Intra-Articular Giant Heterotopic Ossification following Total Knee Arthroplasty for Charcot Arthropathy

Although the Charcot arthropathy may be associated with serious complications, total knee arthroplasty (TKA) is the preferred choice of treatment by patients. This case report presents an 80-year-old man with intra-articular giant heterotopic ossification following loosening of femoral and tibial implants and femoral condylar fracture. He had undergone TKA because of Charcot neuropathy seven years ago and had been doing well since. Immediately after a left knee sprain, he became unable to walk. Because he had developed a skin ulcer on his left calf where methicillin-resistantStaphylococcus aureuswas detected, we postponed revision surgery until the ulcer was completely healed. While waiting, intra-articular bony fragments grew larger and formed giant heterotopic ossified masses. Eventually, the patient underwent revision surgery, and two major ossified masses were carefully and successfully extirpated. It should be noted that intra-articular heterotopic giant ossification is a significant complication after TKA for neuropathic arthropathy.

Download Full-text

Costs of unicompartmental compared with total knee arthroplasty

The Bone & Joint Journal ◽

10.1302/0301-620x.103b6.bjj-2020-2259.r1 ◽

2021 ◽

Vol 103-B (6 Supple A) ◽

pp. 23-31

Author(s):

Robert A. Burnett III ◽

JaeWon Yang ◽

P. Maxwell Courtney ◽

E. Bailey Terhune ◽

Charles P. Hannon ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Revision Surgery ◽

Healthcare Costs ◽

Cost Savings ◽

Vein Thrombosis ◽

Total Knee ◽

The Mean ◽

One Year ◽

Surgery Rates

Aims The aim of this study was to compare ten-year longitudinal healthcare costs and revision rates for patients undergoing unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA). Methods The Humana database was used to compare 2,383 patients undergoing UKA between 2007 and 2009, who were matched 1:1 from a cohort of 63,036 patients undergoing primary TKA based on age, sex, and Elixhauser Comorbidity Index. Medical and surgical complications were tracked longitudinally for one year following surgery. Rates of revision surgery and cumulative mean healthcare costs were recorded for this period of time and compared between the cohorts. Results Patients undergoing TKA had significantly higher rates of manipulation under anaesthesia (3.9% vs 0.9%; p < 0.001), deep vein thrombosis (5.0% vs 3.1%; p < 0.001), pulmonary embolism (1.5% vs 0.8%; p = 0.001), and renal failure (4.2% vs 2.2%; p < 0.001). Revision rates, however, were significantly higher for UKA at five years (6.0% vs 4.2%; p = 0.007) and ten years postoperatively (6.5% vs 4.4%; p = 0.002). Longitudinal-related healthcare costs for patients undergoing TKA were greater than for those undergoing UKA at one year ($24,771 vs $22,071; p < 0.001) and five years following surgery ($26,549 vs $25,730; p < 0.001); however, the mean costs of TKA were comparable to UKA at ten years ($26,877 vs $26,891; p = 0.425). Conclusion Despite higher revision rates, patients undergoing UKA had lower mean healthcare costs than those undergoing TKA up to ten years following the procedure, at which time costs were comparable. In the era of value-based care, surgeons and policymakers should be aware of the costs involved with these procedures. UKA was associated with fewer complications at one year postoperatively but higher revision rates at five and ten years. While UKA was significantly less costly than TKA at one and five years, costs at ten years were comparable with a mean difference of only $14. Lowering the risk of revision surgery should be targeted as a source of cost savings for both UKA and TKA as the mean related healthcare costs were 2.5-fold higher in patients requiring revision surgery. Cite this article: Bone Joint J 2021;103-B(6 Supple A):23–31.

Download Full-text

AB0267 Rheumatoid Arthritis and Revision Surgery Increase the Risk of Preoperative Deep Vein Thrombosis in Patients Undergoing Total Knee Arthroplasty

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2015-eular.2190 ◽

2015 ◽

Vol 74 (Suppl 2) ◽

pp. 981.2-981

Author(s):

H. Wakabayashi ◽

M. Hasegawa ◽

R. Niimi ◽

M. Noriki ◽

S. Miyazaki ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Total Knee Arthroplasty ◽

Deep Vein Thrombosis ◽

Knee Arthroplasty ◽

Revision Surgery ◽

Vein Thrombosis ◽

Total Knee ◽

Deep Vein

Download Full-text

Three-dimensional printed porous tantalum prosthesis for treating inflammation after total knee arthroplasty in one-stage surgery – a case report

Journal of International Medical Research ◽

10.1177/0300060519891280 ◽

2019 ◽

Vol 48 (3) ◽

pp. 030006051989128

Author(s):

Fuyou Wang ◽

Hao Chen ◽

Pengfei Yang ◽

Aikeremujiang Muheremu ◽

Peng He ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Chronic Inflammation ◽

Knee Arthroplasty ◽

Three Dimensional ◽

Bone Defects ◽

Left Knee ◽

Severe Osteoporosis ◽

Porous Tantalum ◽

3D Printed ◽

Total Knee

Chronic inflammation and bone defects after total knee arthroplasty are a challenge for the orthopedic surgeon. There have been few reports on application of a three-dimensional (3D) printed porous tantalum prosthesis in such situations. We report an 83-year-old female patient who presented to our clinic with consistent pain of the left knee for 10 years and a severe decline in mobility for 2 years. Chronic inflammation, loosening of a tibial prosthesis with a bone defect, and severe osteoporosis were diagnosed. The patient was treated with computer designed and manufactured, personalized, 3D printed porous pure tantalum pad-assisted left total knee arthroplasty. The surgery went smoothly and the patient achieved a satisfactory recovery after surgery. A 3D printed porous tantalum prosthesis can be used to reconstruct tibial bone defects in patients with chronic inflammation after joint replacement surgeries.

Download Full-text