Cobalt-chrome alloy or titanium tibial tray
UHMWPE tibial bearing component
UHMWPE patella component

25. A Complete Medical History
Thorough Physical Examination
Laboratory Work-up
 Anesthesia Assessment
25

26. 1.Standing full-length anteroposterior radiograph
from hip to ankle
1.Lateral knee x ray
2.Merchant’s view

27. Pain relief
Restoration of normal limb alignment
Restoration of a functional range of motion

28. Precise surgical technique
Sound implant design
Appropriate material
Patient compliance with rehabilitation

33. Post Operative Rehabilitation