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Technique guide are not considered high yield topics for orthopaedic standardized exams including the ABOS, EBOT and RC.
A 65-year-old man presents with aseptic loosening 3 years after total knee arthroplasty. The surgeon reviews radiographs of his knee and takes him to the operating room for revision total knee arthroplasty. During surgery, the exposure technique shown in Figure A is used. Which of the following radiographs (Figures B-F) has the greatest likelihood of needing this exposure technique?
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A 71 year-old-male who underwent a primary total knee replacement in 1990 presents with right knee pain and instability for the past several months. Current images are shown in Figure A and Figure B. Which of the following is the most appropriate treatment at this time?
Revision of tibial component only
Management with a knee immobilizer for 3 months
Revision of tibial component with LCL reconstruction
Revision of tibial and femoral components with stems and/or augments
Revision of tibial and femoral components without stems and/or augments
A 64-year-old female with rheumatoid arthritis is undergoing a left total knee arthroplasty. During the tibial cut, a ligament is transected by a reciprocating saw. The ligament is not able to be repaired. The surgeon is balancing the tibial and femoral cuts with sizing blocks and finds that the knee has valgus instability greater than 1cm in full extension. Which implant offers the most appropriate level of constraint while limiting the amount of implant-host interface stresses?
Unlinked constrained (varus-valgus constrained)
Fixed bearing PCL-substituting (posterior-stabilized)
Mobile bearing PCL-substituting (posterior-stabilized)
A 67-year-old female has elected to undergo total knee arthroplasty for degenerative arthritis. A pre-operative radiograph is provided in Figure A. Exposure to place the distal femoral cutting guide is difficult due to poor knee flexion following a standard medial parapatellar arthrotomy. Which of the following techniques will enhance the exposure without altering post-operative rehabilitation or clinical outcomes?
Complete release of the superficial and deep MCL
Extending the arthrotomy to an extensile rectus snip exposure
Converting to a mobile-bearing TKA design
When compared to the standard medial parapatellar approach for revision total knee arthroplasties, the oblique rectus snip approach showed impairment in which of the following post-operative outcomes?
WOMAC function score
no difference in outcomes
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HPI - Had knee revision three years following aseptic loosening
HPI - Patient had simultaneous B/L total knee joint replacement 1 year back.5 months after surgery patient developed pain in left knee joint.ESR and CRP was elevated ESR 90 CRP 35 Xrays showed lysis at the tibial base plate.
Aspirate from bilateral knee joint had polymorps more than 3000WBC/ml with majority of polymorps. Culture sensitivity was positive.
Implant were removed bilaterally. Antibiotic Impregnated articulated cement spacer were inserted using vacomycin inserted cement. Post operative antibiotic were continued for 6 weeks and then stopped. ESR had come down to 45 andCRP had fallen to 20.
Antibiotics were stopped for 3 weeks and B/L knee joint were aspirated which still showed counts more than 2000wbc/ml.culture was negative.
ESR at present is 25 and CRP is 17
No pain and range of motion is 0 to110 degree
Considering final CRP of 17 and ESR of 25 four weeks after stopping antibiotics and 10 weeks post spacer insertion, how would you treat the patient at this time.
HPI - Female 78 years old, with a left TKA revised 3 years ago, tripped on a small stair and fell on her opperated left knee.
How would you treat