Vastus Medialis and Lateralis Flaps for Quadriceps Insufficiency Post TKA by Dr. Anoop Jhurani

Description

In this instructional video, Dr. Anoop Jhurani discusses the complexities of soft tissue reconstruction for patients with proximal quadriceps deficiency or insufficiency following total knee arthroplasty (TKA). The video outlines the various factors that contribute to extensor mechanism failure, emphasizing the importance of addressing soft tissue issues when bone and implant-related causes are ruled out. One specific patient case is examined, illustrating how he presented post-bilateral TKA with a palpable gap in the quadriceps, leading to difficulties in mobility and significant weight-bearing challenges.



The presentation includes detailed insights into diagnosing quadriceps insufficiency, differentiating it from neurological or muscular causes, and evaluating the patient condition through imaging. Dr. Jhurani then elaborates on a surgical plan involving the use of Vastus Medialis and Lateralis flaps—rotating local muscle flaps to reconstruct the damaged extensor mechanism. He emphasizes the significance of meticulous dissection and suturing techniques to ensure optimal flap integration and overall patient outcomes.



The video further covers surgical steps, such as the careful elevation of flaps, mobilization toward the defect, and precise closure techniques to prevent dead space and post-operative complications. It guides viewers on rehabilitation protocols, highlighting the challenge of maintaining knee extension post-surgery. Dr. Jhurani shares positive rehabilitation progress for the discussed patient, indicating improvements in function and stability. He concludes by encouraging orthopedic surgeons to master these approaches, particularly in regions where allografts may not be readily available, thus promoting enhanced post-operative recovery for patients facing similar conditions.

DOI: 10.1302/3114-230027

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