Soft Tissue Incision Research Articles

Multiple Needle Puncturing: Balancing the Varus Knee

The so-called "pie crusting" technique using multiple stab incisions is a well-established procedure for correcting tightness of the iliotibial band in the valgus knee. It is, however, not applicable for balancing the medial side in varus knees because of the risk for iatrogenic transsection of the medial collateral ligament (MCL). This article presents our experience with a safer alternative and minimally invasive technique for medial soft tissue balancing, where we make multiple punctures in the MCL using a 19-gauge needle to progressively stretch the MCL until a correct ligament balance is achieved. Our technique requires minimal to no additional soft tissue dissection and can even be performed percutaneously when necessary. This technique, therefore, does not impact the length of the skin or soft tissue incisions. We analyzed 61 cases with varus deformity that were intraoperatively treated using this technique. In 4 other cases, the technique was used as a percutaneous procedure to correct postoperative medial tightness that caused persistent pain on the medial side. The procedure was considered successful when a 2- to 4-mm mediolateral joint line opening was obtained in extension and 2 to 6 mm in flexion. In 62 cases (95%), a progressive correction of medial tightness was achieved according to the above-described criteria. Three cases were overreleased and required compensatory release of the lateral structures and use of a thicker insert. Based on these results, we consider needle puncturing an effective and safe technique for progressive correction of MCL tightness during minimally invasive total knee arthroplasty.

Pott's puffy tumor in a 5-year-old male and a review of the literature

Pott's puffy tumor is a rare entity, described as a subperiosteal abscess associated with underlying cranial osteomyelitis. It is more commonly seen in the adolescent age group and may result from frontal sinusitis or trauma. We present a case of a 5-year-old male with forehead swelling, meningitis, and brain abscess communicating between epidural and subdural spaces. Treatment included 8 weeks antibiotic therapy with broad spectrum coverage of anerobic and aerobic organisms. Initial surgical approach included soft tissue incision and drainage of abscess, right frontal sinus trephine, and right endoscopic sinus surgery. One week after his initial procedure, he returned to OR for right pterional craniotomy for drainage of multiple intracranial abscesses. Total inpatient care was 4 weeks duration, and a full recovery was achieved with no long term neurological sequelae. We include an updated review of the literature of pediatric Pott's puffy tumor in children less than 10 years of age.

In vitro study of the soft tissue effects of microsecond‐pulsed CO2 laser parameters during soft tissue incision and sulcular debridement

Carbon dioxide (CO(2)) lasers are an important part of dental treatment. Advances in laser technology have produced microsecond pulse durations and small beam sizes. The histological effects of porcine intraoral soft tissue with a range of microsecond-pulsed CO(2) laser parameters used for incision and sulcular debridement were evaluated in vitro and compared with historical histologic data. Fresh pig mandibles were used to perform incision and sulcular debridement using a microsecond-pulsed CO(2) laser. lambda = 10,600 nm, articulated arm delivered non-contact with spot size 200 microm, 500 microm, and 1 mm, and focal distance of 1 mm. For sulcular debridement, epithelium within periodontal pocket (6 mm x 6 mm) was removed. Laser parameters for incision were from 30 Hz, 350 microseconds, 28 mJ and energy density of 143 J/cm(2) to 90 Hz, 1,000 microseconds, 60 mJ, and 1,911 J/cm(2). Width and depth of tissue removed, as well as coagulation effects of the tissue treated were measured. These were compared to historical histologic database. Laser-treated surfaces were observed qualitatively using scanning electron microscopy (SEM). All laser parameters studied were able to reach the defined simulation objectives in reasonable amounts of time, less than a minute for incision and <20 seconds for sulcular debridement. The depth of the cut was significantly greater than the historical 95% confidence interval, but equivalent for width, lateral, and deep coagulation to the historical database. Sulcular debridement was achieved with minimal coagulation, <100 microm. SEM analysis did not identify any alteration to enamel, dentin, or bone during sulcular debridement. The treatment objectives of incision and sulcular debridement were achieved with minimal lateral and deep coagulation in reasonable amount of time. Microsecond-pulsed CO(2) lasers can be safely and effectively used for incision and sulcular debridement.

