Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast) artwork

Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)

103 episodes - English - Latest episode: almost 2 years ago - ★★★★★ - 4 ratings

Dr. Adam Rosen is an orthopedic surgeon who specializes in total joint replacement. He created this podcast which is aimed at interns, residents, fellows, and general orthopedists who are looking to dive into the details of total knee replacements. I do not claim that my way is the best way or the only way. My personal approach to my patients, total knee replacement surgery and the ever important post-operative recovery has been developed over the years. My protocols are ever changing based on scientific evidence and personal experience.I know many of you will want to jump right ahead to the operative step episodes - and that is okay. The first few episodes are not as exciting but they do contain important information in my opinion. If you jump ahead just be sure to come back and listen to the first few episodes.I will attempt to offer you my brain and the algorithm within it. Here I will share my thoughts and my approach to caring for total knee replacement patients. I hope that you learn something from this podcast. I hope that my thought process stimulates your thinking and approach. Most importantly I hope that I can offer one or more tips or pearls that may benefit your patients. If you like the information and have a friend or colleague that you think would benefit from the material please be sure to share this podcast with them. (Disclaimer: This is my opinion. Any information gathered is not medical education. Practitioners need to use their education and experience to determine how to treat their own patients.)

Medicine Health & Fitness knee total knee total knee arthroplasty total knee replacement ortho virtual fellowship tka surgery fellowship adam rosen
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Episodes

Uni's

June 10, 2022 08:00 - 13 minutes - 9.26 MB

I am going to cover some of the things I consider when approaching Uni's Please take the time to leave a review and subscribe. Stay safe. Support the show

Suicide, Burnout, Mental Wellness

May 27, 2022 08:00 - 20 minutes - 14.4 MB

This is an important episode because we are all at risk. If you are in trouble or suffering ask for help, get help, seek help and ask for help again. If you see a colleague or friend who is having trouble ask how you can help and be sure to check in with them or seek help from your attending or other supervisors. Support the show

TKA Specs - 100th Episode

May 13, 2022 08:00 - 32 minutes - 22.7 MB

This is the 100th Episode of the Total Knee Tips & Pearls Podcast Some techy stuff on TKA Recommended Distal Femoral Resections 8mm - Stryker Triathlon 9mm - DePuy Attune 9.5mm - Smith & Nephew 10mm - Zimmer Persona, DJO, Microport Anterior Flange Angle to Prevent Notching 3 degrees - S&N, Zimmer 5 degrees - DJO, DePuy 6 degrees - Microport 7 degrees - Stryker Recommended Tibial Slope 0 degrees - Stryker PS, Aesculap 3 degrees - Stryker CR, Aesculap, Persona PS, Attune PS, Microport, S&N...

Essential Amino Acids after TKA

April 29, 2022 08:00 - 12 minutes - 8.32 MB

Two studies have shown that essential amino acids (EAA) can help function, and suppress atrophy of the rectus after TKA. Dreyer et al. J Clinc Invest. 2013;123(11):4654-4666. Essential amino acid supplementation in patients following total knee arthroplasty.  Ueyama et al. The Bone & Joint Journal Vol 102-B, No. 6, Supp A. Perioperative essential amino acid supplementation suppresses rectus femoris muscle atrophy and accelerates early functional recovery following total knee arthroplasty. ...

Acetabular Cups - Reaming and Liner Options

April 15, 2022 18:00 - 13 minutes - 8.95 MB

Do not take my word for it but do your research and verify everything. Here I'll review the four common cups many of us use Zimmer G7 - ream under by 1 mm, 36 mm ID options at 50 with 10 degree and +5 lat offset Stryker Trident II Tritanium - ream line to line, 36 neutral option at 48 and 36 mm options with lip and offset at 52 mm DePuy Pinnacle - under by 1 mm, 2mm or line to line, 36 mm ID options at 52 mm Smith and Nephew - under by 1 mm or line to line, 36 mm ID option at 52 mm If y...

