PREOPERATIVE EVALUATION FOR TOTAL KNEE ARTHROPLASTY

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PREOPERATIVE evaluation FOR TKR:

Dr Arojuraye S.A NOHD-Kano PREOPERATIVE evaluation FOR TKR

Preoperative evaluation:

Preoperative evaluation Indications Severe pain not responding to conservative Rx Progressive deformity

Preoperative evaluation:

Preoperative evaluation History P ain- onset/duration Activity of daily living affectation Associated deformities: Varus / Valgus Drug hx Risk of vte Previous surgery / infections Social hx

Preoperative evaluation:

Preoperative evaluation Examination Head to toe Spine & Hip Gait Stability Deformities Knee score

Preoperative evaluation:

Preoperative evaluation Knee society scoring system 1989, updated in 2011 Symptom, alignment, function, satisfaction Score 80-100 (Excellent) Score 70-79 (Good) Score 60-69 (Fair) Score below 60 (Poor)

Preoperative evaluation:

Standing knee radiographs Anteroposterior view Lateral view Skyline view (patella ) Preoperative evaluation

Preoperative evaluation:

Preoperative evaluation Medical evaluation Most are elderly Comorbidities Smoking Fit for anaesthesia Able to withstand a blood loss up to 1500 ml

Preoperative evaluation:

Preoperative evaluation Routine preoperative laboratory investigation Complete blood cell count Electrolytes Urinalysis Blood grouping & cross matching

Preoperative evaluation:

Preoperative evaluation Other investigations CXR (cardiopulmonary dx) Coagulation studies (coagulopathy) Serum albumin (malnutrition) Doppler USS scan (Vascular disorders)

Preoperative evaluation:

Preoperative evaluation Informed Consent Surgery Anaesthesia Complications

Preoperative evaluation:

Preoperative evaluation Templating Anticipate approximate component size Bone defects that would need to be treated

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