tka

Here I will give you a full audio walk thru of a typical TKA from draping to closure.  Although previous episodes have gone into more detail of each individual part of the operation, this episode will take you through the procedure with a focus on knee position and retractor position from start to finish.  This should hopefully build on what you have listened to in previous episodes.

Again, I do not believe that this is the best or only way to do a TKA but it is a step-wise pattern that works well for me.

I believe that these are all important so I wanted to re-review some important operative tips.  I will review ways that you could potentially alter the alignment during the procedure.  We will also go over ways to control the saw and decrease potential contamination and infection.  Lastly, I will go over ways to be more efficient.  Remember: slow is smooth and smooth is fast.  Having a plan, working with teams and being purposeful can make you a more efficient surgeon.

Balancing a TKA is a long and complex topic.  It is also an art.  Individual biology can play a role.  I will review some tips on what I look for when balancing a knee.  The discussion will include both bony resections and soft tissue releases.  I will also cover some areas where you may inadvertently affect the balancing while implanting the TKA.

In this episode I will go over how I expose and prepare the tibia cut.  I will go over things to be aware of such as the tibial slope, rotation, cut thickness and tips on how to accurately pin your block and cut the tibia.

The PFJ and its kinematics are quite complex.  When dealing with the patella during TKA you have many options on how to prepare the patella.  Here I will discuss some of the options and go into detail how I expose and prepare the patella.

Listen to Mr Andrew Duckworth interview Dr Matt Abdel about his paper "Reliable outcomes and survivorship of primary total knee arthroplasty for osteonecrosis of the knee", published in the November 2019 issue of The Bone and Joint Journal.

Click here to read the article

Seeking to clarify its original MLN Matters guidance on total knee arthroplasty (TKA) issued earlier this month, the Centers for Medicare & Medicaid Services (CMS) released an updated memo on the subject on Thursday.

The latest version contains misdirection and ambiguity, the likes of which was first reported by RACmonitor, prompting CMS to rescind its initial memo. Reporting our lead story during the next edition of Monitor Mondays will be R. Phillip Baker, MD, medical director of case management at Self Regional Healthcare.

The broadcast rundown also will include:

• Monday Focus Report: Blockchain: Distributed ledger systems (DLS), also known as blockchain, will be the Monday Focus when RACmonitor investigative reporter and New York attorney Edward Roche will report on new healthcare technologies we can expect to see in 2019.
  
  
• War on Drugs: The U.S. Department of Justice announced this week that Walgreens Boots Alliance agreed to pay $269.2 million to settle two healthcare fraud lawsuits alleging that Walgreens overbilled the government. In a related matter, United HealthCare Services filed a federal lawsuit last week against more than 40 drug companies, alleging they violated federal and state antitrust laws. Whistleblower attorney Mary Inman will report on both lawsuits.
  
  
• Risky Business: Healthcare attorney David Glaser will return to Monitor Mondays with his popular segment “Risky Business,” in which he reports on problematic issues facing providers.
  
  
• Hot Topics: Monitor Mondays senior correspondent Nancy Beckley, president and CEO of Nancy Beckley and Associates, will return to report on all the latest hot topics.
  
  
• Monday Rounds: Ronald Hirsch, MD, vice president of R1 Physician Advisory Services, will be making his Monday Rounds with another installment of his popular segment.