Knee arthroplasty
Anesthesia type

General or spinal Regional

Airway

ETT/LMA if general

Lines and access

PIV

Monitors

Standard 5-lead ECG

Primary anesthetic considerations
Preoperative
Intraoperative
Postoperative
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Knee arthroplasty is a surgical procedure to resurface a knee damaged by arthritis.

Overview

Indications

  • Knee arthritis (inflammatory) or arthrosis (non-inflammatory degeneration)
  • Infected knee
  • Loose or malpositioned knee prothesis

Surgical procedure

Preoperative management

Patient evaluation

System Considerations
Airway
Neurologic Arthritis may impair neck ROM or cause cervical nerve root compression.
Cardiovascular Patients with arthritis may have limited exercise tolerance due to knee pain, thus impairing assessment of cardiovascular function. Stress echo may be needed for cardiac evaluation.
Pulmonary
Gastrointestinal
Hematologic
Renal
Endocrine
Other Patients may have rheumatoid arthritis

Labs and studies

Operating room setup

Patient preparation and premedication

Regional and neuraxial techniques

  • Adductor canal block
  • Femoral nerve block +/- lateral femoral cutaneous
  • Sciatic nerve block


Note: Some surgeons will perform a periarticular injection with a long-lasting local anesthetic (i.e. liposomal bupivicaine) prior to emergence.

Intraoperative management

Monitoring and access

  • Standard ASA monitors
  • PIV

Induction and airway management

Positioning

Maintenance and surgical considerations

Emergence

Postoperative management

Disposition

Pain management

Potential complications

Procedure variants

Variant 1 Variant 2
Unique considerations
Position
Surgical time
EBL
Postoperative disposition
Pain management
Potential complications

References