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Intraoperative Practice Variability in Total Knee Arthroplasty.

Liam C Bosch¹, Samuel B Beger², Stephen T Duncan³

¹Department of Orthopaedic Surgery, Stanford Hospital and Clinics, Redwood City, CA.

The Journal of Arthroplasty

|November 25, 2019

Summary

This summary is machine-generated.

High-volume orthopedic surgeons performing total knee arthroplasty (TKA) show practice variability. Conventional techniques, including cemented implants and posterior-stabilized designs, are frequently preferred over newer methods.

Keywords:

TKA management variation practice variability revision TKA total knee arthroplasty

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Area of Science:

Orthopedic Surgery
Arthroplasty Research
Surgical Technique Analysis

Background:

Significant variability exists in orthopedic surgeons' total knee arthroplasty (TKA) practices.
Understanding standard TKA surgical and perioperative techniques is crucial.

Purpose of the Study:

To identify standard TKA surgical and perioperative techniques used by high-volume academic knee arthroplasty surgeons.
To assess current practices among leading TKA practitioners.

Main Methods:

A 59-question survey on TKA management preferences was distributed to arthroplasty-trained physicians.
Responses were collected from 45 attending physicians across 13 medical centers.

Main Results:

Most surgeons rarely performed outpatient TKA; 80% used conventional alignment guides and cemented implants.
Posterior-stabilized implants were most common (67%), with frequent patellar resurfacing (73%) and tourniquet use (73%).
Tranexamic acid (91%) and specific intra-articular anesthetic injections were widely used; aspirin was the primary anticoagulant (60%).

Conclusions:

Considerable variability exists in TKA surgical and perioperative techniques among surveyed surgeons.
A preference for conventional, rather than developmental, TKA techniques was observed.