approach

TSA Technique

TSR APTSR Lateral

 

Goal

- head that translates 50% in all directions

- allows 30o ER with arm at side

- stable posteriorly

 

Pre-Op 

- antibiotics

- consider specific Propionobacterium cover

Surgical Technique

ApproachRevision TKR Tibial Lysis

 

Incision

 

Always use the most lateral scar

- blood supply comes from medial aspect

- want to avoid a large lateral flap of dubious quality

- cross transverse scars at 90o

- minimum 7 cm skin bridge

 

Options

- can do trial / sham incision down to capsule

C Approach and Implant Removal

Pre-operative Planning


CT / quantify bone loss
X match 4 units
Cell saver
Anaesthetic review
Bone graft (cortical, cancellous)
Component removal gear

- extraction gear for femur / liners

- cement removers for cemented femur

- curved osteotomes for cemented cup

- X-plant for uncemented cup
Revision long stem femoral implants
Revision acetabular implants including cages

 

Arthroplasty

Indications

 

RA 

- very good results

- 97% 10 year survival Coonrad-Morrey prosthesis

 

Other Dx 

- OA / post-traumatic arthritis / nonunion

- tend to have worse survival than RA

 

Haemophilia

- elbow joint commonly involved

- 90% of haemophiliacs

 

Acute unreconstructable fracture > 60