{"id":3643,"date":"2024-04-14T21:09:21","date_gmt":"2024-04-14T13:09:21","guid":{"rendered":"https:\/\/ndhorth.synology.me\/wordpress\/?p=3643"},"modified":"2024-04-15T23:36:27","modified_gmt":"2024-04-15T15:36:27","slug":"tkr","status":"publish","type":"post","link":"https:\/\/ndhot.uk\/wordpress\/?p=3643","title":{"rendered":"TKR"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"3643\" class=\"elementor elementor-3643\" data-elementor-post-type=\"post\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-cbabf11 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"cbabf11\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-46440f1\" data-id=\"46440f1\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-c44304a elementor-nav-menu--stretch elementor-nav-menu--dropdown-tablet elementor-nav-menu__text-align-aside elementor-nav-menu--toggle elementor-nav-menu--burger elementor-widget elementor-widget-nav-menu\" data-id=\"c44304a\" data-element_type=\"widget\" data-settings=\"{&quot;full_width&quot;:&quot;stretch&quot;,&quot;layout&quot;:&quot;horizontal&quot;,&quot;submenu_icon&quot;:{&quot;value&quot;:&quot;&lt;i class=\\&quot;fas fa-caret-down\\&quot;&gt;&lt;\\\/i&gt;&quot;,&quot;library&quot;:&quot;fa-solid&quot;},&quot;toggle&quot;:&quot;burger&quot;}\" data-widget_type=\"nav-menu.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t<nav aria-label=\"Menu\" class=\"elementor-nav-menu--main elementor-nav-menu__container elementor-nav-menu--layout-horizontal e--pointer-underline e--animation-fade\">\n\t\t\t\t<ul id=\"menu-1-c44304a\" class=\"elementor-nav-menu\"><li class=\"menu-item menu-item-type-post_type menu-item-object-post menu-item-3647\"><a href=\"https:\/\/ndhot.uk\/wordpress\/?p=3643\" class=\"elementor-item menu-link\">TKR<\/a><\/li>\n<\/ul>\t\t\t<\/nav>\n\t\t\t\t\t<div class=\"elementor-menu-toggle\" role=\"button\" tabindex=\"0\" aria-label=\"Menu Toggle\" aria-expanded=\"false\">\n\t\t\t<i aria-hidden=\"true\" role=\"presentation\" class=\"elementor-menu-toggle__icon--open fas fa-book\"><\/i><i aria-hidden=\"true\" role=\"presentation\" class=\"elementor-menu-toggle__icon--close eicon-close\"><\/i>\t\t\t<span class=\"elementor-screen-only\">Menu<\/span>\n\t\t<\/div>\n\t\t\t\t\t<nav class=\"elementor-nav-menu--dropdown elementor-nav-menu__container\" aria-hidden=\"true\">\n\t\t\t\t<ul id=\"menu-2-c44304a\" class=\"elementor-nav-menu\"><li class=\"menu-item menu-item-type-post_type menu-item-object-post menu-item-3647\"><a href=\"https:\/\/ndhot.uk\/wordpress\/?p=3643\" class=\"elementor-item menu-link\" tabindex=\"-1\">TKR<\/a><\/li>\n<\/ul>\t\t\t<\/nav>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-d06d2cb elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"d06d2cb\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-ab71896\" data-id=\"ab71896\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-f1d9cdf elementor-widget elementor-widget-heading\" data-id=\"f1d9cdf\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">Total Knee Replacement<\/h4>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-f5e6eba elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"f5e6eba\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-640b983\" data-id=\"640b983\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-047aff9 elementor-widget elementor-widget-shortcode\" data-id=\"047aff9\" data-element_type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-shortcode\">\n<style>\n\t#hotspot-3640 .hotspots-image-container,\n\t#hotspot-3640 .leaflet-container {\n\t\tbackground: #efefef\t}\n\n\t#hotspot-3640 .hotspots-placeholder,\n\t.featherlight .featherlight-content.lightbox-3640 {\n\t\tbackground: #fafbff;\n\t\tborder: 0 #fafbff solid;\n\t\tcolor: #001440;\n\t}\n\n\t#hotspot-3640 .hotspot-title,\n\t#hotspot-3640 .bc-product__title