Knee Arthroscopy

April 01, 2022 07:00 - 23 minutes - 16.2 MB

Here I share with some some tips and tricks on what I look for and what I do when caring for the 50 and older patient with knee pain that does not have severe arthritis and does have a meniscus tear. I also share some tips on what to do during boards collections to make sure you have copies of the intra-op photos and how I discuss the surgical findings with my patients in the office. Support the show

Hip Stems

March 18, 2022 18:00 - 23 minutes - 16.4 MB

Here is my take on the three new broach only collared hip stems Depuy Actis 130 degree neck shaft angle sizes 0-12 high offset 6mm (sizes 0-3) and 8 mm (sizes 4-12) Zimmer Avenier 135 neck shaft angle sizes 0-9 high offset 6mm collared and non-collared options coxa vara neck 126.5 degrees Stryker Insignia 130 degress neck shaft angle sizes 0-11 high offset 5 mm Support the show

Talking to patients about Leg Length Discrepancy

January 30, 2022 17:00 - 15 minutes - 10.4 MB

LLD is a real issue. Here I will go over a number of things that can cause or lead to a LLD. I will share things I look for and how I talk to patients about LLD and what things you can do at the time of surgery to control for LLD. Support the show

Fellowship - What to look for

January 23, 2022 00:00 - 16 minutes - 11.5 MB

What you are looking for in a fellowship is a personal decision. I covered this topic before but we are in the middle of fellowship applications and most applicants have the same questions. Here I discuss volume, autonomy, approaches, implants, technology, clinic, revisions and finding a job. Support the show

Robotics or Lack There Of - You still need training in manual total knees

January 07, 2022 08:00 - 16 minutes - 11.3 MB

I used nav in 2005 and was looking forward to robotics when they came on the scene. First it was Mako and now Rosa and Velys. Unfortunately, the powers that be have not allowed them in our system yet. I think it is important for residents and fellows to be trained with robots. It is a part of education today. Robotic training will help you land a job. Robotics may help you attract patients. Augmented reality may offer some of the same information because that technology is advancing quickl...

Augmented Reality

December 31, 2021 08:00 - 10 minutes - 7.51 MB

AR is something I am really excited about. Here is my two cents on the future of AR technology in total knees Support the show

The Knee Book - A Guide to the Aging Knee

December 20, 2021 14:00 - 10 minutes - 7.12 MB

I am happy to share my new book THE KNEE BOOK - A GUIDE TO THE AGING KNEE It was written for patients and it is written to patients in easy to understand language. The book is a perfect recommendation for patients with knee pain that have questions. I believe it is also a great resource for residents and young surgeons. In it I review the algorithm for treating patients with knee pain from the most conservative up to knee replacement. What I think is the best benefit for young surgeons i...

Pre-Flight Checklist

December 17, 2021 11:00 - 16 minutes - 11.7 MB

I still do this every Friday (sooner if it is a complicated revision) Check the patient, age, BMI, nasal swab, dvt proph. Check the x-rays and make sure the implants are ordered. Review the labs and any clearances that are needed. Double check everything necessary with the patient the day of surgery. Make sure the room is set up with everything you need prior to the patient coming into the room. Support the show

Cement Technique for Hemi's & THA

December 03, 2021 08:00 - 11 minutes - 8.19 MB

Whether you are doing a hemi or total, cementing the femoral component takes some skill. Here I will share with you my tips on how to get a good cement mantle. A link to the episode on cement grading: https://www.buzzsprout.com/725061/episodes/7501843 Support the show

Biofilmology

November 19, 2021 23:00 - 13 minutes - 9.34 MB

SSI is the number one reason for unplanned admission after TJA. Biofilm can form within minutes and be mature within 24 hours. Biofilm contains approximately 80% ECM and 20% bacteria. Check out this lecture by Next Science that was given at AAOS 2021 https://www.youtube.com/watch?v=5WPZ02t8hEs&list=PL226EPMMG9vYS9F1oDCU9SvOOBIqjJXze&index=6 And this two part series: https://www.youtube.com/watch?v=cG3iOT4vZlA&list=PL226EPMMG9vYWosH11BTZh1_2g02R-M92&index=7&t=31s https://www.youtube.com...

