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

Mapping Intimacies ◽

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.

Download Full-text

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.

Download Full-text

Cardiac arrest in orthopedic surgery – a case report

10.21203/rs.2.329/v1 ◽

2019 ◽

Author(s):

Anna-Maria Burgdorff ◽

Lilit Flöther ◽

David Wohlrab

Keyword(s):

Total Knee Arthroplasty ◽

Cardiac Arrest ◽

Case Report ◽

High Risk ◽

Orthopedic Surgery ◽

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 asystole 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. Keywords: Cardiac arrest, bradycardia, asystole, total knee arthroplasty.

Download Full-text

Fracture of the Tibial Baseplate in Bicompartmental Knee Arthroplasty

Case Reports in Orthopedics ◽

10.1155/2015/693025 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Bart Stuyts ◽

Melanie Vandenberghe ◽

Hans Van der Bracht ◽

Yves Fortems ◽

Elke Van den Eeden ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Case Report ◽

Knee Arthroplasty ◽

Conservative Therapy ◽

High Impact ◽

Daily Routine ◽

Early Generation ◽

Case Presentation ◽

Total Knee ◽

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.

Download Full-text

Isolated Liner Revision for Total Knee Arthroplasty Instability: A Road That Should Remain Less Taken

The Journal of Knee Surgery ◽

10.1055/s-0040-1721091 ◽

2020 ◽

Author(s):

Jason D. Tegethoff ◽

Rafael Walker-Santiago ◽

William M. Ralston ◽

James A. Keeney

Keyword(s):

Total Knee Arthroplasty ◽

Femoral Component ◽

Knee Arthroplasty ◽

Primary Total Knee Arthroplasty ◽

P Value ◽

Surgical Morbidity ◽

Exact Test ◽

Total Knee ◽

Component Revision

AbstractIsolated polyethylene liner exchange (IPLE) is infrequently selected as a treatment approach for patients with primary total knee arthroplasty (TKA) prosthetic joint instability. Potential advantages of less immediate surgical morbidity, faster recovery, and lower procedural cost need to be measured against reoperation and re-revision risk. Few published studies have directly compared IPLE with combined tibial and femoral component revision to treat patients with primary TKA instability. After obtaining institutional review board (IRB) approval, we performed a retrospective comparison of 20 patients treated with IPLE and 126 patients treated with tibial and femoral component revisions at a single institution between 2011 and 2018. Patient demographic characteristics, medical comorbidities, time to initial revision TKA, and reoperation (90 days, <2 years, and >2 years) were assessed using paired Student's t-test or Fisher's exact test with a p-value <0.01 used to determine significance. Patients undergoing IPLE were more likely to undergo reoperation (60.0 vs. 17.5%, p = 0.001), component revision surgery (45.0 vs. 8.7%, p = 0.002), and component revision within 2 years (30.0 vs. 1.6%, p < 0.0001). Differences in 90-day reoperation (p = 0.14) and revision >2 years (p = 0.19) were not significant. Reoperation for instability (30.0 vs. 4.0%, p < 0.001) and infection (20.0 vs. 1.6%, p < 0.01) were both higher in the IPLE group. IPLE does not provide consistent benefits for patients undergoing TKA revision for instability. Considerations for lower immediate postoperative morbidity and cost need to be carefully measured against long-term consequences of reoperation, delayed component revision, and increased long-term costs of multiple surgical procedures. This is a level III, case–control study.

Download Full-text