knee positioning. It's a
simple attachment that
mounts directly to the
OR table and provides
stability at the joint and
foot padding, which is
essential for preventing
pressure injuries.
When using this posi-
tioning technique,
"Avoid putting too much
pressure on the perineal
nerve at the fibular neck by leaning on it or pushing it against the post,"
says Dr. Archdeacon.
There are plenty of other simple positioning devices that can be used for
total knees, such as femur and tibia triangles, which fit directly under the
knee to form a triangle when the knee is properly bent and the foot is rest-
ing on the table.
While the feet are resting firmly on the table during total knee replace-
ments, surgeons often have the leg hanging off the table's edge during
arthroscopic procedures. "Surgeons are always moving and repositioning
the leg to look behind corners in the joint," says Dr. Bates.
Although more leg flexibility is needed during arthroscopies, you still
want to keep the thigh stable. There are a number of positioning aids you
can attach to a standard OR table to achieve that goal.
Shoulders
Patients are placed laterally or in the beach chair position for most shoul-
der procedures. "Both require surgeons to have access to the front and
back of the joint as they're maneuvering scopes and instruments," says
A U G U S T 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 3 9
Pamela
Bevelhymer,
RN,
BSN,
CNOR
• SIDE VIEW Placing patients in the lateral position for shoulder surgery allows for
secure arm traction and clear visualization of the joint space.
