scholarly journals Heterotrophic ossification post total knee arthroplasty in a patient with rheumatoid arthritis: a case report

2021 ◽  
Vol 7 (6) ◽  
pp. 1227
Author(s):  
Aswin Thankachan Veliyil ◽  
Dileep S. ◽  
Renjit John Mathew ◽  
John Thayyil John
Keyword(s):  
Rheumatoid Arthritis ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Quadriceps Tendon ◽  
X Ray ◽  
The Past ◽  
Total Knee ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

<p class="abstract">Even though minor degrees of heterotrophic ossification are common in total knee arthroplasty, it is of little clinical significance. But severe degrees of heterotrophic ossification are very rare after total knee arthroplasty. Here we discuss about a 70 years old woman who initially had excellent post-operative range of movements after cemented total knee arthroplasty, but later presented with knee pain, swelling and loss of range of movements after 3 months. X ray showed severe heterotrophic ossification around knee near the quadriceps tendon. She was treated conservatively with non-steroidal anti inflammatory drugs and physiotherapy. After a period of 3 months of physiotherapy, patient regained the lost range of movements and is currently under follow up for the past 1 year. Hence this case instantiates that even in cases of severe Heterotrophic Ossification after total knee arthroplasty, non-operative treatments such as physiotherapy with anti-inflammatory drugs should be the primary option to treat the stiffness before considering surgery.</p><p class="abstract"> </p>

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.

15-year follow-up study of total knee arthroplasty in patients with rheumatoid arthritis

2003 ◽  
Vol 18 (8) ◽  
pp. 984-992 ◽  
Author(s):  
Jun Ito ◽  
Tomihisa Koshino ◽  
Renzo Okamoto ◽  
Tomoyuki Saito
Keyword(s):  
Rheumatoid Arthritis ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Follow Up Study ◽  
Total Knee

scholarly journals Direct Repair of Extensor Mechanism Disruption After Total Knee Arthroplasty “A Case Series of 31 Patients”

2021 ◽  
Author(s):  
Tie-jian Li ◽  
Jing-yang Sun ◽  
Yin-qiao Du ◽  
Jun-min Shen ◽  
Bo-han Zhang ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Case Series ◽  
Quadriceps Tendon ◽  
Clinical Results ◽  
Extensor Mechanism ◽  
Direct Repair ◽  
Kaplan Meier ◽  
Total Knee

Abstract Background Extensor mechanism disruption following total knee arthroplasty is a destructive complication with poor outcomes. Presently, limited data exists regarding the direct repair therapy and long-term outcomes. This study was to evaluate the clinical results and complications of direct repair therapy, and compare it with similar studies to determine whether there is a better treatment. Methods During the period of 2008 to 2020, 31 patients underwent direct repair for an extensor mechanism disruption after total knee arthroplasty (15 patellar fractures, 9 patellar tendon disruptions, and 7 quadriceps tendon disruptions). Mean follow-up was 4.9 years. Demographic, operative, and clinical data were collected. The following statistical methods will be employed to analyze the data: descriptive statistics, paired t test, and the Kaplan-Meier method. Results For all 31 patients underwent direct repair for extensor mechanism disruption, 6 patients failed : 2 knees (6%) of infections and 4 knees (13%) of re-rupture. ROM was 94.1° ± 15.7° preoperatively to 73° ±52° postoperatively, average extensor lag reduced from 45° to 20.2° at follow-up, and the WOMAC and HSS averaged 65 and 72 points. The Kaplan-Meier estimated survivorship with failure for complications as the end point was 81% (95% confidence interval [95% CI], 42.7% to73.3%) at 12 years. Conclusion Direct repair of the extensor mechanism disruption is not an ideal therapy, it’s actually ineffective for the recovery of knee joint function in patients, and will remain severe knee extension lag. No matter which part of the extensor mechanism disruption, direct repair should not be the preferred treatment

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