TRAUMATIC DISLOCATION (CAM JUMP) IN A MORBID OBESE POST TOTAL KNEE REPLACEMENT PATIENT: A CASE REPORT ON A RARE COMPLICATION IN FIELD OF TOTAL KNEE ARTHROPLASTY.

2021 ◽  
pp. 68-69
Author(s):  
Sai Kumar Reddy Mukkamalla ◽  
P. Yuvarajan
Keyword(s):  
Total Knee Arthroplasty ◽  
Case Report ◽  
Knee Arthroplasty ◽  
Closed Reduction ◽  
Rare Complication ◽  
Total Knee Replacement Patient ◽  
History Of ◽  
Total Knee ◽  
Morbid Obese

Dislocation after total knee arthroplasty is uncommon and more challenging if it occurs in morbid obese patients with multiple comorbid factors. Case Report: This is a case of a 70- year-old male patient with a BMI of 40 with known HTN, Ischemic Heart Disease presenting with posterior dislocation of his right knee post TKR in a posterior stabilized knee after 3 years without a history of trauma. Results: The patient underwent closed reduction under spinal anaesthesia and reduced under uoroscopic guidance. Range of movements were found to be satisfactory. The patient has been kept under a long knee brace and was encouraged to walk on POD-2. His Post-op 3 months follow up is uneventful. Conclusion: Identifyng the cause and closed reduction under uoroscopic guidance, stability, alignment, range of motion was found satisfactory. The patient can undergo closed reduction without any other procedure of choice.

scholarly journals Quadriceps Tendon Rupture Following Total Knee Arthroplasty

2019 ◽  
Vol 13 (1) ◽  
pp. 250-254
Author(s):  
Steven T. Heer ◽  
James O'Dowd ◽  
Rebecca R. Butler ◽  
David O. Dewitt ◽  
Gaurav Khanna ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Rare Complication ◽  
Quadriceps Tendon ◽  
Quadriceps Tendon Rupture ◽  
Significant Difference ◽  
Total Knee ◽  
Suture Anchor Repair ◽  
Extensor Lag

Introduction: Rupture of a Quadriceps Tendon (QT) following a Total Knee Arthroplasty (TKA) is a rare complication. The purpose of this study was to report outcomes and complications of QT repair following TKA. Methods: From a cohort of 437 QT repairs, 19 individuals were identified who had previously undergone a TKA on the ipsilateral leg. Data was collected on individuals with a minimum follow up of 3 months post QT repair (n=16), including Knee Society Scores, pre and post-operative lag, and pre and post-operative range of motion. Results: 13 patients were treated with End-to-End (EE) repairs and 6 were treated with transosseous or suture anchor repair (ATO). In the ATO group, there was no difference in pre (68.0 ± 22.5) and post KSS (82 ± 9.16) (p=0.231), but in the EE group, there was a significant improvement in KSS (pre=67.8 ± 13.1, post=86 ± 16.75, p=0.0027). There was significant difference in post-operative extension lag between ATO (26.0 ± 12.6) vs. EE (4.0 ± 2.74) (p=0.0083). Four out of six ATO patients had extension lag ≥10 degree extensor lag (66.7%) compared to 2 out of 13 (15.4%) patients in the EE group. Compared to EE, ATO repair had an 8.00 times odds of re-tear (95% CI: 0.53,120.6; p=0.133) and 2.75 times greater risk of infection (95% CI: 0.284, 26.61; p=0.382). Conclusion: Patients who underwent EE repair had better functional improvements compared to the ATO group and smaller extension lag.

scholarly journals Fungal Prosthetic Joint Infection Following Total Knee Arthroplasty: A Case Report

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Baraa W Mafrachi ◽  
Ashraf H Al Debei ◽  
Farah M Al Muhtaseb ◽  
Jihad M Al Ajlouni ◽  
Yazan S Hammad
Keyword(s):  
Total Knee Arthroplasty ◽  
Case Report ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Knee Arthroplasty ◽  
Prosthetic Joint Infection ◽  
Rare Complication ◽  
Joint Infection ◽  
Prosthetic Joint ◽  
Total Knee

