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Revision Total Knee Replacement Facebook case 87 year old gentleman had undergone Total Knee Replacement for both knees 14 years back. Subsequently a revision Total Knee Replacement had been done on right side in 2004 for loose implants.
Now he has presented to us with complains of abnormal mobility of left knee with inability to bear weight on left leg and difficulty in walking. Fresh radiographs and examination were suggestive of loose implants of left Total Knee Replacement(TKR) with bone loss of distal femur. He has been operated for implant removal and revision total knee replacement of left side using stem and wedges for both tibia and femur and trabecular metal block for reconstruction of femoral defect along with LCCK implant. He has been discharged and regained a good pain free and stable range of motion at his left knee. He is also able to walk comfortably
56 years old lady , 11 years post bilateral Total Knee Replacement. Developed acute infection on the left knee. Debridement carried out but infection did not settle. Patient taken up for 2 stage revision surgery.
1. 1st stage revision done and k- nail along with antibiotic loaded cement spacer placed in the joint.
2. Wounds healed but patients presented with supracondylar fracture 9 weeks after the 1st stage revision.
3. She was taken up for revision surgery. Thorough debridement was done.
4. Bone defects on the femur and the tibial side were reconstructed with trabecular metal cones and Rotating hinge- Total knee replacement with long intramedullary stem on the femur.
60 years old lady underwent Bilateral total knee replacement done elsewhere for osteoarthritis. Post op uneventful and patient progress was poor leading to Independent ambulation. At 7 months she fell down while walking and dislocated the left knee. She was treated with closed reduction and knee brace. She presented to us with Recurrent dislocation at one month. Procedure: Revision Total Knee Replacement was done using special Constrained Condylar Implants. The patient is no longer in pain and can walk comfortably.
We had a very interesting case in which a patient had a bilateral total knee replacement 5 years ago elsewhere. Post operative period was uneventful. The patient kept complaining of progressively increasing pain in the left knee for 6 months. No history of fever or trauma. On examination, the patient had range of motion of the knees from 0-70 degrees. Mediolateral laxity +, no distal neurovascular deficit. Procedure : Implant removal + Revision Total Knee Replacement with stem and wedge on the tibial side.
This 60 year old lady is suffering from osteoarthritis of both knees with Varus Deformity. She also has a stress fracture on the right side. Her knee range of motion is 10-90 degrees on both sides. Right Total Knee Replacement was done with the use of a wedge (half wedge 260) and stem in the tibial component.
December 2, 2013 :
November 23, 2013 :