Abstract
Total knee arthroplasty (TKA) has evolved particularly since the 1970s, with improvements in implants and surgical instruments, and has thus become an effective intervention for treating knee arthrosis. Many studies have presented rates of satisfactory clinical and radiological results greater than 90%, from follow-ups of over ten years. Nevertheless, despite scientific evidence showing the efficacy of TKA, the approaches taken present controversies in certain respects. The objective of this study was to evaluate how the Brazilian orthopedists deal with TKA, with investigation of the main aspects of this procedure. Cross-sectional survey conducted during the 39th Brazilian Congress of Orthopedics and Traumatology, in São Paulo, Brazil, in November 2007. We applied a questionnaire to orthopedists registered at the congress. The questionnaire was randomly distributed and participation was voluntary; 858 completed questionnaires were included in the analysis. Most of the Brazilian orthopedists were members of SBOT and worked in the southeastern region. They used imported cemented implants through an anterior access route centered on the patella, with replacement of the joint surface of the patella and preservation of the posterior cruciate ligament. They did not have experience with simultaneous bilateral TKA. Postoperatively, they used antibiotics and suction drains for 48 hours. There was no consensus regarding prophylaxis for venous thromboembolism or the frequency of the main complications. The majority of Brazilian orthopedists work in the southeastern region of the country and agree about the main aspects of the approaches towards TKA.
Highlights
Total knee arthroplasty (TKA) has evolved since the start of the 1970s, with improvements in the quality of implants and surgical instruments, and has become an effective intervention for treating knee arthrosis if conservative treatment fails
During the 39th Brazilian Congress of Orthopedics and Traumatology (BCOT), which was held in São Paulo, Brazil, between November 14 and 17, 2007, we applied a questionnaire to participating orthopedists, covering the methods they used and their preferences when performing TKA
With regard to the geographical region in which the respondents were working as orthopedists, we observed that 62% were in southeastern Brazil, while only 3% were in the north of the country (Graph 2)
Summary
Total knee arthroplasty (TKA) has evolved since the start of the 1970s, with improvements in the quality of implants and surgical instruments, and has become an effective intervention for treating knee arthrosis if conservative treatment fails. Many studies have presented rates of satisfactory clinical and radiological results greater than 90%, from follow-ups of over ten years.[1,2,3,4,5]. It is an effective surgical procedure,[1,2,3,4,5,6,7,8,9,10] several aspects of the approaches taken towards TKA present controversy. The parameters guiding us were previous cross-sectional studies published in Brazil.[12]
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