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Basic most important tips and tricks for treatment of the non-infected unhappy total knee arthroplasty - what to do?

Published in N°016 - March / April 2022
Article viewed 78 times

Basic most important tips and tricks for treatment of the non-infected unhappy total knee arthroplasty - what to do?

By Michael T. Hirschmann , Manuel Sava, Dominic Mathis in category TECHNIQUE
Département d'orthopédie et de traumatologie, Kantonsspital Baselland, CH-4101 Bruderholz, Suisse / [email protected]

About 10-30 % of the patients after total knee arthroplasty (TKA) report ongoing or recurrent pain or are not satisfied after TKA and some require subsequent revision surgery. The number of revision TKAs is rising in many countries all over the world. National registries report revision rates between 3 and 12 %, depending on the length of the observed period and included interventions.

About 10-30 % of the patients after total knee arthroplasty (TKA) report ongoing or recurrent pain or are not satisfied after TKA and some require subsequent revision surgery. The number of revision TKAs is rising in many countries all over the world. National registries report revision rates between 3 and 12 %, depending on the length of the observed period and included interventions (1,2). Previous studies have analysed failure modes after primary TKA. According to those results, five most common failure modes could be identified (1,2) (Table 1)

Table 1: most frequent failure modes

 

Most data on the causes of TKA failure and further revision surgery are obtained from national joint registries, health care providers and multicentre studies (1,2). This article aims to emphasize on basic tips and tricks for revision total knee arthroplasty (TKA) and represents the perspective of a specialized revision center.

 

Diagnostic algorithm

Standardised diagnostic algorithm should be run in specialized centers for knee arthroplasty including revisions! Such a diagnostic algorithm (Fig.1) helps to standardize diagnostics and subsequent treatment of patients with problems after TKA. This algorithm needs to be adapted to local hospital conditions.

Figure 1 : Algorithme standardisé pour...

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