Valgus Knees

November 05, 2021 07:00 - 16 minutes - 11.2 MB

I discussed varus knees previously, here is my two cents on what I look for and how I approach the valgus deformity when performing a TKA Krackow I - min valgus II - deformity > 10 degree, medial soft tissue stretching III - severe, incompetent medial soft tissues, have constrained/hinge avail Support the show

Dr. Colwell Interview #2

October 22, 2021 07:00 - 1 hour - 43.1 MB

I had the chance to sit down for the second time with Dr. Colwell. In this episode we cover teaching fellows, running two rooms, bilateral total joints and more. If you haven't listen to the first episode you can listen here: https://podcasts.apple.com/us/podcast/interview-with-dr-colwell/id1507691532?i=1000536512016 Support the show

Varus Knees

October 08, 2021 12:00 - 18 minutes - 12.9 MB

Know if it is fixed or correctable Assess the amount of osteophytes Release MCL around to semimembranous Assess PCL if using CR Consider downsizing tibial and removing additional medial bone Further Reading: Master Techniques Knee Arthroplasty - Lotke and Lonner Chapter 7 by Scuderi and Insall Advanced Reconstruction of the Knee AAOS Chapter 27 - Varus Knee - Windsor and Choi JAAOS Article Dr. Mihalko -  http://upload.orthobullets.com/journalclub/free_pdf/19948701_19948701.pdf Support t...

Interview with Dr. Colwell

September 24, 2021 14:00 - 1 hour - 41.3 MB

I first met Dr. Colwell when I came west to interview for a fellowship at Scripps Clinic. I had the pleasure to sit down and ask him some questions about orthopedics and his career. We talked for an hour and a half and I could have spent all day listening to his stories. We didn't have time to get to every question that I had for him so I hope we can sit down again soon for a second Dr. Colwell interview. Support the show

Optimize your patient

September 10, 2021 16:00 - 22 minutes - 15.6 MB

References: Ng et al. Preoperative Risk Stratification and Risk Reduction for Total Joint Reconstruction. AAOS 2013 Aram et al. Estimating an Individual's Probability of Revision Surgery After Knee Replacement. Am J of Epid 2018 Gronbeck et at. Risk stratification in primary total joint arthroplasty. Arthroplasty Today 2019 Florschutz et al. Estimating patient specific mortality after joint replacement. Osteoarthritis and Cartilage 2019 Ziebma-Davis et al. Outpatient Joint Arthroplasty. J Ar...

Hip Balancing

August 29, 2021 18:00 - 24 minutes - 16.8 MB

I find this topic a more difficult topic to teach than knee balancing. Everything is important to get a stable hip. You need a good approach, pre-op planning, implant positioning and the restoration of length and offset. You need to be aware of balancing and how to address anatomic on anatomic impingement, implant on anatomic and implant on implant impingement. Impingement with total hip replacement by Malik JBJBm 2007 - https://pubmed.ncbi.nlm.nih.gov/17671025/ Support the show

Tips for Hemi's

August 15, 2021 16:00 - 8 minutes - 6.1 MB

These two tips can be used when performing a hemiarthroplasty for a hip fracture. You may also consider it even if doing a THA for a fracture or a THA for arthritis in certain patients such as parkinson's disease. Check out my other episode on a more detailed explanation of how I do my posterior approach to the hip. - https://www.buzzsprout.com/725061/episodes/4250591 Support the show

Reading an X-ray

July 31, 2021 22:00 - 13 minutes - 9.55 MB

Its good to have an algorithm that works for you when describing an x-ray. Here I will go through my thought process to make sure that you cover everything and not miss things. Support the show

The PFJ in TKA (#79)

July 09, 2021 07:00 - 11 minutes - 7.83 MB

The kinematics of the knee are so complex. You can not overlook the PFJ. We are taught early on about medializing the button and lateralize the femur and make sure your femoral rotation is correct. If not you are taught to do a lateral release. The balancing of the PFJ is so important. Overstuff it and you have pain and limited range of motion.  Too loose and you lose efficiency of the extensor mechanism. Here I will share some tips and my thoughts on what I look for when I do a TKA specif...

A Comparison of Four Models of Total Knee Replacement Prostheses

June 26, 2021 17:00 - 18 minutes - 13.1 MB

A Comparison of Four Models of Total Knee Replacement Prostheses John Insall, Chitranjan Ranawat, Paolo Aglietti, John Shine JBJS 1976 Support the show

Merchant View

May 28, 2021 07:00 - 4 minutes - 3.33 MB

Roentgenographic Analysis of Patellofemoral Congruence Alan Merchant, Richard Mercer, Richard Jacobsen, Charles Cool JBJS 1974 Merchant View - patient is supine on the x-ray table. The knees are flexed 45 degrees and the legs are strapped. The beam to femur angle is 30 degrees and the plate is positioned against the shins. Sulcus Angle of Brattstrom - angle formed by the highest points on the medial and lateral femoral condyles and the lowest point of the sulcus Congruence Angle - sulcu...