Quadsparing-Zugang bei Knietotalendoprothesenimplantation

Approach to the knee joint for total knee arthroplasty (TKA) with gentle soft-tissue handling. Primary TKA with range of motion>or=100 degrees, leg axis up to 10 degrees varus or valgus, body weight<100 kg. Contracted knees, leg axis>10 degrees varus or valgus, obesity, previous knee surgery except arthroscopic procedures, rheumatoid arthritis. Anterior midline incision. Soft-tissue preparation and capsule incision start at the upper tip of the patella and are continued distally along the medial patellar border ending at the tibial tuberosity. After opening of the joint, the patella is dislocated laterally without everting it. Exposure of the articular surface using a "mobile window". Preparation and insertion of the TKA components using special instruments. Wound closure in layers. Mobilization on crutches with full weight bearing starting on the day of surgery. Daily medical training therapy. Passive motion therapy continued twice a day. Low-dose heparin s.c. for 35 days after surgery. In a prospective randomized clinical study, 50 patients with a quadsparing (QS) approach were observed up to 3 months after surgery. In three patients, the use of large femoral components required an extended approach. During the hospital stay knee flexion was significantly greater in patients with the QS approach than in patients with the standard procedure (midvastus approach). There were no differences in implant positioning, Knee Society Score and complication rate between both groups. Use of the QS approach prolonged the duration of surgery by 25 min.

Poster 049: Maxillary Vestibular Incision for Surgically Assisted Rapid Palatal Expansion: Evidence for a Conservative Approach

Introduction: Surgically assisted rapid palatal expansion (SARPE) is a widely used, simple, effective, and stable procedure in the correction of severe maxillary transverse deficiencies. Esthetic changes after SARPE depend not only on the bony architecture, but also alteration in the superjacent soft tissue. It has been suggested that soft tissue changes may be more affected by the type and position of the soft tissue incision and methods of closure than by the surgically induced hard tissue change. The traditional bilateral mucoperiosteal incision made from the piriform rims to zygomatic buttress can cause muscle detachment during stripping of the periosteum which shortens and retracts laterally causing thinning of the upper lip, decrease of visible vermillion and flaring of the alar base. Our aim was to present a conservative alternative approach to the traditional maxillary vestibular incision and to evaluate soft tissue changes in upper lip length, vermillion width, and alar base width between patients who received a traditional incision and those of a conservative incision.

口腔軟組織疾患に対するＥｒ，Ｃｒ：ＹＳＧＧレーザーの臨床評価

Recently, CO2 lasers, diodelasers, Nd: YAG lasers, Er: YAG lasers, and Ho: YAG lasers have been used in dental treatment. A new laser device, Er, Cr: YSGG laser, has been developed that can be used for hard tissue ablation and soft tissue incision. Moreover, since use of this laser device hardly causes any sharp pain to occur when making incisions in soft tissue, the operation using this laser can be performed without local anesthesia. The purpose of this clinical study was to examine the clinical evaluation of oral soft tissue diseases that were treated by incision using a surgical scalpel and an Er, Cr: YSGG laser device. Sixty patients (28 males; 32 females), with gingival hyperplasia (n=20), gingival polyp (n=20), or abnormalities of the frenum (n=20) were selected and randomly divided to a control group treated by incision with a surgical scalpel and a laser treatment group. The scores of the clinical evaluations were recorded before treatment and immediately, 1 week, 2 weeks, and 4 weeks after treatment. The total scores of each case in the control group and laser treatment group were calculated and divided into three categories (very effective: 100-80, effective: 79-60, and no effect: 59-0). All cases treated using the Er, Cr: YSGG laser device fall into the very effective category, and there were no complications or side effects during the follow-up period of this clinical study. In conclusion, these results suggest that the Er, Cr: YSGG laser device had equal efficiency and safety compared to use of a surgical scalpel in the treatment of oral soft tissue diseases. Moreover, since the Er, Cr: YSGG laser could be employed without the use of local anesthesia in many cases, it was deemed extremely suitable for use in treating elderly or hypertension patients.

