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Updated: May 31, 2026
Surgical Technique for the Implantation of Tissue Engineered Vascular Grafts and Subsequent In Vivo Monitoring
Published on: April 3, 2015
[Extension first technique for TKA implantation]
1OCM-Klinik München, Steiner Str. 6, 81369, München, Deutschland. robert.hube@ocm-muenchen.de
Objective:
Surgical technique in total knee arthroplasty (TKA) to combine the femur first and tibia first techniques in order to reduce surgical mistakes regarding rotation and alignment.
Indications:
Symptomatic arthritis of the knee.
Contraindications:
General contraindications for TKA.
Surgical Technique:
Osseous preparation starting with a distal femur cut. Then the proximal tibia cut is accomplished and the knee is balanced in extension after checking for correct alignment. Bone-referenced positioning of the femoral cutting block for further preparation of the femur. Finally, the rotation of the femur is checked in 90° of flexion by means of ligament tension. If required, the rotation is checked and the flexion gap balanced, respectively.
Postoperative Management:
Mobilization with weight bearing and range of motion as tolerated.
Results:
In a prospective study, 267 knees (160 women, 107 men, average age of 69.3 [46-89] years) were followed up preoperatively and after 6 weeks. The clinical results were based on the American Knee Society score. The scores were 48.9 (32-68) preoperatively and 86.5 (75-100) at follow-up. Radiologically 92.1% of the knees showed a malposition <3°.