Rosenberg View

May 21, 2021 07:00 - 7 minutes - 5.2 MB

The Forty-five-Degree Posteroanterior Flexion Weight-Bearing Radiograph of the Knee Thomas Rosenberg, Lonnie Paulos, Richard Parker, David Coward, Steven Scott JBJS 1988 PA x-ray with the knee in 45 degrees of flexion and the patella touching the cassette. The beam is aimed at the inferior pole of the patella and aimed 10 degrees caudad, 55 patients in 1981-1982 (age 19-70) Major narrowing in the medial compartment AP xray - 25% Rosenberg - 85% Major narrowing in the lateral compartment...

Hip Stability - Dorr

May 14, 2021 19:00 - 34 minutes - 23.9 MB

Current Concepts Review Impingement with Total Hip Replacement JBJB 2007 Aamer Malik, MD, Aditya Maheshwari, MD, and Lawrence Dorr, MD For hip stability: Evaluate the x-rays and template Be wary of hypermobile patients and spine patients Know your implants (head options, neck options, etc) Check patients supine and again lateral (for posterior approach) Meticulous approach Proper reaming and cup placement and remove osteophytes Proper broaching and remove osteophytes Check Ranawat sign 1. ...

ORDERS - ADCVAANDIMLS

May 07, 2021 18:00 - 15 minutes - 10.6 MB

Hopefully your system does not go down but when it does here is your cheat sheet. 1. ALWAYS DATE AND TIME 2. SIGN and print your name and/or doctor number, pager number, etc 3. Make sure the patients name and medical record number or DOB is on the page A- Admit D - Diagnosis C - Condition and Code Status V - Vitals A - Allergies A - Activity N- Nursing D - Diet I - IVF M - Medications L - Labs and Tests S - Special - PT, OT, Case Management And DATE AND TIME IT Common Meds after TKA - al...

ORDERS - ADCVAANDIMLS

May 07, 2021 18:00 - 15 minutes - 10.6 MB

Hopefully your system does not go down but when it does here is your cheat sheet. 1. ALWAYS DATE AND TIME 2. SIGN and print your name and/or doctor number, pager number, etc 3. Make sure the patients name and medical record number or DOB is on the page A- Admit D - Diagnosis C - Condition and Code Status V - Vitals A - Allergies A - Activity N- Nursing D - Diet I - IVF M - Medications L - Labs and Tests S - Special - PT, OT, Case Management And DATE AND TIME IT Common Meds after TKA - al...

DeLee and Charnley

May 01, 2021 16:00 - 9 minutes - 6.28 MB

Radiological Demarcation of Cemented Sockets in Total Hip Replacement Jesse DeLee and John Charnley CORR 1976 3 Types/Zones Zone 1 - Superior lateral Zone 2 - Central or Medial Zone 3 - Inferior medial Support the show

Singh Index and Ward's Triangle

April 09, 2021 07:00 - 9 minutes - 6.44 MB

Changes in Trabecular Pattern of the Upper End of the Femur as an Index of Osteoporosis Manmohan Singh et al JBJS 1970 Grade 6 - All normal trabeculae are visible Grade 5 - accentuation of the principal compressive and principal tensile trabeculae           - Ward's triangle looks empty Grade 4 - tensile trabeculae are reduced           - Ward's triangle opens up laterally           - border line between osteoporotic and normal bone Grade 3 - break in the continuity of the priciple tensile ...

Crowe Classification

April 02, 2021 07:00 - 10 minutes - 6.91 MB

Total Hip Replacement in Congenital Dislocation and Dysplasia of the Hip John Crowe, John Mani, Chitranjan Ranawat JBJS 1979 I - < 50% subluxation II - 50% - 75% subluxation III - 75% - 100% subluxation IV - >100% subluxation Support the show

ICM 2018 Criteria for PJI

March 26, 2021 07:00 - 8 minutes - 6.18 MB

The International Consensus Meeting on MSK Infection presented their new criteria in 2018 Major Criteria 1. Two positive periprosthetic cultures w/ phenotypically identical organisms 2. A sinus tract communicating with the joint ____________________ Minor Criteria > or equal to 6 = infected 4-5 = inconclusive < or equal to 3 = not infected ___________________ 2 points for: Serum CRP 100 in acute or 10 in chronic or D-dimer 860 in chronic 1 point for: ESR 30 in chronic 3 points for: synovi...

