Fracture of the Tibial Baseplate in Bicompartmental Knee Arthroplasty

Introduction. Bicompartmental knee arthroplasty (BKA) addresses combined medial and patellofemoral compartment osteoarthritis, which is relatively common, and has been proposed as a bridge between unicompartmental and total knee arthroplasty (TKA).Case Presentation. We present the case report of a young active man treated with BKA after unsuccessful conservative therapy. Four years later, loosening with fracture of the tibial baseplate was identified and the patient was revised to TKA.Discussion. Although our case is only the second fractured tibial baseplate to be reported, we believe that the modular titanium design, with two fixation pegs, is too thin to withstand daily cyclic loading powers. Light daily routine use, rather than high-impact sports, is therefore advised. Failures may also be related to the implant being an early generation and known to be technically complex, with too few implant sizes. We currently use TKA for the treatment of medial and patellofemoral compartment osteoarthritis.

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Total Knee Arthroplasty in Ochronosis Arthropathy: A Case Report and Systematic Review

Case Reports in Orthopedics ◽

10.1155/2019/1871856 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8

Author(s):

Wu Chean Lee ◽

Tong Leng Tan ◽

Ying Ho Chan

Keyword(s):

Systematic Review ◽

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Conservative Therapy ◽

Rare Condition ◽

Case Presentation ◽

Outcome Scores ◽

Total Knee ◽

End Stage ◽

The Ideal

Introduction. Ochronosis arthropathy (OcA) is a rare condition which may be treated with total knee arthroplasty (TKA) at the end stage. The condition is often discovered only intraoperatively and the ideal choice of TKA is unknown. Case Presentation. A 54-year-old male with worsening chronic bilateral mechanical knee pain had failed conservative therapy. Posterior stabilised (PS), cemented TKA and patella resurfacing was performed. Intraoperatively, collagenous structures such as the menisci and cartilage were noted to be black. Histological examination showed deposition of large amorphous brown material suggestive of ochronosis. He recovered well and underwent TKA of the contralateral knee the following year. At 2 years postindex TKA, his outcome scores improved and he was satisfied. Discussion and Conclusion. With increasing TKA performed worldwide, a surgeon may eventually be surprised by the above findings once in their lifetime. However, OcA may be considered a likely diagnosis and it is safe to proceed with TKA. There is no particular TKA design that proved to be superior in our systematic review of 19 publications regarding TKA as all reported good outcomes. However, as the pathogenesis of OcA appears to be inflammatory in nature, we suggest using cemented PS TKA with resurfacing of the patella.

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Multiple asystoles in a patient undergoing total knee arthroplasty - a case report

10.21203/rs.2.329/v2 ◽

2019 ◽

Author(s):

Anna-Maria Burgdorff ◽

Lilit Flöther ◽

David Wohlrab

Keyword(s):

Total Knee Arthroplasty ◽

Cardiac Arrest ◽

Case Report ◽

High Risk ◽

Knee Arthroplasty ◽

Cardiac Disease ◽

Case Presentation ◽

Total Knee ◽

Additional Monitoring

Abstract Background Unexpected cardiac arrest in patients during surgery is associated with high mortality. Reasons are often multifactorial and not exactly clear. Case presentation Therefore, this case report describes a patient, who developed reversible asystoles during knee surgery under general anesthesia. All diagnostic cardiac examinations were unremarkable. After surgery the patient showed no further symptoms. Conclusion To prevent cardiac arrest due to non-cardiac reasons, patients with high risk for asystole caused by vasovagal reflex or pain need to be identified. Preoperative conditions like hypovolemia need to be improved and additional monitoring should be used. Further investigations to find the influence of non-cardiac disease and long-term medication are necessary.

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Multiple asystole events in a patient undergoing total knee arthroplasty - a case report

10.21203/rs.2.329/v3 ◽

2019 ◽

Author(s):

Anna-Maria Burgdorff ◽

Lilit Flöther ◽

David Wohlrab

Keyword(s):

Total Knee Arthroplasty ◽

Cardiac Arrest ◽

Case Report ◽

High Risk ◽

Knee Arthroplasty ◽

Cardiac Disease ◽

Case Presentation ◽

Total Knee ◽

Additional Monitoring

Abstract Background: Unexpected cardiac arrest in patients during surgery is associated with high mortality. Reasons are often multifactorial and unclear. Case presentation: This case report describes a patient who developed reversible asystole during knee surgery under general anaesthesia. All diagnostic cardiac examinations were unremarkable. After surgery, the patient showed no further symptoms. Conclusion: To prevent cardiac arrest due to non-cardiac reasons, patients with a high risk for asystole caused by vasovagal reflex or by pain need to be identified. Preoperative conditions such as hypovolemia need to be improved prior to surgery, and additional monitoring should be used. Further investigations to determine the influence of non-cardiac disease and long-term medication are necessary.

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