a,\n\t.featherlight .featherlight-content.lightbox-3640 .hotspot-title,\n\t.featherlight .featherlight-content.lightbox-3640 .bc-product__title a {\n\t\tcolor: #20418d;\n\t}\n\n\t\t\t#hotspot-3640 .hotspot-style-1 {\n\t\t\tstroke-width: 3;\n\t\t\tfill: #ffffff;\n\t\t\tfill-opacity: 0;\n\t\t\tstroke: #ffffff;\n\t\t\tstroke-opacity: 0;\n\t\t}\n\t\t#hotspot-3640 .hotspot-style-1:hover,\n\t\t#hotspot-3640 .hotspot-style-1:focus,\n\t\t#hotspot-3640 .hotspot-style-1.hotspot-active {\n\t\t\tfill: #ffffff;\n\t\t\tfill-opacity: 0.81;\n\t\t\toutline: none;\n\t\t\tstroke: #ffffff;\n\t\t\tstroke-opacity: 0.01;\n\t\t}\n\t\t\t#hotspot-3640 .hotspot-default {\n\t\t\tstroke-width: 3;\n\t\t\tfill: #ffffff;\n\t\t\tfill-opacity: 0;\n\t\t\tstroke: #ffffff;\n\t\t\tstroke-opacity: 0;\n\t\t}\n\t\t#hotspot-3640 .hotspot-default:hover,\n\t\t#hotspot-3640 .hotspot-default:focus,\n\t\t#hotspot-3640 .hotspot-default.hotspot-active {\n\t\t\tfill: #20418d;\n\t\t\tfill-opacity: 0.01;\n\t\t\toutline: none;\n\t\t\tstroke: #001440;\n\t\t\tstroke-opacity: 0.01;\n\t\t}\n\t\t#hotspot-3640 .leaflet-tooltip,\n\t#hotspot-3640 .leaflet-rrose-content-wrapper {\n\t\tbackground: #fafbff;\n\t\tborder-color: #fafbff;\n\t\tcolor: #001440;\n\t}\n\n\t#hotspot-3640 a.leaflet-rrose-close-button {\n\t\tcolor: #20418d;\n\t}\n\n\t#hotspot-3640 .leaflet-rrose-tip {\n\t\tbackground: #fafbff;\n\t}\n\n\t#hotspot-3640 .leaflet-popup-scrolled {\n\t\tborder-bottom-color: #001440;\n\t\tborder-top-color: #001440;\n\t}\n\n\t#hotspot-3640 .leaflet-tooltip-top:before {\n\t\tborder-top-color: #fafbff;\n\t}\n\n\t#hotspot-3640 .leaflet-tooltip-bottom:before {\n\t\tborder-bottom-color: #fafbff;\n\t}\n\t#hotspot-3640 .leaflet-tooltip-left:before {\n\t\tborder-left-color: #fafbff;\n\t}\n\t#hotspot-3640 .leaflet-tooltip-right:before {\n\t\tborder-right-color: #fafbff;\n\t}\n<\/style>\n\n\n\t<div class=\"hotspots-container  layout-lightbox event-click\" id=\"hotspot-3640\" data-layout=\"lightbox\" data-trigger=\"click\">\n\t\t<div class=\"hotspots-interaction\">\n\t\t\t<div class=\"hotspots-image-container\">\n\t<img\n\t\twidth=\"1280\"\n\t\theight=\"720\"\n\t\tsrc=\"https:\/\/ndhot.uk\/wordpress\/wp-content\/uploads\/2024\/04\/TKR.png\"\n\t\talt=\"TKR\"\n\t\tclass=\"hotspots-image skip-lazy\"\n\t\tusemap=\"#hotspots-image-3640\"\n\t\tdata-image-title=\"TKR\"\n\t\tdata-image-description=\"\"\n\t\tdata-event-trigger=\"click\"\n\t\tdata-always-visible=\"false\"\n\t\tdata-id=\"3640\"\n\t\tdata-no-lazy=\"1\"\n\t\tdata-lazy-src=\"\"\n\t\tdata-lazy=\"false\"\n\t\tloading=\"eager\"\n\t\tdata-skip-lazy=\"1\"\n\t\t>\n<\/div>\t\t<\/div>\n\t\t<map name=\"hotspots-image-3640\" class=\"hotspots-map\">\n\t\t\t\t\t\t\t\t\t\t\t<area\n\t\t\t\t\tshape=\"polygon\"\n\t\t\t\t\tcoords=\"96,273,96,225,376,225,376,273\"\n\t\t\t\t\thref=\"#hotspot-hotspot-3640-0\"\n\t\t\t\t\trel=\"\"\n\t\t\t\t\ttitle=\"Position and Draping\"\n\t\t\t\t\talt=\"Position and Draping\"\n\t\t\t\t\tdata-action=\"\"\n\t\t\t\t\tdata-color-scheme=\"\"\n\t\t\t\t\tdata-id=\"area-hotspot-3640-0\"\n\t\t\t\t\ttarget=\"\"\n\t\t\t\t\tclass=\"more-info-area\"\n\t\t\t\t\t>\n\t\t\t\t\t\t\t\t\t\t\t<area\n\t\t\t\t\tshape=\"polygon\"\n\t\t\t\t\tcoords=\"104,505,104,447,376,447,376,505\"\n\t\t\t\t\thref=\"#hotspot-hotspot-3640-1\"\n\t\t\t\t\trel=\"\"\n\t\t\t\t\ttitle=\"Procedure\"\n\t\t\t\t\talt=\"Procedure\"\n\t\t\t\t\tdata-action=\"\"\n\t\t\t\t\tdata-color-scheme=\"\"\n\t\t\t\t\tdata-id=\"area-hotspot-3640-1\"\n\t\t\t\t\ttarget=\"\"\n\t\t\t\t\tclass=\"more-info-area\"\n\t\t\t\t\t>\n\t\t\t\t\t\t\t\t\t\t\t<area\n\t\t\t\t\tshape=\"polygon\"\n\t\t\t\t\tcoords=\"870,321,870,269,1231,269,1231,321\"\n\t\t\t\t\thref=\"#hotspot-hotspot-3640-2\"\n\t\t\t\t\trel=\"\"\n\t\t\t\t\ttitle=\"Consumable\"\n\t\t\t\t\talt=\"Consumable\"\n\t\t\t\t\tdata-action=\"\"\n\t\t\t\t\tdata-color-scheme=\"\"\n\t\t\t\t\tdata-id=\"area-hotspot-3640-2\"\n\t\t\t\t\ttarget=\"\"\n\t\t\t\t\tclass=\"more-info-area\"\n\t\t\t\t\t>\n\t\t\t\t\t<\/map>\n\n\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t<div