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Elle est couramment pratiquée pour soulager les douleurs et restaurer la mobilité chez les patients souffrant d’arthrose avancée, de polyarthrite rhumatoïde ou d’autres pathologies dégénératives du genou.Indications pour une Prothèse Totale de Genou","text",{"type":132,"image":133,"children":177},"image",{"ext":134,"url":135,"hash":136,"mime":137,"name":138,"size":139,"width":140,"height":141,"caption":142,"formats":143,"provider":175,"createdAt":176,"updatedAt":176,"previewUrl":142,"alternativeText":138,"provider_metadata":142},".jpg","https:\u002F\u002Flircos.org\u002Fapi\u002Fuploads\u002FPTG_6_cdb5d5e88c.jpg","PTG_6_cdb5d5e88c","image\u002Fjpeg","PTG 6.jpg",567.11,3734,2490,null,{"large":144,"small":152,"medium":160,"thumbnail":167},{"ext":134,"url":145,"hash":146,"mime":137,"name":147,"path":142,"size":148,"width":149,"height":150,"sizeInBytes":151},"\u002Fuploads\u002Flarge_PTG_6_cdb5d5e88c.jpg","large_PTG_6_cdb5d5e88c","large_PTG 6.jpg",58.65,1000,667,58649,{"ext":134,"url":153,"hash":154,"mime":137,"name":155,"path":142,"size":156,"width":157,"height":158,"sizeInBytes":159},"\u002Fuploads\u002Fsmall_PTG_6_cdb5d5e88c.jpg","small_PTG_6_cdb5d5e88c","small_PTG 6.jpg",21.14,500,333,21141,{"ext":134,"url":161,"hash":162,"mime":137,"name":163,"path":142,"size":164,"width":165,"height":157,"sizeInBytes":166},"\u002Fuploads\u002Fmedium_PTG_6_cdb5d5e88c.jpg","medium_PTG_6_cdb5d5e88c","medium_PTG 6.jpg",38.06,750,38057,{"ext":134,"url":168,"hash":169,"mime":137,"name":170,"path":142,"size":171,"width":172,"height":173,"sizeInBytes":174},"\u002Fuploads\u002Fthumbnail_PTG_6_cdb5d5e88c.jpg","thumbnail_PTG_6_cdb5d5e88c","thumbnail_PTG 6.jpg",7.46,234,156,7461,"local","2024-10-12T15:41:03.994Z",[178],{"text":179,"type":130},"",{"type":126,"children":181},[182],{"text":183,"type":130},"L’indication principale pour une prothèse totale de genou est la gonarthrose (arthrose du genou) sévère, qui provoque des douleurs invalidantes et une diminution significative de la mobilité. Cette dégénérescence progressive du cartilage peut entraîner des frottements entre les os (fémur, tibia et rotule), causant des douleurs chroniques et un handicap fonctionnel.",{"type":126,"children":185},[186],{"text":179,"type":130},{"type":188,"level":107,"children":189},"heading",[190],{"text":191,"type":130},"Les critères d’indication incluent :",{"type":126,"children":193},[194],{"text":179,"type":130},{"type":126,"children":196},[197,199,202],{"text":198,"type":130},"\t•\t",{"bold":200,"text":201,"type":130},true,"Douleurs intenses et persistantes",{"text":203,"type":130}," malgré un traitement médical bien conduit (antalgiques, anti-inflammatoires, infiltrations).",{"type":126,"children":205},[206,207,209],{"text":198,"type":130},{"bold":200,"text":208,"type":130},"Limitation importante de la mobilité et difficultés dans les activités quotidiennes",{"text":210,"type":130}," comme marcher, monter des escaliers, ou même rester debout.",{"type":126,"children":212},[213,214,216],{"text":198,"type":130},{"bold":200,"text":215,"type":130},"Déformation du genou",{"text":217,"type":130}," (genu varum ou genu valgum) en raison de la dégradation articulaire.",{"type":126,"children":219},[220,221,223],{"text":198,"type":130},{"bold":200,"text":222,"type":130},"Échec des autres options thérapeutiques conservatrices",{"text":224,"type":130},", comme la rééducation ou le port de