Optimized Patient Care in the Perioperative Management of Hip and Knee Arthroplasty: Pre-operative Planning of TKA (Conventional Technique, Patient-specific Instrumentation, Robotic-arm Assisted Technique

This chapter delves into the critical aspect of pre-operative planning in total knee arthroplasty (TKA), emphasising its key role in ensuring optimised patient outcomes. The comprehensive approach begins with patient evaluation in the clinic, incorporating a detailed history and physical examination, coupled with an assessment of psychological factors that may impact post-operative satisfaction. The chapter underscores the importance of addressing various patient-specific factors, including age, gender, weight, BMI and comorbidities, to tailor surgical strategies effectively. Significant attention is given to the role of imaging in pre-operative planning, highlighting the utility of different modalities like radiographs, CT and MRI in understanding knee alignment and informing implant selection. Furthermore, the chapter extensively covers the integration of robotic technology in pre-operative planning, emphasising the steps to achieve precision in implant positioning and alignment tailored to the patient phenotype. The discussion extends to the intricacies of alignment philosophies, including mechanical, kinematic and functional alignment facilitated by advances in surgical technologies such as robotic-arm-assisted arthroplasty. Patient-specific instrumentation (PSI) and its role in achieving precise implant positioning are also explored, along with insights into complex primary TKA scenarios.