class=\"hotspot-info \" id=\"hotspot-hotspot-3640-0\">\n\t\t\t\t\n\t\t\t\t<h2 class=\"hotspot-title\">Position and Draping<\/h2>\t\t\t\t\t\t\t\t\t<div class=\"hotspot-thumb\">\n\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"682\" height=\"924\" src=\"https:\/\/ndhot.uk\/wordpress\/wp-content\/uploads\/2024\/04\/TKR-draping.png\" class=\"attachment-large size-large\" alt=\"\" srcset=\"https:\/\/ndhot.uk\/wordpress\/wp-content\/uploads\/2024\/04\/TKR-draping.png 682w, https:\/\/ndhot.uk\/wordpress\/wp-content\/uploads\/2024\/04\/TKR-draping-221x300.png 221w\" sizes=\"(max-width: 682px) 100vw, 682px\" \/>\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"hotspot-content\">\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t\t\n\t\t\t\t\t\t<div class=\"hotspot-info \" id=\"hotspot-hotspot-3640-1\">\n\t\t\t\t\n\t\t\t\t<h2 class=\"hotspot-title\">Procedure<\/h2>\t\t\t\t\t\t\t\t<div class=\"hotspot-content\">\n\t\t\t\t\t<p style=\"margin-top: 0pt;margin-bottom: 0pt;margin-left: .09in;text-align: left;direction: ltr\"><u><span style=\"font-size: 14.0pt;font-family: Calibri;color: black;font-weight: bold\">Procedure<\/span><\/u><\/p>\n<div style=\"margin-top: 0pt;margin-bottom: 0pt;margin-left: .25in;text-indent: -.25in;text-align: left;direction: ltr\"><span style=\"font-size: 12.0pt\"><span style=\"font-family: +mj-lt\">1.<\/span><\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">Skin <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">incision with surgical blade No. 20. <\/span><\/div>\n<div style=\"margin-top: 0pt;margin-bottom: 0pt;margin-left: .25in;text-indent: -.25in;text-align: left;direction: ltr\"><span style=\"font-size: 12.0pt\"><span style=\"font-family: +mj-lt\">2.<\/span><\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">Haemostasis<\/span> <span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">with diathermy pen. <\/span><\/div>\n<div style=\"margin-top: 0pt;margin-bottom: 0pt;margin-left: .25in;text-indent: -.25in;text-align: left;direction: ltr\"><span style=\"font-size: 12.0pt\"><span style=\"font-family: +mj-lt\">3.<\/span><\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">Dissect <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">muscle and expose knee joint with diathermy, mayo curved scissors and periosteal elevator. <\/span><\/div>\n<div style=\"margin-top: 0pt;margin-bottom: 0pt;margin-left: .25in;text-indent: -.25in;text-align: left;direction: ltr\"><span style=\"font-size: 12.0pt\"><span style=\"font-family: +mj-lt\">4.<\/span><\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">Perform <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">initiate <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">tibial<\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\"> plateau cutting. <\/span><\/div>\n<div style=\"margin-top: 0pt;margin-bottom: 0pt;margin-left: .25in;text-indent: -.25in;text-align: left;direction: ltr\"><span style=\"font-size: 12.0pt\"><span style=\"font-family: +mj-lt\">5.<\/span><\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">Apply <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">anterotation<\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\"> guide to mark a reference on distal femur for resection guide. <\/span><\/div>\n<div style=\"margin-top: 0pt;margin-bottom: 0pt;margin-left: .25in;text-indent: -.25in;text-align: left;direction: ltr\"><span style=\"font-size: 12.0pt\"><span style=\"font-family: +mj-lt\">6.