genouillères.",{"type":126,"children":226},[227],{"text":179,"type":130},{"type":126,"children":229},[230],{"text":231,"type":130},"La PTG peut aussi être envisagée chez des patients souffrant de polyarthrite rhumatoïde ou après des traumatismes graves du genou ayant conduit à la destruction de l’articulation.",{"type":126,"children":233},[234],{"text":179,"type":130},{"type":188,"level":6,"children":236},[237],{"text":238,"type":130},"Déroulement de l’intervention et hospitalisation de 3 jours",{"type":132,"image":240,"children":273},{"ext":134,"url":241,"hash":242,"mime":137,"name":243,"size":244,"width":245,"height":246,"caption":142,"formats":247,"provider":175,"createdAt":272,"updatedAt":272,"previewUrl":142,"alternativeText":243,"provider_metadata":142},"https:\u002F\u002Flircos.org\u002Fapi\u002Fuploads\u002FPTG_2_1820527448.jpg","PTG_2_1820527448","PTG 2.jpg",527.97,4450,2967,{"large":248,"small":254,"medium":260,"thumbnail":266},{"ext":134,"url":249,"hash":250,"mime":137,"name":251,"path":142,"size":252,"width":149,"height":150,"sizeInBytes":253},"\u002Fuploads\u002Flarge_PTG_2_1820527448.jpg","large_PTG_2_1820527448","large_PTG 2.jpg",61.85,61845,{"ext":134,"url":255,"hash":256,"mime":137,"name":257,"path":142,"size":258,"width":157,"height":158,"sizeInBytes":259},"\u002Fuploads\u002Fsmall_PTG_2_1820527448.jpg","small_PTG_2_1820527448","small_PTG 2.jpg",17.82,17819,{"ext":134,"url":261,"hash":262,"mime":137,"name":263,"path":142,"size":264,"width":165,"height":157,"sizeInBytes":265},"\u002Fuploads\u002Fmedium_PTG_2_1820527448.jpg","medium_PTG_2_1820527448","medium_PTG 2.jpg",36.26,36264,{"ext":134,"url":267,"hash":268,"mime":137,"name":269,"path":142,"size":270,"width":172,"height":173,"sizeInBytes":271},"\u002Fuploads\u002Fthumbnail_PTG_2_1820527448.jpg","thumbnail_PTG_2_1820527448","thumbnail_PTG 2.jpg",5.33,5331,"2024-10-12T15:25:03.617Z",[274],{"text":179,"type":130},{"type":126,"children":276},[277,279,281,283,285],{"text":278,"type":130},"Avec les progrès dans les techniques chirurgicales et les soins péri-opératoires, ",{"bold":200,"text":280,"type":130},"l’hospitalisation",{"text":282,"type":130}," pour une prothèse totale de genou peut être réduite à",{"bold":200,"text":284,"type":130}," 2 ou 3 jours",{"text":286,"type":130}," . Cette prise en charge rapide repose sur une réhabilitation précoce et une gestion efficace de la douleur.",{"type":126,"children":288},[289,291,293],{"text":290,"type":130},"L’intervention dure généralement",{"bold":200,"text":292,"type":130}," 1 à 2 heures.",{"text":294,"type":130}," Le chirurgien remplace les parties endommagées du fémur, du tibia et de la rotule par des composants métalliques et plastiques de la prothèse. La chirurgie est réalisée sous anesthésie générale ou rachianesthésie (péridurale) en fonction des indications médicales et des préférences du patient. ",{"type":132,"image":296,"children":334},{"ext":134,"url":297,"hash":298,"mime":137,"name":299,"size":300,"width":301,"height":302,"caption":142,"formats":303,"provider":175,"createdAt":333,"updatedAt":333,"previewUrl":142,"alternativeText":299,"provider_metadata":142},"https:\u002F\u002Flircos.org\u002Fapi\u002Fuploads\u002FPTG_4_dc21d0bb53.jpg","PTG_4_dc21d0bb53","PTG 4.jpg",354.82,2449,1380,{"large":304,"small":311,"medium":318,"thumbnail":325},{"ext":134,"url":305,"hash":306,"mime":137,"name":307,"path":142,"size":308,"width":149,"height":309,"sizeInBytes":310},"\u002Fuploads\u002Flarge_PTG_4_dc21d0bb53.jpg","large_PTG_4_dc21d0bb53","large_PTG 