Knee Surgery

welcome to virtual knee surgery this activity will show you the process of replacing a failing knee joint are you ready today our patient is a 76 year old man it is mandatory to check the patient's vital signs before beginning surgery an anesthesiologist in the operating room performs this step if the patient's vital signs are not in the normal ranges we will not proceed with the surgery using the healthy persons vital sign chart as a reference can our patient undergo surgery today it looks like surgery will precede this plan take a moment to look at our patients x-rays what you need do you think needs surgery right his left knee appears worn down and lacking cartilage which is likely the cause of his pain the nurse has begun prepping our patient for surgery by placing an IV needle in his right hand now it's your turn use the marker and write your initials on the proper knee to be operated on this may seem silly but it's an actual step taken to prevent wrong sight surgeries you the anesthesiologist administers drugs through the IV and through a mask over the patient's face what function should these drugs perform good work great fantastic after the patient is unconscious and before the first incision is made we need to establish a sterile field around the surgical area a series of sterile drapes isolates the surgical field from the rest of the patient's body a tourniquet is applied to cut off blood flow which allows a clearer view of the surgical field during surgery to kill the bacteria on the patient's leg clean it in a betadine solution this scrubbing process will limit the chance of bacterial infection betadine scrub is applied two more times followed by the final arrangement of sterile drapes why do you think knee surgery involves so many great good work use the sterile marker to draw the location for our incision and don't forget to mark the perpendicular lines to typically the incision line is six to seven inches long you you what purpose do you think the perpendicular lines serve outstanding now for the incision take the scalpel and cut the skin following your markings let's use the Bovie pencil to cauterize the veins this will help decrease blood flow into the surgical field the rake retractors fold the skin and tissue out of the way exposing our patients need to operate we need the patient's knee elevated and bent so the bones are fully exposed now the legs at the proper angle use the wrong juror to remove the anterior cruciate ligament or ACL the meniscus and any bone spurs that may be lurking about are you a good sculptor it's time to shape the femur tibia and patella so the new knee components fit properly a hole must be drilled inside the femur to set up the distal femoral cutting jig and alignment device the jig is put into position and helps ensure that the cuts made to the bone are exactly what are needed now hammer in the pins to hold the jig we can now remove the alignment device the pins will hold the jig firmly in place now for some real bone shaping use the bone saw to cut the bone so it is prepared for the new femoral component another cutting jig along with the bone saw allows us to finish shaping the femur let's move on and shape the tibia the tibial cutting jig is aligned with the big toe and the highest point of the tibia this will ensure the leg is properly aligned after surgery secure the jig in place with more pins use the bone saw to cut off the top of the tibia and prepare it for the new tibial components now we'll use the patellar cutting jig and bone saw to remove the back of our patients patella ah holes in the tibia and patella are drilled and chiseled out which will enable the new components to attach properly time to place the trial components first attach the femoral trial component attach the metal tray trial component to the tibia insert the plastic trial spacer into the metal tray component lastly attach the patellar trial component why do you think the two tibial components are inserted separately instead of as one unit fantastic conductive range of motion tests to assure proper knee alignment and successful prosthetic fit typically a normal range of motion allows the leg to move from 0 to 130 degrees how does our patients range of motion look knees aren't meant to bend sideways so it's important to determine whether there is a gap or space between the femoral and tibial components there is no noticeable gap so this knee is a good fit why do you think there are so many steps taken to ensure proper alignment great we've tested the trial components now let's remove them and prepare for the permanent components by applying a special cement compound that binds metal and plastic to bone a scrub technician is mixed up a batch of cement for you to use with the cement in place the final components are permanently attached to the knee any excess cement will be scraped off and thrown away lay the leg flat on the table so the new knee components put pressure on each other this allows the bone and components to bond with a cement the cement can take anywhere from 10 to 15 minutes to harden we perform our range of motion tests one final time our patients nuni is looking good let's close up the incision first suture the deep tissue and fat layers back together foreclosing the surface incision you have a choice between the stapler and the suture what is the primary difference between these two methods of closing the incision excellent you know we couldn't ask for a better participant you've done an excellent job are you sure this is your first total knee replacement our patient will remain in the hospital for three days followed by three to eight weeks of physical therapy because of this surgery our patient will have significantly reduced pain and increased mobility before you leave let's think about the life of the new knee components what kind of forces do you think the new knee will need to withstand nice job people average about 5,000 steps per day our patients new prosthetics will withstand a great deal of force for 36 million steps or more I'm off to check on another patient while the o.r team prepares the room for the next surgery you've been a great help see you next time

Channel: R8cer

Views: 1,694,282

Rating: 4.5576239 out of 5

Keywords: New, Project, Surgery (Medical Specialty), r8cer, 0n3, ed, edheads, head, heads, First, Inside, knee, surgery, virtual, knee surgery, virtual knee, virtual knee surgery, Real, Health, Therapy, Pain, Doctor, Doctor (title), Your, Plastic

Id: mDZNOEp1Ec0

Length: 8min 24sec (504 seconds)

Published: Wed Jan 23 2013