Introduction: Prosthetic joint infection (PJI) is a rare complication of total knee replacement (TKR), yet it is a serious and debilitating condition. Bacterial infection accounts for the majority of cases and fungal infection is estimated to cause 1% of all prosthesis infection. Case Report: This case presents a 60years female, who presented to our outpatient orthopedic clinic complaining of right knee pain, swelling, and hotness. The physical examination revealed redness, hotness, restricted range of movement, and tibial loosening, 9 months following TKR revision. Culture of the joint aspirate showed growth of “Candida parapsilosis” and second aspirate confirmed the diagnosis. The patient then underwent two stages revision surgery with placement of amphotericin B loaded cement, to maintain high local antifungal concentration in addition to decrease the side effects of amphotericinB infusion such as thrombophlebitis and the more serious systemic effect as nephrotoxicity. The post-operative course was uneventful, with gradual improvement and restoration of normal movement range. Conclusion: Fungal PJI is a rare complication of TKR, yet it results in severe debilitating symptoms and impairment of the patient functional capacity. Careful evaluation of the patient followed by a detailed workup is necessary for the identification of the underlying causative micro-organism. Two-stage revision surgery with antifungal loaded cement spacer and antifungal therapy currently is the standard of management. To the best of our knowledge, this is the first fungal PJI following total knee arthroplasty reported in Jordan. Keywords: Fungal prosthetic joint infection, fungal infection, total knee replacement, total knee replacement complication.

Outcomes in Patients with a Calipered Kinematically Aligned TKA That Already Had a Contralateral Mechanically Aligned TKA

2019 ◽  
Vol 34 (01) ◽  
pp. 087-093 ◽  
Author(s):  
Trevor J. Shelton ◽  
Manpreet Gill ◽  
Gurbir Athwal ◽  
Stephen M. Howell ◽  
Maury L. Hull
Keyword(s):  
Total Knee Arthroplasty ◽  
Retrospective Study ◽  
Outcome Measures ◽  
Knee Arthroplasty ◽  
Contralateral Limb ◽  
Primary Tkas ◽  
Clinical Benefits ◽  
History Of ◽  
Total Knee

AbstractPrior studies suggest kinematically aligned (KA) total knee arthroplasty (TKA) provides some clinical benefits. There are no reports of self-reported outcome measures in patients treated with a calipered KA TKA that already had a contralateral mechanically aligned (MA) TKA. We performed a retrospective study and asked the following questions: (1) Were you satisfied with your MA TKA when you were treated with the KA TKA? (2) What are the Forgotten Joint Scores (FJS) and Oxford Knee Scores (OKS) in each of your knees? (3) Do you favor one knee? and (4) Did one knee recover faster? From January 2013 to January 2017, 2,378 consecutive primary TKAs were performed of which all were treated with calipered KA that uses serial verification checks incorporating measurements of bone resections and positions to restore the prearthritic or native joint lines accurately. A records review identified patients with a prior primary MA TKA in the contralateral limb. Excluded were those with a history of fracture, osteotomy, infection, or revision knee surgery in either limb. In September 2018, 78 patients (57 females) with a mean age of 73 years (range, 50–91 years) completed a follow-up evaluation consisting of the FJS and OKS questionnaires and three anchor questions. A total of 83% of patients were satisfied with the MA TKA and 92% were satisfied with the KA TKA. The KA TKA had a 15 point higher median FJS and a comparable OKS to that of the MA TKA. Also, 56% of patients favored the KA TKA, and 8% favored the MA TKA. Seventy four percent of patients favored the recovery of the KA TKA, and 6% favored the recovery of the MA TKA. Accordingly, a patient considering a contralateral KA TKA can expect that more often than not the KA TKA will have a higher FJS, a similar OKS, be their favorite knee, and recover faster. Present study is therapeutic and reflects level IV evidence.

Total knee arthroplasty in achondroplasia without deformity correction: A case report with 11 years' follow-up

The Knee ◽  
2020 ◽  
Vol 27 (3) ◽  
pp. 740-746
Author(s):  
Xavier Bayle-Iniguez ◽  
Gilles Udin ◽  
Matteo Regusci ◽  
Hermes H. Miozzari
Keyword(s):  
Total Knee Arthroplasty ◽  
Case Report ◽  
Knee Arthroplasty ◽  
Deformity Correction ◽  
Total Knee

Short- to Midterm Outcomes of a Novel Guided-Motion Rotational Hinged Total Knee Arthroplasty

2021 ◽  
Author(s):  
David Yeroushalmi ◽  
Simon Van Laarhoven ◽  
Alex Tang ◽  
Petra J. C. Heesterbeek ◽  
Gijs Van Hellemondt ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Two Stage ◽  
Survivorship Analysis ◽  
Kaplan Meier ◽  
History Of ◽  
Total Knee ◽  
Component Revision