4.jpg",84.6,563,84604,{"ext":134,"url":312,"hash":313,"mime":137,"name":314,"path":142,"size":315,"width":157,"height":316,"sizeInBytes":317},"\u002Fuploads\u002Fsmall_PTG_4_dc21d0bb53.jpg","small_PTG_4_dc21d0bb53","small_PTG 4.jpg",28.21,282,28210,{"ext":134,"url":319,"hash":320,"mime":137,"name":321,"path":142,"size":322,"width":165,"height":323,"sizeInBytes":324},"\u002Fuploads\u002Fmedium_PTG_4_dc21d0bb53.jpg","medium_PTG_4_dc21d0bb53","medium_PTG 4.jpg",53.54,423,53544,{"ext":134,"url":326,"hash":327,"mime":137,"name":328,"path":142,"size":329,"width":330,"height":331,"sizeInBytes":332},"\u002Fuploads\u002Fthumbnail_PTG_4_dc21d0bb53.jpg","thumbnail_PTG_4_dc21d0bb53","thumbnail_PTG 4.jpg",8.77,245,138,8772,"2024-10-12T15:36:47.021Z",[335],{"text":179,"type":130},{"type":126,"children":337},[338],{"text":339,"type":130},"Après l’opération, le patient est placé en salle de réveil pendant quelques heures pour surveillance. Un protocole de gestion de la douleur est immédiatement mis en place pour assurer le confort du patient. Dès le lendemain, une équipe de kinésithérapeutes commence la rééducation fonctionnelle avec des exercices de mobilisation du genou et des séances de marche assistée.",{"type":126,"children":341},[342],{"text":179,"type":130},{"type":188,"level":107,"children":344},[345],{"text":346,"type":130},"Modalités Péri-opératoires",{"type":126,"children":348},[349],{"text":179,"type":130},{"type":126,"children":351},[352],{"text":353,"type":130},"1. Gestion de la douleur :",{"type":126,"children":355},[356],{"text":179,"type":130},{"type":126,"children":358},[359],{"text":360,"type":130},"Le contrôle de la douleur est une priorité après une PTG. Un protocole de gestion multimodale de la douleur est souvent mis en place, comprenant des antalgiques, des anti-inflammatoires et, dans certains cas, des infiltrations locales d’anesthésiques. La gestion optimale de la douleur permet de favoriser une mobilisation précoce.",{"type":126,"children":362},[363],{"text":179,"type":130},{"type":126,"children":365},[366],{"text":367,"type":130},"2. Rééducation précoce :",{"type":126,"children":369},[370],{"text":179,"type":130},{"type":126,"children":372},[373],{"text":374,"type":130},"La rééducation commence dès le lendemain de l’intervention. Les objectifs sont de restaurer progressivement la mobilité de l’articulation et de permettre au patient de marcher avec des aides (béquilles) rapidement. Le kinésithérapeute aide à renforcer les muscles et à retrouver une amplitude de mouvement correcte, tout en prévenant les raideurs et les complications comme les phlébites.",{"type":126,"children":376},[377],{"text":179,"type":130},{"type":126,"children":379},[380],{"text":381,"type":130},"3. Retour à domicile :",{"type":126,"children":383},[384],{"text":179,"type":130},{"type":126,"children":386},[387],{"text":388,"type":130},"Après 3 jours, si l’état général du patient le permet, celui-ci peut rentrer chez lui avec un plan de rééducation à domicile ou en centre spécialisé. Des séances régulières de kinésithérapie sont recommandées pour poursuivre la récupération et optimiser les