OPERATION NOTE:

Left Right  Posterior Stabilised (Total) Knee replacement
(*=delete as appropriate)
Date of operation:

Patient name:      

Hospital number:

Date of Birth:      

Consultant   

Surgeon:                                                       Supervision:   Independent/Unscrubbed/Scrubbed
Grade:           FY2/CT1/CT2 StR/SpR Fellow Consultant

Assistant:     
Grade:            FY2/CT1/CT2 StR/SpR Fellow Consultant

Anaesthetist: _
Grade:            FY2/CT1/CT2 StR/SpR Fellow Consultant

Indication:       Osteoarthritis Inflammatory arthritis Post-traumatic arthritis Avascular Necrosis

Background:    Patient consented including alternative procedures and non-surgical treatments, understanding the risks of pain, bleeding, infection, damage to nerves or blood vessels, wear, loosening, instability, stiffness, need for further surgery, leg length discrepancy, fracture, dislocation, scars, venous thromboembolism, dissatisfaction / failure to meet expectations, future revision surgery and anaesthetic (including heart attack, stroke and death).

Setup:              WHO safety checklist performed .Prepped with Betadine/Chlorhexidine* and draped

EUA / Range of movement: Extension:         Flexion:       Alignment: Varus Valgus Neutral Correctible Non-Correctible Not fully correctible

Anaesthetic:     General Anaesthetic Spinal +/- Block

Antibiotics:        Cefuroxime Co-Amoxiclav Clindamycin Teicoplanin Gentamycin               At induction __mg

Additional:        Tranexamic acid

Equipment:      Tourniquet:                       Tourniquet pressure: _ mmHg      Tourniquet time: mins

     Inflated after Exsanguination Elevation

Position:            Supine with side support

Approach:         Midline incision, medial parapatellar approach lateral parapatellar approach mid vastus sub vastus

Findings:           Tricompartmental Bicompartmental Unicompartmental arthritis.

System/Impants used:

Procedure:          Approach to knee through soft tissues and osteophytes cleared

• MCL/LCL protected for cuts

Releases required: Medial       Lateral       Quads

Femoral preparation:

IM referencing. Distal cut 5 6 7 4 Valgus

Rotational alignment: Whiteside’s line    Trans Epicondylar Axis

Referencing: Anterior Posterior

Measure & sized:. Champfers cut. Box for PS cut using jig

 

Tibial preparation:

Referencing: Intramedullary      Extramedulary

Meniscal remnants, osteophytes & osteophyes cleared

Cut: 10 2 3 4 8 9 11 12 mm from the Lateral Medial side. Slope: 0 degrees 3 degrees 5 degrees

Measured / sized:

Rotation check and pinned. Stem preparation (shaft + fin punch)

 

Patellar preparation:

Patellaplasty / denervation

Resurfaced   : Measured/cut/sized:

 

Satisfactory trial to confirm implant choices:

Stability, rotation, range of motion and tracking with above implants and tibal poly trial

Local anaesthetic infiltration with

Cemented as above. Excess cement removed.

Haemostasis

Washout

Closure:               In layers, Vicryl 1, Vicyl 2-0

Clips Monocryl 3-0 Nylon 3-0 PDS 3-0  for skin. Opsite Mepore Softpore Aquacel/Duoderm dressing

Skin glue 

Wool & crepe bandage.

Post-op:               Routine and neurovascular observations

Full weight-bearing

Check bloods and x-rays mane

VTE prophylaxis as per trust protocol

Further post op anti-biotics for doses hours days

Follow-up with GP Surgeon Nurse specialist in 10-14 days for wound review and removal of sutures / clips .

Follow-up in clinic in six weeks

Signed: ______________________