Abstract
BackgroundTotal knee arthroplasty represents a common orthopedic surgical procedure. Achieving proper alignment of its components with the predrilled patellar and tibial peg holes prior to polymerization of the bone cement can be challenging.TechniqueAfter establishing the femoral, patellar and tibial bone cuts, the cancellous bone around the tibial keel, as well as the peg holes for the patella and femoral components are marked with methylene blue using a cotton swab stick. If bone cement is then placed onto the cut and marked bone edges, the methylene blue leaches through the bone cement and clearly outlines the tibial keel and predrilled femoral and patellar peg holes. This allows excellent visualization of the bone preparations for each component, ensuring safe and prompt positioning of TKA components while minimizing intraoperative difficulties with component alignment while the cement hardens.ConclusionThe presented technical note helps to improve the accuracy and ease of insertion when the components of total knee arthroplasty are impacted to their final position.
Highlights
Total knee arthroplasty represents a common orthopedic surgical procedure
In the present technical note, we describe a simple modification prior to cementation of Total knee arthroplasty (TKA) components to ensure alignment of patella peg holes, tibial keel, and femoral prosthesis
The cancellous bone around the tibial keel, as well as the peg holes for the patella and femoral components are marked with methylene blue using a cotton swab stick
Summary
The prevalence of degenerative joint disease has seen a considerable increase due to general aging of the population [1,2,3]. In the present technical note, we describe a simple modification prior to cementation of TKA components to ensure alignment of patella peg holes, tibial keel, and femoral prosthesis. This surgical technique can be performed in as little as 30 seconds. Patellar and tibial bone cuts are established and the knee is balanced correctly, the cut bone surfaces are prepared for cementation in the choosen standard fashion At this point, the cancellous bone around the tibial keel, as well as the peg holes for the patella and femoral components are marked with methylene blue using a cotton swab stick. Having the appropriate positioning marked prior to component impaction or application of the patella clamp allows for fast completion of the surgical procedure avoiding repositioning of any components
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