DESCRIPTION OF PROCEDURE: The patient was taken to the operating room
and placed under anesthesia. The left knee was prepped and draped in
the usual sterile manner. A timeout was completed. The correct side
and site identified. An anterior incision was made, taken out through
the skin and subcutaneous tissue and fascia. Fascia divided along the
skin incision. Medial arthrotomy was made. Medial release was
performed. Medial and lateral gutters were repaired. Suprapatellar
synovium was removed. Severe arthritis removed with osteophytes.
Upon entering the knee, he had a large what appeared to be a synovial
cyst off the anteromedial aspect of his knee. I did find the entrance
hole for the cyst. We did expand this. We subsequently performed a
synovial cyst resection, debridement. The area was thoroughly irrigated
out with IrriSept. Again, we performed a cyst resection and debridement
of a large anteromedial synovial cyst.
After this was done, I placed my guide pin and placed in the distal
femur, placed my OrthAlign, hip was taken through range of motion. This
was registered, set to 0 degrees anterior-posterior and 0 degrees to
mechanical axis. I made my distal femur resection.
Proximal tibia was exposed. I registered off the lateral malleolus and
medial malleolus, set to 0 degrees varus and valgus, 3 degrees posterior
slope, made my tibial resection. The knee was flexed, sized to size 6.
The flexion gap equalled my extension gap. Made my anterior cut,
posterior cut, chamfer cuts, box cut, and ACL and PCL were removed. The
remaining medial and lateral meniscus was removed. Posterior
osteophytes were carefully removed. Care was taken to protect the
posterior neurovascular structures of the MCL and LCL. After this was
done, I placed my trials. I did have to go back and take 2 more mm off
the tibia because it was tight in flexion and extension. Overall, after
this was done, I was happy with this. Excellent fit, excellent bone
quality. Patella, interesting, really had no significant wear. It had
osteophytes, but really no significant wear. I removed the osteophytes.
I performed a lateral patellar facetectomy, circumferential neurotomy,
patella tracked centrally, marked on my tibial rotation, sized my tibia,
punched for my tibia, excellent quality of bone.
Thoroughly irrigated out the knee, pressing a size 6 femoral component,
size 6 tibial component, and no patellar component. We trialed them
going with a 7 mm AOX poly thickness. I had full extension, full
flexion, stable to varus and valgus. I was very happy with this.
Thoroughly irrigated out the knee. Placed my real poly. Tourniquet was
released. Hemostasis was obtained.
and placed under anesthesia. The left knee was prepped and draped in
the usual sterile manner. A timeout was completed. The correct side
and site identified. An anterior incision was made, taken out through
the skin and subcutaneous tissue and fascia. Fascia divided along the
skin incision. Medial arthrotomy was made. Medial release was
performed. Medial and lateral gutters were repaired. Suprapatellar
synovium was removed. Severe arthritis removed with osteophytes.
Upon entering the knee, he had a large what appeared to be a synovial
cyst off the anteromedial aspect of his knee. I did find the entrance
hole for the cyst. We did expand this. We subsequently performed a
synovial cyst resection, debridement. The area was thoroughly irrigated
out with IrriSept. Again, we performed a cyst resection and debridement
of a large anteromedial synovial cyst.
After this was done, I placed my guide pin and placed in the distal
femur, placed my OrthAlign, hip was taken through range of motion. This
was registered, set to 0 degrees anterior-posterior and 0 degrees to
mechanical axis. I made my distal femur resection.
Proximal tibia was exposed. I registered off the lateral malleolus and
medial malleolus, set to 0 degrees varus and valgus, 3 degrees posterior
slope, made my tibial resection. The knee was flexed, sized to size 6.
The flexion gap equalled my extension gap. Made my anterior cut,
posterior cut, chamfer cuts, box cut, and ACL and PCL were removed. The
remaining medial and lateral meniscus was removed. Posterior
osteophytes were carefully removed. Care was taken to protect the
posterior neurovascular structures of the MCL and LCL. After this was
done, I placed my trials. I did have to go back and take 2 more mm off
the tibia because it was tight in flexion and extension. Overall, after
this was done, I was happy with this. Excellent fit, excellent bone
quality. Patella, interesting, really had no significant wear. It had
osteophytes, but really no significant wear. I removed the osteophytes.
I performed a lateral patellar facetectomy, circumferential neurotomy,
patella tracked centrally, marked on my tibial rotation, sized my tibia,
punched for my tibia, excellent quality of bone.
Thoroughly irrigated out the knee, pressing a size 6 femoral component,
size 6 tibial component, and no patellar component. We trialed them
going with a 7 mm AOX poly thickness. I had full extension, full
flexion, stable to varus and valgus. I was very happy with this.
Thoroughly irrigated out the knee. Placed my real poly. Tourniquet was
released. Hemostasis was obtained.