Operative Note |
PROCEDURE: Total knee arthroplasty. |
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SUMMARY: The patient was brought to the operating
room and placed supine on the operating table. He was given a spinal anesthetic with Duramorph in the spinal.
A
Foley catheter was inserted. He was given 2 grams of Ancef and a tourniquet was placed about the thigh. The extremity
was prepped and draped in the usual manner. The limb was elevated, exsanguinated, and the tourniquet inflated to 300 mm/Hg initially
for 70 minutes. It was then deflated for 10 and reinflated for another 15 minutes.
An anterior midline incision
was made with the distal end just distal to the tibial tubercle. Incision was made with the knife. Medial parapatellar
incision was made thereafter. Pin was placed in the tibia tubercle to prevent inadvertent avulsion and was removed at the end
of the case. Patella was pushed laterally and an intramedullary guide was used on the femur with a 6 degree valgus cut. An extramedullary guide was used on the tibia and after the tibial cuts were completed the femoral cuts were completed and then the
insert patella button was done with inset reamer. The knee was copiously irrigated, dried, and components cemented in place
in the standard manner using Polycose G cement. A tourniquet was deflated, bleeders coagulated as needed, and then the tourniquet
reinflated after 10 minutes for an additional 15 minutes as stated above. Hemovac was brought out proximally and laterally. The parapatellar incision and retinaculum was closed with 1 Vicryl. The subcutaneous with 0 Vicryl and the skin with staples. The incision was covered with Xeroform, Kerlix, and an anterior splint applied with the knee in extension. The splint was held
on with Ace wrap.
The patient tolerated the procedure well. No complications were sustained. Blood
loss was approximately 250 mL.
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