<\/span><\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">Apply <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">anterior resection guide for initial anterior resection. <\/span><\/div>\n<div style=\"margin-top: 0pt;margin-bottom: 0pt;margin-left: .25in;text-indent: -.25in;text-align: left;direction: ltr\"><span style=\"font-size: 12.0pt\"><span style=\"font-family: +mj-lt\">7.<\/span><\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">Followed <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">by distal cutting. <\/span><\/div>\n<div style=\"margin-top: 0pt;margin-bottom: 0pt;margin-left: .25in;text-indent: -.25in;text-align: left;direction: ltr\"><span style=\"font-size: 12.0pt\"><span style=\"font-family: +mj-lt\">8.<\/span><\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">Measure <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">femur size with femoral sizer<\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">.<\/span><\/div>\n<div style=\"margin-top: 0pt;margin-bottom: 0pt;margin-left: .25in;text-indent: -.25in;text-align: left;direction: ltr\"><span style=\"font-size: 12.0pt\"><span style=\"font-family: +mj-lt\">9.<\/span><\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">Test <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">the flexion and extension gaps with spacer block. <\/span><\/div>\n<div style=\"margin-top: 0pt;margin-bottom: 0pt;margin-left: .25in;text-indent: -.25in;text-align: left;direction: ltr\"><span style=\"font-size: 12.0pt\"><span style=\"font-family: +mj-lt\">10.<\/span><\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">Perform <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">A--P cut, chamfer cut and notch cut accordingly. <\/span><\/div>\n<div style=\"margin-top: 0pt;margin-bottom: 0pt;margin-left: .25in;text-indent: -.25in;text-align: left;direction: ltr\"><span style=\"font-size: 12.0pt\"><span style=\"font-family: +mj-lt\">11.<\/span><\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">Apply <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">appropriate femoral provisional. <\/span><\/div>\n<div style=\"margin-top: 0pt;margin-bottom: 0pt;margin-left: .25in;text-indent: -.25in;text-align: left;direction: ltr\"><span style=\"font-size: 12.0pt\"><span style=\"font-family: +mj-lt\">12.<\/span><\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">Size <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">the tibia with <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">tibial<\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\"> template. <\/span><\/div>\n<div style=\"margin-top: 0pt;margin-bottom: 0pt;margin-left: .25in;text-indent: -.25in;text-align: left;direction: ltr\"><span style=\"font-size: 12.0pt\"><span style=\"font-family: +mj-lt\">13.<\/span><\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">Prepare <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">tibial<\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\"> side with <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">tibial<\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\"> stem broach. <\/span><\/div>\n<div style=\"margin-top: 0pt;margin-bottom: 0pt;margin-left: .25in;text-indent: -.25in;text-align: left;direction: ltr\"><span style=\"font-size: 12.0pt\"><span style=\"font-family: +mj-lt\">14.<\/span><\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">+\/-Prepare <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">patella with patella cutting guide and patella drill. <\/span><\/div>\n<div style=\"margin-top: 0pt;margin-bottom: 0pt;margin-left: .25in;text-indent: -.25in;text-align: left;direction: ltr\"><span style=\"font-size: 12.0pt\"><span style=\"font-family: +mj-lt\">15.