Pre-operative Planning in Primary Total Knee Arthroplasty

Abstract

AbstractPre-operative planning is imperative for a successful outcome of knee arthroplasty. Thorough history taking is imperative for appropriate patient selection. The physical examination should include gait analysis, limb deformity assessment and degree of correctability, range of motion, the neurovascular status and assessment of the soft tissue status including the collateral ligaments to help determine the level of constraint required. Standard radiographs, with accurate magnification, should be obtained for pre-operative total knee arthroplasty templating. Routine standing Anteroposterior (AP), lateral and skyline radiographs of the knee aid the surgeon to plan the bony resection and select the right implant size and position at the time of surgery. Long-leg radiographs can be useful in case of any extra-articular deformity for placement of intramedullary guides. In certain circumstances, such as severe coronal deformities, bone deficiencies and/or extra-articular deformities, additional measures are frequently necessary to successfully reconstruct the knee. Use of constrained implants, augments and bone grafts must be anticipated in appropriate cases and should be a part of the surgeon’s inventory.KeywordsPre-operativeKnee arthroplastyTemplating