Kellgren-Lawrence Classification

March 19, 2021 07:00 - 10 minutes - 7.42 MB

Kellgren, Lawrence. Radiological Assessment of Osteoarthritis. Ann Rheum Dis. 1957;16:494-502 Grade 0 - No presence of OA Grade 1 - Doubtful narrowing, possible osteophytes Grade 2 - Possible narrowing, definite osteophytes Grade 3 - Definite narrowing, moderate osteophytes, some sclerosis and possible deformity Grade 4 - severe narrowing, large osteophytes, marked sclerosis, definite deformity X-rays finding of OA narrowing of joint space osteophytes sclerosis of subchondral bone pseudocy...

Paprosky Classification of femoral bone loss

March 12, 2021 08:00 - 7 minutes - 5.47 MB

Paprosky Classification of Femoral Bone Loss Type I - minimal metaphyseal bone loss Type II - extensive metaphyseal bone loss, minimal diaphyseal bone loss Type IIIA - extensive metaphyseal and diaphyseal bone loss with greater or equal to 4 cm intact diaphysis for "scratch fit" Type IIIB - extensive metaphyseal and diaphyseal bone loss with less than 4 cm of intact diaphysis Type IV - extensive metaphyseal and diaphyseal bone loss with a non-supportive isthmus Treatments I - cylindrical f...

Gruen and Modes of Failure

March 05, 2021 08:00 - 9 minutes - 6.66 MB

"Modes of Failure" of Cemented Stem-type Femoral Components Gruen, McNeice and Amstutz CORR 1979 Seven Gruen zones 1 - proximal lateral 1/3 2 - central lateral 1/3 3 - distal lateral 1/3 4 - tip 5 - distal medial 1/3 6 - central medial 1/3 7 - proximal medial 1/3 Modes of Failure I. Pistoning      Ia. stem pistons in cement (punch-out crack)      Ib. cement pistons in bone (halo) II. Medial Midstem Pivot - medial migration of proximal stem, lateral migration of tip III. Calcar Pivot - ...

The Future of TKA's with AI

March 05, 2021 00:00 - 15 minutes - 10.4 MB

I just wanted to share my thoughts and give you my two cents on where we may be in ten years. We still have 20% of patients that are dissatisfied after TKA. WHY? We get answers from industry - nav and robots? But, what is the question? Listen in to hear my thoughts on AR and AI and how a heads up display could help you decide how to best perform a TKA to get satisfaction rates up to 95% or higher. Support the show

Garden and Pauwels

February 26, 2021 08:00 - 16 minutes - 11.4 MB

Low-Angle Fixation in Fractures of the Femoral Neck Garden JBJS-B 1961 Stage I - Incomplete and abducted or valgus impacted Stage II - Complete and non-displaced Stage III - Complete partially displaced Stage IV - Complete fully displaced Pauwels Classification 1935 I - up to 30 degrees II - 30 - 50 degrees III - greater than 50 degrees a line drawn thru the fracture on the AP x-ray in relation to a line from the horizontal Bonus credit - look up Wards Triangle first described in 1838 ...

AORI

February 19, 2021 08:00 - 11 minutes - 8.19 MB

AORI Classification Type 1 - Minimal bone defect, intact metaphysis      - Treat with cement or impaction grafting Type 2A - Metaphyseal bone damage of 1 femoral condyle (F2A) or 1 half of the tibial plateau (T2A); posterior condyles are reduced      - Treat with cement, augments, bone graft, cones/sleeves Type 2B - Metaphyseal bone damage of bone femoral condyles (F2B) or both sides of the plateau (T2B)      - Treat with cement, augments, bone graft, cones/sleeves Type 3 - Massive bone ...

