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Soft Tissue Issues and Considerations in Total Knee Arthroplasty

Padilla, Jorge A. MD*; Teo, Greg MD; Vigdorchik, Jonathan M. MD*; Schwarzkopf, Ran MD, MSc*; Long, William J. MD, FRCSC*,†

doi: 10.1097/BTO.0000000000000380

Total knee arthroplasty is projected to increase beyond substantial numbers due to an aging population. An important factor to avoid common complications is meticulous attention to soft tissue and skin healing. Comprehensive knowledge of wound healing and vascular anatomy provides a stable foundation for the physician and surgeon. This is complimented by updated information on common complications and preoperative optimization of undesirable factors that could hinder the success of a total knee arthroplasty. The need for prophylactic intervention may be determined during the preoperative evaluation and is recommended in patients with severe compromise of the overlying soft tissues. Meticulous surgical technique and careful handling of the surrounding soft tissues is imperative to prevent postoperative skin issues. Postoperative considerations and treatments are now available to avoid progression of complications to failure of prosthesis.

*Adult Reconstructive Division, Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital

Insall Scott Kelly Institute, New York, NY

This project was supported by an unrestricted grant from KCI, an Acelity company. Project management support was provided by MedicusWorks.

W.J.L. serves as a board or committee member of AAOS; serves in the editorial or governing board of Journal of Arthroplasty; is a paid presenter of Convatec, Pacira, and Think Surgical; is a paid consultant of Depuy, Ortho Development, and Microport, and TJO. He receives royalties from Elsevier, Ortho Development, and Microport. R.S. serves as a board or committee member of AAOS and AAHKS; serves in the editorial or governing board of Arthroplasty Today and Journal of Arthroplasty; is a paid consultant of Smith & Nephew and Intellijoint; and holds stock in Gauss Surgical and Intellijoint. The remaining authors declare that they have nothing to disclose.

For reprint requests, or additional information and guidance on the techniques described in the article, please contact William J. Long, MD, FRCSC, at or by mail at Department of Orthopedic Surgery, NYU Langone Health, Insall Scott Kelly Institute, 260 East 66th Street, New York, NY 10065. You may inquire whether the author(s) will agree to phone conferences and/or visits regarding these techniques.

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