一からわかるレーザー歯科治療

Laser therapy is currently applied in various dental fields. Lasers are used not only in oral surgery such as soft tissue incision and coagulation, but also for periodontal therapy, pulp treatment including pulpectomy and infected root canal treatment, tooth preparation, dental caries prevention, and pain relief and acceleration of wound healing for stomatitis, dentin hypersensitivity, and temporomandibular disorder. The laser systems used in dental treatment are mainly divided into two types based on the characteristics of the wavelength: the surface absorption type and the tissue penetration type. The absorption characteristics vary depending on the laser wavelength, and the influence of laser irradiation on body tissues is especially dependent on absorption by water, which accounts for approximately 70% of the body. The Er: YAG and carbon dioxide (CO2) lasers have particularly high water absorption characteristics, and almost all the laser energy is absorbed in the most superfi cial tissue layer and the irradiation does not penetrate into deep tissues. In contrast, lasers with a wavelength in the visible to near-infrared range reach deep tissues, since this energy is unlikely to be absorbed by water. Therefore, Er: YAG and CO2 lasers are superior in terms of vaporization efficiency, whereas visible to near-infrared lasers have stronger coagulation effects. Power density and oscillation mode are also key factors that determine laser characteristics, and the clinical effects of lasers are characterized by a combination of these factors and wavelength.

Side-Firing Germanium Oxide Optical Fibers for Use with Erbium:YAG Laser

During recent experimental studies, the erbium:YAG laser has been shown to be more efficient for lithotripsy and more precise for incision of soft urinary tissues than the conventional holmium:YAG laser. Mid-infrared optical fibers are being developed to allow endoscopic delivery of Er:YAG laser radiation. This paper describes the simple construction and characterization of a side-firing germanium oxide fiber for potential use with the Er:YAG laser in endourology. The 450-microm-core side-firing fibers were constructed from germanium oxide fibers by polishing the distal tip at a 45 degrees angle and placing a protective quartz cap over the tip. The Er:YAG laser radiation, with a wavelength of 2.94 microm, was transmitted through the fibers. The fiber transmission rate and damage threshold measured 48 +/- 4% and 149 +/- 37 mJ, respectively (n = 6 fibers). Sufficient pulse energies were transmitted through the side-firing fibers to produce contact tissue ablation.

Therapeutic applications of lasers in urology: an update

There has been renewed interest in the use of lasers for minimally invasive treatment of urologic diseases in recent years. The introduction of more compact, higher power, less expensive and more user-friendly solid-state lasers, such as the holmium:yttrium–aluminum–garnet (YAG), frequency-doubled neodymium:YAG and diode lasers has made the technology more attractive for clinical use. The availability of small, flexible, biocompatible, inexpensive and disposable silica optical fiber delivery systems for use in flexible endoscopes has also promoted the development of new laser procedures. The holmium:YAG laser is currently the workhorse laser in urology since it can be used for multiple soft- and hard-tissue applications, including laser lithotripsy, benign prostate hyperplasia, bladder tumors and strictures. More recently, higher power potassium–titanyl–phosphate lasers have been introduced and show promise for the treatment of benign prostatic hyperplasia. On the horizon, newer and more effective photosensitizing drugs are being tested for potential use in photodynamic therapy of bladder and prostate cancer. Additionally, new experimental lasers such as the erbium:YAG, Thulium and Thulium fiber lasers, may provide more precise incision of soft tissues, more efficient laser lithotripsy and more rapid prostate ablation. This review provides an update on the most important new clinical and experimental therapeutic applications of lasers in urology over the past 5 years.

Incision design in implant dentistry based on vascularization of the mucosa

The delivery of an adequate amount of blood to the tissue capillaries for normal functioning of the organ is the primary purpose of the vascular system. Preserving the viability of the soft tissue segment depends on the soft tissue incision being properly designed in order to prevent impairment of the circulation. A knowledge of the course of the vessels as well as of their supply area are crucial to the decision of the incision. The aim of this study was to visualize the course of the arteries using different techniques, to perform macroscopic- and microscopic analyses, and to develop recommendations for incisions in implant dentistry. The vascular systems of seven edentulous human cadavers were flushed out and filled with either red-colored rubber bond or Indian ink and formalin mixture. After fixation a macroscopic preparation was performed to reveal the course, distribution and supply area of the major vessels. In the area of the edentulous alveolar ridge specimens of the mucosa were taken and analyzed microscopically. The analyses revealed the major features of mucosal vascularization. The main course of the supplying arteries is from posterior to anterior, main vessels run parallel to the alveolar ridge in the vestibulum and the crestal area of the edentulous alveolar ridge is covered by a avascular zone with no anastomoses crossing the alveolar ridge. The results suggest midline incisions on the alveolar ridge, marginal incisions in dentated areas, releasing incisions only at the anterior border of the entire incision line, and avoidance of incisions crossing the alveolar ridge.

