Knee fusion

There are many types of surgeries in medicine, in addition to the more common open surgery and laparoscopic surgery, there are many other types. However, surgery does bring us a lot of convenience and can reduce the pain of frequent medication. However, everyone needs to know that in addition to anesthesia, there are other types of surgeries, such as knee fusion surgery. Preoperative preparations must be made for the surgery, and the surgical process must be understood.

Anesthesia method

Spinal or epidural anesthesia.

Preoperative preparation and precautions

1. Preoperative Preparation

Traction should be performed before surgery to try to overcome contracture; and steps should be designed to relieve contracture during surgery. Prepare T-board; measure angles with clinical X-rays; inflate tourniquet and prepare blood.

2. Preoperative precautions

Inflammatory joint lesions (such as tuberculous and purulent) should be treated with antibiotics or anti-tuberculosis drugs before surgery to control infection or prevent recurrence of dormant lesions.

Indications

Patients with disproportionate joint surfaces due to joint trauma, inflammation, degenerative changes, etc., causing serious joint dysfunction or stubborn joint pain that affects work and life, and who have not responded to non-surgical treatment and are not suitable for other surgeries to preserve joint mobility; patients with total joint tuberculosis and articular surface destruction; patients with failed knee arthroplasty; patients who cannot restore joint function after resection of benign tumors at the lower end of the femur and upper end of the tibia; patients with sequelae of poliomyelitis and unstable knee joints.

Contraindications

If one side of the same joint of both limbs has ankylosis, arthrodesis should not be performed on the other side; arthrodesis should not be performed on children under 12 years old.

Surgical procedures

The general steps of the operation are: ① Use a median or anteromedial incision at the knee to expose the front of the knee joint cavity. ② First remove the diseased joint capsule, synovium, infrapatellar fat pad and patella on the front side. Flex the knee joint, pull the skin flaps on both sides toward the back, peel off the medial and lateral collateral ligaments, cut the anterior and posterior cruciate ligaments, remove the meniscus, completely dislocate the joint, and thoroughly remove the posterior lesion. ③ Perform appropriate subperiosteal stripping of the soft tissue around the bone end, pull apart and protect the surrounding soft tissue, and then use a plate saw or a wide bone knife to remove the bone end. ④ Align the femoral and tibia cross sections closely, select the femoral and tibia nailing points, and insert the nails upward and downward. Then, put on the knee compression fusion device, tighten the screws, and apply pressure to fix it. Suture layer by layer and fix with plaster splint.

Postoperative Care

Postoperative care: Elevate the affected limb, pad the limb evenly, pay attention to blood circulation to the limb, and loosen the plaster immediately if there is any obstruction. The stitches are removed 10 to 14 days after surgery. 4 to 6 weeks after surgery, the pressor can be removed and replaced with a long-leg cylindrical plaster cast for 4 weeks. You can walk with weight during the immobilization period. After X-rays confirm bone healing, the external fixator can be removed.

Postoperative diet

Drink plenty of water, fresh fruits and vegetables, and foods high in protein, vitamins and calcium. Do not eat spicy, irritating, or greasy food, and avoid smoking and drinking. Patients should mainly eat light food and try to eat less or no seafood.