Knee Reconstruction, Soft Tissue Workup

Updated: Nov 02, 2018
  • Author: Steven L Bernard, MD; Chief Editor: Jorge I de la Torre, MD, FACS  more...
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Workup

Laboratory Studies

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  • Routine preoperative screening of healthy people undergoing elective surgery is not recommended.

  • A serum creatinine level should be ordered for patients older than 40 years.

  • Blood coagulation studies should be performed in all patients currently on anticoagulants.

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Imaging Studies

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  • Order a chest radiograph in patients older than 60 years.

  • All patients with suspected vascular injury should undergo arteriograms of the affected leg.

  • Patients in whom free tissue transfer is considered as an option in the reconstruction should undergo arteriogram of the leg.

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Other Tests

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  • Order an ECG in patients older than 40 years.

  • If the patient has a significant history of cardiopulmonary disease, further testing may be indicated (eg, echocardiography, pulmonary function tests).

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Diagnostic Procedures

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  • For those patients being treated for infected TKA, wound tissue cultures and bone cultures should all be negative and the patient should have completed his or her course of long-term antibiotics prior to replacing an antibiotic knee joint spacer with a new TKA.

  • The procedure can be stage by first proving adequate soft tissue vascularized coverage and later replacing the TKA.

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