Low-invasive Soft Tissue Incision with 6.1.MU.m-light Irradiation-Gelatin Ablation Properties-

For low-invasive laser treatment, stable absorption properties of tissue during laser treatment are essentially needed, which enable us to predict irradiation effect (ablation depth, thermally-altered depth) using them. There are water and proteins as main absorber in the mid-infrared range. During laser treatment, the absorption properties of soft tissue are changed due to laser-induced temperature rise and leading to the induction of unexpected irradiation effects. We have proposed and demonstrated a novel, low-invasive laser surgery with 6.1-μm-light irradiation. 6.1-μm-light can resonantly excite both OH bending (water) and amide-I (proteins). The absorption properties of soft tissue during laser treatment would be come considerably stable because they do not remarkably depend on the surrounding temperature and the water concentration. We examined the gelatin ablation properties by λ=6.1-μm irradiation using a tunable mid-infrared Free-Electron Laser and showed that λ=6.1-μm irradiation is one of the candidates for a low-invasive soft tissue incision. Gelatins were used as a model substrate for soft tissue. From these experiments, it was found as follows. (1) Enhanced gelatin ablation occurred near λ=6.1-μm, but not λ=6.45-μm (Amide II of proteins). (2) The gelatins were removed due to water vaporization, which is reflected in the static absorption properties of the gelatin before laser irradiation. Thus, we showed the applicability of λ=6.1-μm -light for a new light source to realize a low-invasive soft tissue incision.

A clinical investigation on the surgical approach and fixation in operative treatment zygomatic fractures

To investigate the effect of soft tissue incision and rigid internal fixation in the treatment of zygomatic fracture. 70 cases with zygomatic fracture were entered into the study. The clinical data of 65 patients who were performed operations in the treatment were analyzed. The study focused on the incision, number and locations of Titanium plate. The facial contour, reduction,fixation, healing of incision, facial bisymmetry and complications of the operation were followed up 3 - 24 months after surgery. All the incisions were primary healing. Clinical and radiologic assessment of reduction was symmetric and stable in 91.5% of all cases, asymmetric in 8.5% of all cases. Subcutaneous hematoma happened in 5 cases, Ti plate exposure 1 in case, scalp scar width was more than 0.5 cm in 6 cases, frontal part or scalp paresthesia 8 cases. Coronal scalp incision has advantages such as good exposure, precise removal of the bone block and good symmetry of both sides. RIF can improve the stability of fracture, promotes fracture healing and guarantees the rehabilitation of zygomatic complex. direct reduction and rigid internal fixation with Titanium microplate or miniplate are satisfactory in zygomatic fracture.

Soft tissue healing after parasagittal palatal incisions in segmental maxillary surgery: A review of 311 patients

Purpose: This study retrospectively evaluated the soft tissue healing after using parasagittal soft tissue incisions for surgical segmental maxillary expansion. Patients and Methods: The records of 311 patients (224 females, 87 males), with an average age of 28.5 years (range, 12 to 62 years) who had transverse maxillary hypoplasia, were retrospectively evaluated. All patients underwent segmental maxillary osteotomies, surgical maxillary expansion greater than 5 mm, and placement of midpalatal porous block hydroxyapatite (PBHA). Parasagittal palatal soft tissue incisions were used to facilitate expansion, minimize soft tissue damage, and maintain soft tissue coverage over the PBHA implants. At postoperative follow-up visits, any signs or symptoms of complications associated with the use of the parasagittal incisions were recorded. Results: Average patient follow-up was 3.4 years (range, 1.0 to 7.2 years). In 293 patients (94%), the palates healed uneventfully without complications. Eighteen patients (6%) had complications; 9 (2.9%) had infections associated with the midpalatal implants, 8 (2.6%) had oronasal communications, and 1 (0.3%) had problems associated with a palatal wire. Six patients with midpalatal implant problems required removal of the implant, 4 patients required closure of their oronasal communications, and 1 patient required removal of a palatal wire. Therefore, 11 patients (3.5%) required minor secondary surgical procedures. No teeth or alveolar bone were lost in any of the cases. Conclusions: The use of parasagittal palatal incisions appears to be a safe technique for soft tissue management during large surgical maxillary expansions associated with segmental maxillary osteotomies and midpalatal placement of PBHA implants. © 2002 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 60:20-25, 2002

Laser Incisional Surgery

Soft tissue surgery is more efficient, and sometimes more effective, using laser incisional surgery as opposed to standard techniques. The modern generation of lasers produces soft tissue incisions with a minimum amount of thermal damage at wound edges. The transition to laser incisional surgery requires a knowledge of methods, maneuvers, and safety information.