AbstractHinged prostheses have been increasingly utilized in complex and revision total knee arthroplasty (TKA) cases requiring additional mechanical support and global stability. However, there is limited data detailing the outcomes of modern hinge designs in these procedures. The aim of this study is to report a minimum 2-year functional outcomes and survivorship of a novel-guided motion-hinged knee TKA system. A multicenter, retrospective cohort study was conducted on consecutive TKA patients between March 2013 and August 2017 with a novel-guided motion-hinged knee system. Demographics, change in range of motion (ΔROM), quality metrics, and implant survivorship were collected with a minimum of 2-year follow-up. Implant survival was analyzed by using the Kaplan–Meier method. Overall, 147 hinged knee cases (18 complex primaries and 129 revisions) were identified with an average follow-up duration of 3.8 ± 1.2 years. Patients presented with an average of 2.4 ± 1.6 prior knee surgeries, and 51 (34.7%) had a history of knee infections. The ROM improved postoperatively: Δ extension = 2 ± 1 degrees, Δflexion = 7 ± 3 degrees, Δtotal ROM = 9 ± 4 degrees. Kaplan–Meier survivorship analysis for implant revision at 2- and 5-year follow-up showed a survival rate of 100 and 98.5% (95% confidence interval: 94.3–99.6%), respectively, with one patient undergoing two-stage revision for infection and another undergoing femoral revision for aseptic loosening. Survivorship for aseptic all-cause reoperation at 2- and 5-year follow-up was 93.2% (87.7–96.3%) and 88.2% (80.0–93.2%), respectively. Fourteen patients underwent aseptic reoperation (patellar complications: n = 7 [4.8%]; instability: n = 5 [3.4%]; tuberosity fixation: n = 1 [0.7%]; extensor mechanism failure: n = 1 [1.1%]). Survivorship for all-cause reoperation at 2- and 5-year follow-up were 85% (78.2–90.0%) and 77.7% (68.8–84.3%), respectively. Fifteen patients underwent reoperation for infection (DAIR: n = 14 (9.5%); two-stage revision: n = 1 [0.7%]). Despite some reoperations, this guided-motion hinged-knee TKA system demonstrates excellent survivorship for component revision compared to other modern hinged knee implants reported in the literature. Patients also displayed an improvement in knee ROM at their latest follow-up.

scholarly journals Pseudoaneurysm of the superior lateral genicular artery: case report of a rare complication after total knee arthroplasty

2013 ◽  
Vol 7 (1) ◽  
pp. 15 ◽  
Author(s):  
Pramod Saini ◽  
Sanjay Meena ◽  
Rajesh Malhotra ◽  
Shivanand Gamanagatti ◽  
Vijay Kumar ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Case Report ◽  
Knee Arthroplasty ◽  
Rare Complication ◽  
Genicular Artery ◽  
Total Knee

Effect of Manipulation under Anesthesia of the First Knee in Staged Bilateral Total Knee Arthroplasty on Clinical Outcome and Satisfaction

2020 ◽  
Author(s):  
Jung-Won Lim ◽  
Yong-Beom Park ◽  
Dong-Hoon Lee ◽  
Han-Jun Lee
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Functional Score ◽  
Manipulation Under Anesthesia ◽  
Total Knee

AbstractThis study aimed to evaluate whether manipulation under anesthesia (MUA) affect clinical outcome including range of motion (ROM) and patient satisfaction after total knee arthroplasty (TKA). It is hypothesized that MUA improves clinical outcomes and patient satisfaction after primary TKA. This retrospective study analyzed 97 patients who underwent staged bilateral primary TKA. MUA of knee flexion more than 120 degrees was performed a week after index surgery just before operation of the opposite site. The first knees with MUA were classified as the MUA group and the second knees without MUA as the control group. ROM, Knee Society Knee Score, Knee Society Functional Score, Western Ontario and McMaster Universities (WOMAC) score, and patient satisfaction were assessed. Postoperative flexion was significantly greater in the MUA group during 6 months follow-up (6 weeks: 111.6 vs. 99.8 degrees, p < 0.001; 3 months: 115.9 vs. 110.2 degrees, p = 0.001; 6 months: 120.2 vs. 117.0 degrees, p = 0.019). Clinical outcomes also showed similar results with knee flexion during 2 years follow-up. Patient satisfaction was significantly high in the MUA group during 12 months (3 months: 80.2 vs. 71.5, p < 0.001; 6 months: 85.8 vs. 79.8, p < 0.001; 12 months: 86.1 vs. 83.9, p < 0.001; 24 months: 86.6 vs. 85.5, p = 0.013). MUA yielded improvement of clinical outcomes including ROM, and patient satisfaction, especially in the early period after TKA. MUA in the first knee could be taken into account to obtain early recovery and to improve patient satisfaction in staged bilateral TKA.

scholarly journals Management and results in periprosthetic tibial fracture after total knee arthroplasty: Two-center 15-case retrospective series at 2 years’ follow-up

2020 ◽  
Vol 106 (3) ◽  
pp. 449-458
Author(s):  
Camille Bauer ◽  
Bogdan Zaharia ◽  
Florent Galliot ◽  
Jauffrey Parot ◽  
Fayçal Houfani ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Tibial Fracture ◽  
Total Knee
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