Cement Plug Embedded in the Patella: A Rare Complication of Total Knee Arthroplasty

2009 ◽  
Vol 22 (02) ◽  
pp. 145-146
Author(s):  
R.G. Kakwani ◽  
N. Hulse
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Rare Complication ◽  
Total Knee ◽  
Cement Plug

scholarly journals Recurrent hemarthrosis after total knee arthroplasty in rheumatoid arthritis successfully treated with selective embolization: A case report

2020 ◽  
Vol 8 ◽  
pp. 2050313X2096411
Author(s):  
Takeo Mammoto ◽  
Toshiyuki Irie ◽  
Nobuyuki Takahashi ◽  
Shun Nakajima ◽  
Atsushi Hirano
Keyword(s):  
Rheumatoid Arthritis ◽  
Computed Tomography ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Rare Complication ◽  
Selective Embolization ◽  
Acute Complications ◽  
Genicular Artery ◽  
Suprapatellar Pouch ◽  
Total Knee

Recurrent hemarthrosis after total knee arthroplasty is a rare complication. This usually occurs in osteoarthritis, but is relatively rare in rheumatoid arthritis. This is a report of recurrent hemarthrosis after total knee arthroplasty in a rheumatoid arthritis patient. An 85-year-old woman with rheumatoid arthritis had received total knee arthroplasty without acute complications. At 6 months after surgery, the first hemarthrosis occurred and an initial conservative treatment failed. Contrast computed tomography showed prominent synovial enhancement in the superior lateral suprapatellar pouch. Selective catheterization revealed an abnormal hyperemic blush supplied from the branches of the superior lateral genicular artery. After embolization with N-butyl-2-cyanoacrylate, abnormal staining of the synovium diminished and knee swelling and pain disappeared without complications. Selective embolization is favorable for successful treatment of recurrent hemarthrosis after total knee arthroplasty in patients with rheumatoid arthritis.

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.

Intraoperative tibial plateau fracture during bone preparation in a cruciate retaining primary total knee arthroplasty

2020 ◽  
Vol 13 (9) ◽  
pp. e233826
Author(s):  
Shea K Taylor ◽  
Andrew Sephian ◽  
Timothy Clader
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Rare Complication ◽  
Primary Total Knee Arthroplasty ◽  
Medial Tibial Plateau ◽  
Cement Penetration ◽  
Plateau Fracture ◽  
Total Knee

Intraoperative fractures are a rare complication in total knee arthroplasty. Limited literature exists in regard to the incidence, mechanism of injury and management of intraoperative fractures. The authors report a unique case of an 80-year-old man who sustained a medial tibial plateau fracture that occurred intraoperatively during final tibia bone preparation with the use of the Woolley Tibia Punch (Innomed, Savannah, Georgia, USA). The fracture was managed with the addition of 4.5 mm cortical lag screws and the addition of a stemmed tibial implant to bypass the fracture. This is the first reported case in literature that describes an intraoperative medial tibial plateau that occurred through the use of a Woolley Tibia Punch. The authors recommend the consideration of drilling to prepare sclerotic bone for cement penetration rather than a punch in order to minimise the potential for intraoperative fractures that may occur with the use of a punch.

Current Trends in Knee Arthroplasty

2016 ◽  
Vol 9 (3) ◽  
pp. 234
Author(s):  
Mohammadjavad Zehtab ◽  
Mohammadhassan Kaseb ◽  
Mohammadnaghi Tahmasebi ◽  
Mohammad Ayati Firoozabadi
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Bypass Surgery ◽  
Rare Complication ◽  
Medical Practices ◽  
Current Trends ◽  
Key Factor ◽  
Total Knee ◽  
Meta Analyses

<p>Total knee arthroplasty (TKA) is a commonly performed surgical procedure designed to alleviate knee pain and improve function in individuals with knee osteoarthritis the purpose of collecting the latest information and updating the reports is to summarize the published articles and inform the colleagues. In so doing, the articles published in American journals of arthroplasty and joint surgery and the proceedings of the conferences that were mostly held in 2004 have been utilized so that delicate and precise spotlights retrieved from scholars' breakthroughs can be applied in daily medical practices. It should be noted that this surgery is as much effective as cardiovascular bypass surgery in enhancing the quality of the patients' lives. Pain is one of the major problem for patients underwent Total Knee Arthroplasty (TKA); appropriate pain management is a key factor that can result early to move, physiotherapy, and most importantly, patient satisfaction. Results of recent meta-analyses demonstrated that using COAS for TKA significantly reduced the relative risk of excessive implant misalignment by 25% compared TKA. Infection after total knee replacement (IATJ) is a rare complication. Gentamicin, tobramycin and vancomycin are good alternatives as thermoresistant agents.</p>

scholarly journals Acute Popliteal Artery Occlusion after Revision Total Knee Arthroplasty

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Ryu Tsujimoto ◽  
Tomoyuki Matsumoto ◽  
Koji Takayama ◽  
Yohei Kawakami ◽  
Masato Kamimura ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Surgical Procedures ◽  
Knee Arthroplasty ◽  
Popliteal Artery ◽  
Rare Complication ◽  
Time Lag ◽  
Arterial Occlusion ◽  
Artery Occlusion ◽  
Total Knee ◽  
Revision Tka

