Artikel
One day TKA with the PIPB (Patella in Place Balancer)
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Veröffentlicht: | 10. Oktober 2016 |
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Gliederung
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Objectives: The objective of the retrospective study was to evaluate the feasibility and complications of TKA as a one day procedure with the "LaZIRUSh" method.
Methods: We performed in XXX 80 TKA as a one day procedure. The used method was a pathway for TKA called "LaZIRUSh"
The method or program contains a Teaching Class, General Anesthesia, EMS (Eeklo Modifies Subvastus) approach , PIPB (patella in Place Balancer), No ligament releases, Single Radius TKP, Perop Lokal Pain (PLP) managment, Early mobilization
Teaching Class: Once a month for all patients (no selection)
General Anesthesia: Maximal Muscle relaxation and low BP (syst around 90 mmHG)
EMS: A Far medial Subvastus Approach with preservtion of priosium, Hoffa, Sub quad Patellar pouch
PIPB: A tibia first method with a ligament balancer in flexion with patella in place. The natural hight of the flexion gap is measured. The posterior femoral cut is done at the desired hight with preservation of a the natural posterior offset and parallel to the tibia. Releases are never done and necessary. The extension gap is adapted to the flexion gap
Single Radius TKP: Because of the isometrie of the collateral ligaments a single radius is mandatory to get a equal flexion-extension gap
PLP: Lokal intraarticulair infiltration (Ropivacaïne, Adrenaline and MgSO4). No opstop epiridural postop painpump or nerve blocks are necessary.
Early mobilization: Same day mobilization and discharge from the hospital to theire proper home
Results: First patient was done in 2007. 80 patients chose to go home the same day. No readmission was necessary. No mayor complication observed.
Conclusion: TKA as a one day procedure with the LaZIRUSh method is safe and can be proposed to prepared patients.