Incision properties and thermal effects of three CO 2 lasers in soft tissue

It was the aim of this study to determine thermal and histologic events resulting from soft tissue incision with three CO2 lasers: one emitting light energy via a hollow waveguide at 9.3 microns; the others emitting light energy at 10.6 microns, one via a hollow waveguide, the other through an articulated arm delivery system. Thirty standardized incisions were made in the oral mucosa of pig's mandibles with three different lasers at actual power levels of 1, 4 and 12 W. Thermal events were recorded with thermocouples, and a histologic examination was performed to determine vertical and horizontal tissue damage as well as incision depth and width. Thermal and histologic results were related to parameters and beam characteristics rather than wavelength. In addition to wavelength, many variables can contribute to the surgical characteristics of a laser.

Temporalis tendon release during mandibular sagittal ramus split osteotomy

Since the original description of the sagittal ramus six dissected specimens (Fig 2). The lingual nerve was also identified and found to be consistently inferior and medial to the temporalis tendon. The tendinous tissue was always easily distinguishable from nerve tissue. The lingual nerve location has been previously described as being on average 0.58 mm + 0.9 horizontally from the lingual plate and 2.28 mm f 1.96 on the average vertically below the alveolar crest (Fig 3).5 This location, verified in the cadaveric dissections, is clearly distinct from the location of the temporalis tendon. split osteotomy by Obwegeser,’ there have been a number of modifications to decrease relapse, reduce complications, and improve the ease with which the osteotomy is performed. Most modifications have dealt with changes in osteotomy design or soft tissue reflection.2.3 Our modification focuses on the insertion of the temporalis muscle and its influence on medial access, tissue reflection, and relapse. It involves elevation and transection of the tendonous insertion of the anterior temporalis muscle along the medial aspect of the mandibular body. Classically, the insertion of the temporalis muscle is described as being into the upper and anterior borders of the coronoid process, with the major portion on the medial side of the ramus and entire medial side of the coronoid. However, Hollinshead4 also found the anterior temporalis insertion to include the anterior part of the ramus, extend’hrg approximately to the third molar region.4 Clinically this is seen as a horizontal tendinous band that runs along the internal oblique ridge just superficial to the periosteum. It is found directly medial to the most common soft tissue incision used for the bilateral sagittal ramus split osteotomy, and is exposed and reflected each time the medial ramus is approached, often appearing as a tight band. After the sagittal ramus split osteotomy, the tendinous insertion remains attached to the distal or advancing segment of the mandible (Fig 1). This structure is easily indentified and has been verified on multiple cadaveric dissections. On exposure of the anterior insertion, the temporalis tendon was found to extend to the distal aspect of the second molar tooth in each of

Bleeding of pulmonate snails

A technique for removing blood (haemolymph) by syringe from African land snails (Achatina spp.) is described. The method avoids the need for shell perforation or incision of soft tissues and appears to have few adverse effects on the snail.