Acute arterial occlusions are a rare complication of total knee arthroplasty (TKA). However, in revision TKA, the risk of such complications is higher and these complications can lead to amputation if not adequately treated. We describe a case of acute popliteal artery occlusion 4 hours after second revision TKA in a patient with a history of several surgical procedures because of periprosthetic infection at a previous hospital. Revascularization was achieved via bypass grafting and amputation was narrowly avoided despite time lag after symptom onset to revascularization. In this case, it was possible that the arterial disease that accompanied the vascular endothelium injury such as pseudoaneurysm had existed since the previous surgery at another hospital and was destroyed by the surgical procedure, which led to the formation of thrombosis and arterial occlusion. Preoperative evaluation of the arterial condition should be considered to avoid acute arterial occlusive disease, especially in patients who had several previous surgical procedures.

scholarly journals Bilateral Stress Fractures of the Femoral Neck after Total Knee Arthroplasty: Importance of Early Diagnosis

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Sei Morinaga ◽  
Kenichi Ueshima ◽  
Yoshinobu Maruhashi ◽  
Noriyuki Hashimoto ◽  
Shoji Watanabe ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Total Knee Arthroplasty ◽  
Total Hip Arthroplasty ◽  
Femoral Neck ◽  
Stress Fracture ◽  
Knee Arthroplasty ◽  
English Literature ◽  
Rare Complication ◽  
Stress Fractures ◽  
Total Knee

Unilateral stress fracture of the femoral neck following total knee arthroplasty (TKA) is a rare complication; only 21 cases are described in English literature so far. Bilateral stress fractures of the femoral neck occurring simultaneously following a bilateral TKA have been seen in only 2 cases till now. We report a patient suffering from rheumatoid arthritis of both knees, who was treated with bilateral TKA. She developed spontaneous fractures of the femoral neck on both sides 12 months following the TKA. She was treated with bilateral total hip arthroplasty (THA). Stress fracture of the femoral neck should be suspected in patients complaining of hip pain who have undergone TKA.

Intraoperative Proximal Tibia Periprosthetic Fractures in Primary Total Knee Arthroplasty

2020 ◽  
Author(s):  
Christopher W. Damsgaard ◽  
Bishoy V. Gad ◽  
Olivia J. Bono ◽  
Marie C. Anderson ◽  
Jonathon M. Brown ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Proximal Tibia ◽  
Rare Complication ◽  
Weight Bearing ◽  
Control Group ◽  
Polyethylene Insert ◽  
Tibia Fractures ◽  
Total Knee

AbstractIntraoperative fracture of the proximal tibia is a rare complication of total knee arthroplasty (TKA) with few studies available reporting risk factors or prognosis. A review of our prospective joint registry was performed to determine the incidence and associated risk factors of intraoperative tibia fractures during primary TKA; 14,966 TKAs of all manufacturers were performed with 9 intraoperative tibia fractures. All fractures occurred in a single TKA design. There were 8,155 TKAs of this design performed with a fracture incidence of 0.110%. All but one fracture occurred on the medial tibial plateau, and all but one occurred during preparation of the tibia with keel punching. A control group of 75 patients (80 knees) with the same TKA design were randomly selected. Baseplates size 3 or smaller were less likely to experience an intraoperative fracture (odds ratio [OR]: 0.864, 95% confidence interval [CI]: 0.785–0.951), as were knees with a polyethylene insert thickness of 13 mm or larger (OR: 0.882, 95% CI: 0.812–0.957). Fractures were treated with a variety of different methods, but every patient had at least one screw placed and most (67%) had postoperative weight-bearing restrictions. At final follow-up, there were no cases of nonunion, component subsidence, or need for reoperation. Intraoperative tibia fractures are a rare complication of this TKA design at 0.11%. Knees with baseplates of size ≤3 and polyethylene thickness ≥13 mm were less likely to experience intraoperative fracture. These findings may be related to the depth of tibial resection, requiring the use of a thicker polyethylene insert, and a change in the keel width in implants size 4 or larger. No fracture patients required reoperation.

scholarly journals Periprosthetic Fracture through a Unicortical Tracking Pin Site after Computer Navigated Total Knee Replacement

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Matt Blue ◽  
Christian Douthit ◽  
Joel Dennison ◽  
Cyrus Caroom ◽  
Mark Jenkins
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Prosthesis ◽  
Rare Complication ◽  
Insertion Site ◽  
Computer Navigation ◽  
Femoral Shaft ◽  
Shaft Fracture ◽  
Total Knee ◽  
Postoperative Fracture

A rare complication from computer-navigated total knee arthroplasty is a fracture through the insertion site of a tracking pin. These pins are inserted across the femoral and tibial shafts either bicortically, transcortically, or unicortically and have a reported fracture incidence of 1.38%, with all published cases occurring after bicortical pin placement. In this case, a 60-year-old female suffered a femoral shaft fracture through a unicortically inserted computer navigation tracking pin 6 weeks after total knee arthroplasty. Her fracture was successfully fixated with an intramedullary nail with retention of the knee prosthesis. This case is important as it records the risk for a postoperative fracture through a unicortically inserted computer navigation pin.

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