résultats.",{"type":132,"image":390,"children":426},{"ext":134,"url":391,"hash":392,"mime":137,"name":393,"size":394,"width":395,"height":396,"caption":142,"formats":397,"provider":175,"createdAt":425,"updatedAt":425,"previewUrl":142,"alternativeText":393,"provider_metadata":142},"https:\u002F\u002Flircos.org\u002Fapi\u002Fuploads\u002FPTG_3_d5eea1f43d.jpg","PTG_3_d5eea1f43d","PTG3.jpg",443.61,3677,2760,{"large":398,"small":405,"medium":412,"thumbnail":418},{"ext":134,"url":399,"hash":400,"mime":137,"name":401,"path":142,"size":402,"width":149,"height":403,"sizeInBytes":404},"\u002Fuploads\u002Flarge_PTG_3_d5eea1f43d.jpg","large_PTG_3_d5eea1f43d","large_PTG3.jpg",48.39,751,48393,{"ext":134,"url":406,"hash":407,"mime":137,"name":408,"path":142,"size":409,"width":157,"height":410,"sizeInBytes":411},"\u002Fuploads\u002Fsmall_PTG_3_d5eea1f43d.jpg","small_PTG_3_d5eea1f43d","small_PTG3.jpg",16.16,375,16157,{"ext":134,"url":413,"hash":414,"mime":137,"name":415,"path":142,"size":416,"width":165,"height":309,"sizeInBytes":417},"\u002Fuploads\u002Fmedium_PTG_3_d5eea1f43d.jpg","medium_PTG_3_d5eea1f43d","medium_PTG3.jpg",30.58,30584,{"ext":134,"url":419,"hash":420,"mime":137,"name":421,"path":142,"size":422,"width":423,"height":173,"sizeInBytes":424},"\u002Fuploads\u002Fthumbnail_PTG_3_d5eea1f43d.jpg","thumbnail_PTG_3_d5eea1f43d","thumbnail_PTG3.jpg",4.55,208,4552,"2024-10-12T15:36:33.942Z",[427],{"text":179,"type":130},{"type":126,"children":429},[430],{"text":431,"type":130},"Bénéfices de la Prothèse Totale de Genou",{"type":126,"children":433},[434],{"text":179,"type":130},{"type":126,"children":436},[437],{"text":438,"type":130},"La PTG offre des résultats très satisfaisants pour la majorité des patients :",{"type":126,"children":440},[441],{"text":179,"type":130},{"type":126,"children":443},[444],{"text":445,"type":130},"\t•\tSoulagement significatif de la douleur : La douleur invalidante causée par l’arthrose est considérablement réduite, voire éliminée.",{"type":126,"children":447},[448],{"text":449,"type":130},"\t•\tAmélioration de la mobilité : Les patients récupèrent une amplitude de mouvement suffisante pour reprendre des activités de la vie quotidienne, comme la marche et la montée des escaliers.",{"type":126,"children":451},[452],{"text":453,"type":130},"\t•\tCorrection des déformations : En plus de restaurer la fonction articulaire, la prothèse peut corriger des déformations telles que le genu varum (genoux arqués) ou le genu valgum (genoux en X).",{"type":126,"children":455},[456],{"text":457,"type":130},"\t•\tAmélioration de la qualité de vie : Le soulagement des douleurs et la restauration de la fonction articulaire permettent un retour à une vie plus active et autonome.",{"type":126,"children":459},[460],{"text":179,"type":130},{"type":188,"level":107,"children":462},[463],{"text":464,"type":130},"Risques et Complications",{"type":126,"children":466},[467],{"text":179,"type":130},{"type":126,"children":469},[470],{"text":471,"type":130},"Bien que la prothèse totale de genou soit une intervention courante, elle n’est pas sans risques, parmi lesquels :",{"type":126,"children":473},[474],{"text":179,"type":130},{"type":126,"children":476},[477,479,481],{"text":478,"type":130},"\t•",{"text":480,"type":130,"underline":200},"\tInfections",{"text":482,"type":130}," : Comme pour toute chirurgie, il existe un risque d’infection post-opératoire, qui peut nécessiter un traitement antibiotique ou, dans les cas graves, une ré-intervention.",{"type":126,"children":484},[485,486,488],{"text":198,"type":130},{"text":487,"type":130,"underline":200},"Phlébites:",{"text":489,"type":130}," Des caillots sanguins peuvent se former dans les veines des jambes (phlébite), nécessitant des mesures préventives comme le port