TKA with retained hardware guided by intraoperative ultrasonography – a case report
Abstract Background When a conservative management of gonarthrosis yields unsatisfactory results, a total knee arthroplasty (TKA) is recommended as an alternative approach. The implant survival is crucial for the long-term success of the procedure. However, in case of patients with retained hardware...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-09-01
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| Series: | BMC Surgery |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12893-019-0585-6 |
| _version_ | 1819112233250062336 |
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| author | Tomasz Poboży Konarski Wojciech Martyna Hordowicz |
| author_facet | Tomasz Poboży Konarski Wojciech Martyna Hordowicz |
| author_sort | Tomasz Poboży |
| collection | DOAJ |
| description | Abstract Background When a conservative management of gonarthrosis yields unsatisfactory results, a total knee arthroplasty (TKA) is recommended as an alternative approach. The implant survival is crucial for the long-term success of the procedure. However, in case of patients with retained hardware after past orthopedic procedures, providing correct alignment of the implant, which contributes to its longevity, is especially challenging. Here we present the use of an intra-operative ultrasonography for implant positioning in a 83-year-old male, undergoing TKA, without hardware removal, which was contraindicated due to his advanced age and comorbidities. Other imaging modalities taken into consideration are also described. Case presentation The right knee joint was approached with anterior incision. A femoral guide was introduced extramedullary. Ultrasonography was used to pinpoint the center of the femur’s head. Tibial’s guide was introduced intramedullary followed by a standard cut of the proximal part. Cemented ZIMMER NEXGEN prosthesis was used. Layered closure was applied. The placement of implant in neutral axis was confirmed on radiographs. Conclusions Our case demonstrates that ultrasonography might be helpful during TKA-procedure for implant positioning. However, more studies are needed to evaluate accuracy and application of ultrasound in the intraoperative settings. |
| first_indexed | 2024-12-22T04:10:15Z |
| format | Article |
| id | doaj.art-28d93629f07a45ec90823c0fde88f20f |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-12-22T04:10:15Z |
| publishDate | 2019-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-28d93629f07a45ec90823c0fde88f20f2022-12-21T18:39:32ZengBMCBMC Surgery1471-24822019-09-011911410.1186/s12893-019-0585-6TKA with retained hardware guided by intraoperative ultrasonography – a case reportTomasz Poboży0Konarski Wojciech1Martyna Hordowicz2Department of Orthopaedic Surgery, Medicover HospitalDepartment of Orthopaedic Surgery, Ciechanów HospitalHospice of St. Christopher, Outpatient Pain ClinicAbstract Background When a conservative management of gonarthrosis yields unsatisfactory results, a total knee arthroplasty (TKA) is recommended as an alternative approach. The implant survival is crucial for the long-term success of the procedure. However, in case of patients with retained hardware after past orthopedic procedures, providing correct alignment of the implant, which contributes to its longevity, is especially challenging. Here we present the use of an intra-operative ultrasonography for implant positioning in a 83-year-old male, undergoing TKA, without hardware removal, which was contraindicated due to his advanced age and comorbidities. Other imaging modalities taken into consideration are also described. Case presentation The right knee joint was approached with anterior incision. A femoral guide was introduced extramedullary. Ultrasonography was used to pinpoint the center of the femur’s head. Tibial’s guide was introduced intramedullary followed by a standard cut of the proximal part. Cemented ZIMMER NEXGEN prosthesis was used. Layered closure was applied. The placement of implant in neutral axis was confirmed on radiographs. Conclusions Our case demonstrates that ultrasonography might be helpful during TKA-procedure for implant positioning. However, more studies are needed to evaluate accuracy and application of ultrasound in the intraoperative settings.http://link.springer.com/article/10.1186/s12893-019-0585-6TKAExtramedullarRetained hardwareGonarthrosisUltrasonography |
| spellingShingle | Tomasz Poboży Konarski Wojciech Martyna Hordowicz TKA with retained hardware guided by intraoperative ultrasonography – a case report BMC Surgery TKA Extramedullar Retained hardware Gonarthrosis Ultrasonography |
| title | TKA with retained hardware guided by intraoperative ultrasonography – a case report |
| title_full | TKA with retained hardware guided by intraoperative ultrasonography – a case report |
| title_fullStr | TKA with retained hardware guided by intraoperative ultrasonography – a case report |
| title_full_unstemmed | TKA with retained hardware guided by intraoperative ultrasonography – a case report |
| title_short | TKA with retained hardware guided by intraoperative ultrasonography – a case report |
| title_sort | tka with retained hardware guided by intraoperative ultrasonography a case report |
| topic | TKA Extramedullar Retained hardware Gonarthrosis Ultrasonography |
| url | http://link.springer.com/article/10.1186/s12893-019-0585-6 |
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