Download - Knee Anatomy, approaches & Osteoarthritis
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KneeAnatomy, approaches and
Review of OA
Dr. Jayesh A Bhanushali
D.ortho
Registrar, RGMC & CSMH
Kalwa, Thane.
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Knee
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Radiology leg and Knee
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Approaches of the knee joint
1.Anteromedial approaches -
• Anteromedial para patellar
• Subvastus anteromedial
2.Anterolateral approach
3.Posterolateral approach
4.Postero medial approach
5.Medial approaches to the knee and supporting structures
6.Transverse approaches to menisci
7.Lateral approaches to the knee and supporting structures
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MEDIAL PARA PATELLAR APPROACH(VON LANGENBECK APPROACH)
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SUBVASTUS ANTEROMEDIAL APPROACH
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ANTEROLATERAL APPROACH(KOCHER’S APPROACH)
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POSTEROMEDIAL APPROACH (HENDERSON APPROACH)
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Osteoarthritis
• Osteoarthritis is a non-inflammatory, degenerative condition of joints Characterized by degeneration of articular cartilage and formation of new bone i.e. osteophytes.
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Risk factors
Obesity
Abnormal mechanical loading
Inherited type II collagen defects
Hereditary
Poor posture
Injured joints and infection
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Pathology
• OA is a degenerative condition primarily affecting the articular cartilage (wear and tear)
1.Articular cartilage - Erosion in weight bearing area
2.Bone - Subchondral cyst, sclerosis, osteophytes.
3.Synovial membrane - Hypertrohy, decreased secretion of fluid
4.Capsule - Fibrous degeneration
5.Ligament - Contracted or elongated
6.Muscle - Wasting
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Clinical features of OA
• Pain
• Stiffness
• Restricted movement
• Deformity
• Muscle weakness or wasting
• Joint enlargement and instability
• Crepitus
• Joint Effusion
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Imaging
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Treatment chart
•Medical
• Surgical
•Regenerative
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Surgical
• Knee preserving procedures
1. Intra articular injection
2. Arthroscopic lavage and debridement
3. Corrective osteotomy
4. Mosaicplasty
• Knee replacing surgeries1. TKR
2. UKR
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Injections
• Visco supplementations.
• Hydrocortisone.
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Arthroscopic lavage
• Joint debridement
• Removal of loose bodies,
• Joint lavage
• Drilling of sclerotic lesions
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Corrective osteotomy
• High Tibial Osteotomy
osteotomy is an option in active patients with unicompartmental OA
• The fundamental goals is to unload diseased articular surfaces and to correct angular deformity at the tibiofemoral articulation.
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Indications for HTO
• OA With Varus Limb Alignment
• OA With Valgus Limb Alignment
• Osteochondritis Dessicans
• Osteonecrosis
• Posterolateral Instability
• Chondral Resurfacing
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HTO types
1. Open wedge
2. Closed wedge
3. Dome
4. Dynamic external fixator
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Lateral close wedge
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Medial open wedge
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Dome osteotomy
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Dynamic external fixator
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Mosaicplasy
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Chondroplasty
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THANK YOU