The Journal of Bone and Joint Surgery (American) 85:S21-S25 (2003)
© 2003 The Journal of Bone and Joint Surgery, Inc.
Modes of Failure and Preoperative Evaluation
Khaled J. Saleh, MD, MSc, FRCSC,
Charles R. Clark, MD,
Peter F. Sharkey, MD,
James A. Rand, MD and
Gregory A. Brown, MD
Corresponding author: Khaled J. Saleh, MD, MSc, FRCSC
Department of Orthopaedic Surgery and Clinical Outcome Research Center, University of Minnesota, 420 Delaware Street S.E., Box 492, Minneapolis, MN 55455
The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. One or more of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity (Smith and Nephew). In addition, a commercial entity (Smith and Nephew) paid or directed, or agreed to pay or direct, benefits to a research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.
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Patient Evaluation
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The initial assessment of pain at the site of a total knee arthroplasty is critical for determining a specific diagnosis and treatment plan. A revision total knee arthroplasty that is performed for an inexact diagnosis is likely to be associated with a poor outcome, while a revision that is performed for a specific cause is more likely to succeed.
The evaluation of pain at the site of a total knee arthroplasty requires a complete history, physical examination, and radiographic assessment and may require additional diagnostic studies. A complete and accurate history must be done when evaluating a patient who has pain after a primary total knee replacement. Previous knee operations, and any complications or morbidity associated with the primary total knee replacement, should be carefully documented. Regardless of the absence of symptoms and signs, the possibility of infection must be considered as the cause of the pain. A thorough review . . . [Full Text of this Article]

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