<\/span><\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">Apply <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">appropriate <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">tibial<\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\"> tray, insert and patella provisional for trial reduction and test the range of motion. <\/span><\/div>\n<div style=\"margin-top: 0pt;margin-bottom: 0pt;margin-left: .25in;text-indent: -.25in;text-align: left;direction: ltr\"><span style=\"font-size: 12.0pt\"><span style=\"font-family: +mj-lt\">16.<\/span><\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">Irrigate <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">wound with <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">pulsavac<\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">. <\/span><\/div>\n<div style=\"margin-top: 0pt;margin-bottom: 0pt;margin-left: .25in;text-indent: -.25in;text-align: left;direction: ltr\"><span style=\"font-size: 12.0pt\"><span style=\"font-family: +mj-lt\">17.<\/span><\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">Turn <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">off diathermy for cement preparation. <\/span><\/div>\n<div style=\"margin-top: 0pt;margin-bottom: 0pt;margin-left: .25in;text-indent: -.25in;text-align: left;direction: ltr\"><span style=\"font-size: 12.0pt\"><span style=\"font-family: +mj-lt\">18.<\/span><\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">Prepare <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">cement for implantation. <\/span><\/div>\n<div style=\"margin-top: 0pt;margin-bottom: 0pt;margin-left: .25in;text-indent: -.25in;text-align: left;direction: ltr\"><span style=\"font-size: 12.0pt\"><span style=\"font-family: +mj-lt\">19.<\/span><\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">Turn <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">on diathermy and perform <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">haemostatsis<\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">. <\/span><\/div>\n<div style=\"margin-top: 0pt;margin-bottom: 0pt;margin-left: .25in;text-indent: -.25in;text-align: left;direction: ltr\"><span style=\"font-size: 12.0pt\"><span style=\"font-family: +mj-lt\">20.<\/span><\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">Irrigate <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">wound with <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">pulsavac<\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\"> again. <\/span><\/div>\n<div style=\"margin-top: 0pt;margin-bottom: 0pt;margin-left: .25in;text-indent: -.25in;text-align: left;direction: ltr\"><span style=\"font-size: 12.0pt\"><span style=\"font-family: +mj-lt\">21.<\/span><\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">Close <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">wound with <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">Stratafix<\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">, <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">vicryl<\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\"> 1, <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">vicryl<\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\"> 2\/O and skin stapler. <\/span><\/div>\n<div style=\"margin-top: 0pt;margin-bottom: 0pt;margin-left: .25in;text-indent: -.25in;text-align: left;direction: ltr\"><span style=\"font-size: 12.0pt\"><span style=\"font-family: +mj-lt\">22.<\/span><\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">Dress <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">wound with <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">Aquacel<\/span> <span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">Ag, plain gauze, <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">velband<\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\"> and crepe bandage.