Dorr Classification

February 12, 2021 08:00 - 5 minutes - 4.14 MB

Dorr Classification; Bone 1993 "Structural and Cellular Assessment of Bone Quality of Proximal Femur" A - Thick cortex - champagne flute canal B - Thin cortex with residual funnel shape C - Thin cortex - "stove pipe canal" Canal/Canal Ratio A - <0.5 B - 0.5 - 0.75 C - >0.75 Support the show

Cement Grading

February 05, 2021 08:00 - 8 minutes - 6.13 MB

Barrack & Harris JBJS-Br 1992 "Improved Cementing Techniques and Femoral Component Loosening in Young Patients with Hip Arthroplasty. A 12 Year Radiographic Review." A - Complete fill, the classic "White Out" B - slight radiolucency C - radiolucencies 50% - 99% D - complete radiolucent line 100% and/or failure to cement the tip of the stem Support the show

Vancouver Classification

January 29, 2021 08:00 - 6 minutes - 4.81 MB

Vancouver Classification by Duncan and Masri ICL 1995 Treatment options added in CORR 2004 Type A AL - lesser trochanter - non-op unless larger medial piece AG - greater trochanter - non-op unless >2.5 cm displacement Type B B1 - well fixed stem - ORIF B2 - loose stem, adequate bone stock - revision w/ ORIF B3 - loose stem poor bone stock - revision w/ allograft or PFR Type C C - fracture below the tip of the stem - ORIF Support the show

Osteonecrosis Staging Systems

January 23, 2021 08:00 - 9 minutes - 6.28 MB

Here I review the two common classifications for ON of the hip, Ficat and Steinberg. The modified Ficat, Idiopathic bone necrosis of the femoral head,  was published in 1985 JBJS-Br 0 - Preclinical and pre-radiographic I - Xray is normal but hip is symptomatic II - sclerosis and cysts on xray III - Crescent sign IV - OA with a deformed head Steinberg, A quantitative system for staging avascular necrosis, JBJS-Br 1995 0 - Normal 1 - Xray normal, BS +, MRI + 2 - sclerosis and cysts on x-ra...

Fairbank

January 16, 2021 08:00 - 5 minutes - 4.09 MB

Knee Joint Changes after Meniscectomy by T.J. Fairbank published JBJS - Br 1948 The following radiological changes were seen after meniscectomy 1. Ridge formation 2. Narrowing of the joint space 3. Flattening of the femoral condyle Support the show

HO - Brooker Classification

January 10, 2021 20:00 - 4 minutes - 3.26 MB

Brooker et al JBJS Vol 55-A 1973 Class I - Islands of bone within the soft tissue around the hip Class II - Bone spurs from the pelvis or proximal femur , leaving at least 1 cm between Class III - Bone spurs from the pelvis or proximal femur, reducing the space between to less than 1 cm Class IV - bony ankylosis Support the show

Patella Clunk

December 26, 2020 08:00 - 6 minutes - 4.46 MB

Although rarely seen with newer TKA designs this was a diagnosis seen in patients with TKAs and could be extremely symptomatic. Patellar clunk was first described by Hozack et al in 1989. Patellar clunk occurred when a fibrous nodule forms above the patella.  This nodule would get caught in the intercondylar notch in flexion and then cause a painful clunk as patients whet from flexion into extension. This is a clinical diagnosis. Patients tend to do well with arthroscopic debridement whe...

The Outerbridge Classification

December 20, 2020 19:00 - 7 minutes - 4.99 MB

This is the first in a series of episodes where I review some classic articles and classifications. The Outerbridge classification was first presented in JBJS-B in 1961 The classification is as follows: 1 - Softening and swelling 2 - Fragmentation and fissuring less than 1/2 inch diameter 3 - Fragmentation and fissuring greater than 1/2 inch diameter 4 - exposed bone Support the show

Using a Star System for Difficult Cases

December 04, 2020 23:00 - 6 minutes - 4.82 MB

In my first year of practice I remember a day where I only had three joints but it took all day and I was exhausted.  Although they were all primaries they each had a component that made them hard - size, bone loss, stiffness. I created a system that allowed me to communicate with my scheduler so they could spread out the hard cases which prevented one day from having all chip shot easy cases and another day which had all of the hard cases. I hope you find this tip helpful in your practice...

Balancing Algorithm in TKA

November 21, 2020 08:00 - 27 minutes - 18.7 MB

Most gunners, interns and residents have memorized "the chart."  That chart with what to do in a TKA when flexion is loose or the extension gap is tight or vice versa.  Here I want to review that and more and discuss the things that I look for during balancing. Support the show

Twitter Mentions

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