Effective one-visit therapy for the acute periapical abscess

Nineteen patients with acute periapical abscess, i.e. frank soft tissue swelling associated with an endodontically involved tooth, were treated using a single-visit endodontic protocol. Only teeth with one or two canals were included in case selection. The treatment consisted of (a) soft tissue incision and drainage of the fluctuant swelling; (b) standardized endodontic preparation and obturation procedures; and (c) proper antibiotic regimen. None of the patients treated according to this protocol experienced exacerbations of presenting signs and symptoms after treatment. Complete resolution of swelling was achieved within 3 to 7 days. All of the patients who were contacted at 24-h postoperatively gave the subjective impression that their initial pain had been significantly decreased or completely resolved. At the 1-yr recall appointment, 11 of the original 19 patients returned. All were asymptomatic and showed radiographic evidence of reduction in lesion size. Nineteen patients with acute periapical abscess, i.e. frank soft tissue swelling associated with an endodontically involved tooth, were treated using a single-visit endodontic protocol. Only teeth with one or two canals were included in case selection. The treatment consisted of (a) soft tissue incision and drainage of the fluctuant swelling; (b) standardized endodontic preparation and obturation procedures; and (c) proper antibiotic regimen. None of the patients treated according to this protocol experienced exacerbations of presenting signs and symptoms after treatment. Complete resolution of swelling was achieved within 3 to 7 days. All of the patients who were contacted at 24-h postoperatively gave the subjective impression that their initial pain had been significantly decreased or completely resolved. At the 1-yr recall appointment, 11 of the original 19 patients returned. All were asymptomatic and showed radiographic evidence of reduction in lesion size. Diezinueve pacientes con absceso periapical agudo, por ej. franco edema de los tejidos blandos asociado a un diente con patología endodóntica fueron tratados en una sola sesión endodóntica. El tratamiento consistió en (1) incisión del tejido blando y drenaje del edema fluctuante, (2) preparación endodóntica estandardizada y obturación del o los conductos, y (3) indicación correcta de antibiótico. Ninguno de los pacientes tratados de esta forma experimentó exacerbaciones de los signos y síntomas presentes después del tratamiento. La resolución completa del edema se obtuvo entre los 3 y 7 días. Todos los pacientes con los que se puso en contacto a las 24 hs del postoperatorio, dieron la impresión subjetiva de que el dolor inicial habíá disminuído significativamente o había desaparecido. Once de los 19 pacientes regresaron para un control postoperatorio al cabo de un año. Todos estaban asintomáticos y habia evidencias radiograficas de reduccion en el tamaño de la lesión. Diezinueve pacientes con absceso periapical agudo, por ej. franco edema de los tejidos blandos asociado a un diente con patología endodóntica fueron tratados en una sola sesión endodóntica. El tratamiento consistió en (1) incisión del tejido blando y drenaje del edema fluctuante, (2) preparación endodóntica estandardizada y obturación del o los conductos, y (3) indicación correcta de antibiótico. Ninguno de los pacientes tratados de esta forma experimentó exacerbaciones de los signos y síntomas presentes después del tratamiento. La resolución completa del edema se obtuvo entre los 3 y 7 días. Todos los pacientes con los que se puso en contacto a las 24 hs del postoperatorio, dieron la impresión subjetiva de que el dolor inicial habíá disminuído significativamente o había desaparecido. Once de los 19 pacientes regresaron para un control postoperatorio al cabo de un año. Todos estaban asintomáticos y habia evidencias radiograficas de reduccion en el tamaño de la lesión.

Immediate surgical repositioning of one- and two-tooth dento-osseous segments

Variable occlusal deformities in 20 adult patients were corrected by immediate repositioning of one- and two-tooth dento-osseous segments. Complications and the technical problems in planning and design of the necessary osteotomies are discussed and illustrated by three case reports. Modifications in the design of the bony and soft tissue incisions were made to pedicle the mobilized segments to lingual or labio-buccal soft tissue. Proper flap design and surgical technique insures adequate intrapulpal and intraosseous circulation and prevents avascular necrosis, non-union, and devitalization of teeth. Clinical results substantiate the basic biologic premises formulated from previous animal investigations.

Aluminous enclaves in gedrite-cordierite gneiss from southwestern new hampshire

<h3>Background:</h3> Total knee arthroplasty (TKA) is the gold-standard treatment for end-stage knee osteoarthritis (OA). An increase in the prevalance of primary and revision TKA is projected due to aging of the population, increase in the obesity and OA prevalence, patients‘ quality of life perceptions and primary TKA procedures. Although TKA reliably improves pain and function; gait ability and function are still low compared to normal levels [1]. It is important to understand the prognosis to decide to undergo a rTKA (revision total knee arthroplasty) or enhance treatment protocols [2]. <h3>Objectives:</h3> The aim of the study is to compare the functional results of primary and revision TKA. <h3>Methods:</h3> Hospital Of Special Surgery knee score (HSS), The Figure-Of-8 Walk Test (F8WT), The Modified Four Step Square Test (mFSST) and the 3-Meter Backwards Walk Test (3MBWT) were used for function assessment. <h3>Conclusion:</h3> Functional status, fall risk, balance and walking skills of the rTKA patients were lower than the TKA patients. rTKA patients experience longer operation time, hospital stay and make fewer functional gains. Improvement after rTKA is also reported to be lower than TKA and balance could be worsened or does not improve after TKA [2]. Walking skills of the rTKA patients were worse than the TKA patients which may cause rTKA patients to be more cautious and tentative due to fear of falling and failure of the implant leading a more impaired function [2]. rTKA patients’ balance was lower and had more fall risk than the patients with TKA. These may be due to the recurrent incision of soft tissues causing a loss of more mechanoreceptors and a greater impairment of proprioception. These findings can help clinicians to make a more informed decision for both primary and revision procedures [3]. <h3>