<\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\"><br \/>\n<\/span><\/div>\n<p style=\"margin-top: 0pt;margin-bottom: 0pt;margin-left: 0in;text-align: left;direction: ltr\"><span style=\"font-size: 14.0pt;font-family: Calibri;color: black;font-weight: bold\">\u00a0<\/span><u><span style=\"font-size: 14.0pt;font-family: Calibri;color: black;font-weight: bold\">Wound closing <\/span><\/u><\/p>\n<p style=\"margin-top: 0pt;margin-bottom: 0pt;margin-left: 0in;text-align: left;direction: ltr\"><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">Stratafix<\/span> <span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">2XCTX @1<\/span><\/p>\n<p style=\"margin-top: 0pt;margin-bottom: 0pt;margin-left: 0in;text-align: left;direction: ltr\"><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">V<\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">icryl<\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\"> 1<\/span> <span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">@2<\/span><\/p>\n<p style=\"margin-top: 0pt;margin-bottom: 0pt;margin-left: 0in;text-align: left;direction: ltr\"><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">V<\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">icryl<\/span> <span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">2\/O <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">@2<\/span><\/p>\n<p style=\"margin-top: 0pt;margin-bottom: 0pt;margin-left: 0in;text-align: left;direction: ltr\"><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">Skin <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">stapler <\/span><\/p>\n<p style=\"margin-top: 0pt;margin-bottom: 0pt;margin-left: 0in;text-align: left;direction: ltr\"><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">Plain <\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">gauze\u00a0 <\/span><\/p>\n<p style=\"margin-top: 0pt;margin-bottom: 0pt;margin-left: 0in;text-align: left;direction: ltr\"><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">Velband<\/span> <span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">@3<\/span><\/p>\n<p style=\"margin-top: 0pt;margin-bottom: 0pt;margin-left: 0in;text-align: left;direction: ltr\"><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">C<\/span><span style=\"font-size: 12.0pt;font-family: Calibri;color: black\">repe bandage @3<\/span><\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t\t\n\t\t\t\t\t\t<div class=\"hotspot-info \" id=\"hotspot-hotspot-3640-2\">\n\t\t\t\t\n\t\t\t\t<h2 class=\"hotspot-title\">Consumable<\/h2>\t\t\t\t\t\t\t\t\t<div class=\"hotspot-thumb\">\n\t\t\t\t\t\t<img decoding=\"async\" width=\"667\" height=\"789\" src=\"https:\/\/ndhot.uk\/wordpress\/wp-content\/uploads\/2024\/04\/TKR-consumable.png\" class=\"attachment-large size-large\" alt=\"\" srcset=\"https:\/\/ndhot.uk\/wordpress\/wp-content\/uploads\/2024\/04\/TKR-consumable.png 667w, https:\/\/ndhot.uk\/wordpress\/wp-content\/uploads\/2024\/04\/TKR-consumable-254x300.png 254w\" sizes=\"(max-width: 667px) 100vw, 667px\" \/>\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"hotspot-content\">\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<\/div>\n\n<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-a8e5760 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"a8e5760\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-ef54c41\" data-id=\"ef54c41\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-70a4f55 elementor-view-stacked elementor-shape-circle elementor-widget elementor-widget-icon\" data-id=\"70a4f55\" data-element_type=\"widget\" data-widget_type=\"icon.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-icon-wrapper\">\n\t\t\t<a class=\"elementor-icon\" href=\"https:\/\/ndhorth.synology.me\/wordpress\/?page_id=903\">\n\t\t\t<i aria-hidden=\"true\" class=\"fas fa-undo\"><\/i>\t\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Total Knee 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