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The Journal of Bone and Joint Surgery (American) 85:S26-S37 (2003)
© 2003 The Journal of Bone and Joint Surgery, Inc.

Intraoperative Assessment in Revision Total Knee Arthroplasty

James A. Rand, MD, Michael D. Ries, MD, G. H. Landis, MD, Aaron G. Rosenberg, MD and S. Haas, MD

Corresponding author: James A. Rand, MD
Department of Orthopaedics, Mayo Clinic Scottsdale, 13400 East Shea Boulevard, Scottsdale, AZ 85259

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.

A video supplement to this article is available to our subscribers at no extra charge on the JBJS web site (www.jbjs.org), for a limited time. The same material is available for purchase from the Video Journal of Orthopaedics (www.vjortho.com; telephone: 805-962-3410).

The first 150 words of the full text of this article appear below.


   Introduction
 
Careful intraoperative management of the patient being treated with revision total knee arthroplasty is critical for a successful result. Preoperative and intraoperative considerations must include the condition of the skin and subcutaneous tissues, the mode of operative exposure of the extensor mechanism, the need for component removal, collateral ligament integrity, and bone loss. Each of these components of the planning process and operative treatment must be performed in a meticulous manner. Failure of any component of intraoperative management can compromise the function of the revision total knee replacement.


   Skin and Subcutaneous Tissues
 
Intact and healthy skin and subcutaneous tissues about the total knee arthroplasty are essential to prevent deep infection. Any skin defect may be a site of bacterial colonization and thus a portal of entry of infection into the joint. Small areas of skin necrosis frequently signal larger areas of underlying deep muscle or fascial necrosis, the extent of which can be underestimated. . . . [Full Text of this Article]


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