de bas de contention et des anticoagulants.",{"type":126,"children":491},[492,493,495],{"text":198,"type":130},{"text":494,"type":130,"underline":200},"Raideur articulaire",{"text":496,"type":130}," : Si la rééducation n’est pas bien suivie, une raideur articulaire peut survenir, limitant l’amplitude de mouvement.",{"type":126,"children":498},[499,500,502],{"text":198,"type":130},{"text":501,"type":130,"underline":200},"Déscellement de la prothèse ",{"text":503,"type":130},": Bien que les prothèses de genou modernes aient une longue durée de vie, des complications comme le descellement ou l’usure prématurée peuvent nécessiter une révision chirurgicale.",{"type":126,"children":505},[506],{"text":179,"type":130},{"type":126,"children":508},[509],{"text":179,"type":130},"2024-10-12T14:08:19.882Z","2024-10-19T13:43:08.274Z","2024-10-12T14:31:32.683Z",[514,518,527,531,534,538,541,549,556,563,570,573,577,580,584,593,605,613,622,626,629,633,636,640,643,647,650,654,657,661,664,668,671,675,684,688,691,695,698,702,706,710,714,717,721,724,728,731,738,745,752,759,762],{"type":126,"children":515},[516],{"text":517,"type":130},"Total knee replacement (TKA) is a surgical procedure intended to replace the damaged knee joint with an artificial prosthesis. It is commonly performed to relieve pain and restore mobility in patients suffering from advanced osteoarthritis, rheumatoid arthritis or other degenerative knee pathologies. Indications for Total Knee Prosthesis",{"type":132,"image":519,"children":525},{"ext":134,"url":135,"hash":136,"mime":137,"name":138,"size":139,"width":140,"height":141,"caption":142,"formats":520,"provider":175,"createdAt":176,"updatedAt":176,"previewUrl":142,"alternativeText":138,"provider_metadata":142},{"large":521,"small":522,"medium":523,"thumbnail":524},{"ext":134,"url":145,"hash":146,"mime":137,"name":147,"path":142,"size":148,"width":149,"height":150,"sizeInBytes":151},{"ext":134,"url":153,"hash":154,"mime":137,"name":155,"path":142,"size":156,"width":157,"height":158,"sizeInBytes":159},{"ext":134,"url":161,"hash":162,"mime":137,"name":163,"path":142,"size":164,"width":165,"height":157,"sizeInBytes":166},{"ext":134,"url":168,"hash":169,"mime":137,"name":170,"path":142,"size":171,"width":172,"height":173,"sizeInBytes":174},[526],{"text":179,"type":130},{"type":126,"children":528},[529],{"text":530,"type":130},"The main indication for a total knee prosthesis is severe gonarthrosis (osteoarthritis of the knee), which causes disabling pain and a significant reduction in mobility. 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A pain management protocol is immediately put in place to ensure patient comfort. The next day, a team of physiotherapists begins functional rehabilitation with knee mobilization exercises and assisted walking sessions.",{"type":126,"children":627},[628],{"text":179,"type":130},{"type":188,"level":107,"children":630},[631],{"text":632,"type":130},"Perioperative Modalities",{"type":126,"children":634},[635],{"text":179,"type":130},{"type":126,"children":637},[638],{"text":639,"type":130},"1. Pain management:",{"type":126,"children":641},[642],{"text":179,"type":130},{"type":126,"children":644},[645],{"text":646,"type":130},"Pain control is a priority after TKA. A multimodal pain management protocol is often implemented, including analgesics, anti-inflammatories and, in certain cases, local anesthetic infiltrations. 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