Metallic Discoloration on the Right Shin Caused by Titanium Alloy Prostheses in a Patient with Right Total Knee Replacement

Background and Purpose: Two-stage revision arthroplasty is a common technique for the treatment of infected total knee replacement. Few reports have addressed the conversion of a fused knee into a total knee replacement. However, there is no case reported of converting an infected fused knee into a hinge knee using a one-stage procedure. Methods: We report on a 51-year old male patient with an infected fused knee after multiple surgeries. Results and Interpretation: A one-stage conversion of septic fused knee into total knee arthroplasty by a rotational hinge prosthesis was performed. The case highlights that with profound preoperative assessment, meticulous surgical technique, combined antibiotic treatment and the right implant, one-stage revision in a surgical challenge may have a role as a treatment option with good functional outcome.

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Ten-year outcomes of a nitrided Ti-6Al-4V titanium alloy fixed-bearing total knee replacement with a highly crosslinked polyethylene-bearing in patients with metal allergy

The Knee ◽

10.1016/j.knee.2020.08.007 ◽

2020 ◽

Vol 27 (5) ◽

pp. 1519-1524

Author(s):

Stefano Marco Paolo Rossi ◽

Loris Perticarini ◽

Mario Mosconi ◽

Matteo Ghiara ◽

Francesco Benazzo

Keyword(s):

Titanium Alloy ◽

Total Knee Replacement ◽

Knee Replacement ◽

Metal Allergy ◽

Fixed Bearing ◽

Total Knee

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Wound closure after total knee replacement: Comparison between staples and sutures

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.38.icon-2022.5782 ◽

2021 ◽

Vol 38 (ICON-2022) ◽

Author(s):

Mansoor Ali Khan ◽

M. Waseem Memon ◽

Amin Chinoy ◽

Salman Javed ◽

Rahil Barkat ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Total Knee Replacement ◽

Knee Replacement ◽

Knee Arthroplasty ◽

Wound Closure ◽

P Value ◽

Incision Length ◽

Total Knee ◽

The Mean ◽

The Right

Background and Objective: Total Knee Arthroplasty is a commonly performed procedure for arthritic knees. Preventing complications is of utmost importance for good functional outcomes and preventing morbidity. Wound closure after the procedure is as important as the replacement aspect of surgery.The objective of this study was to provide subjective and objective evidence of better closure technique and material; we conducted the study so that the outcome of TKA can be further improved. Methods: We conducted a randomized trial at The Indus Hospital, Karachi, from December 2018 to June 2020. All patients from age 40 to 70 years who underwent total knee arthroplasty were included in the study. The wound of one knee was closed with Polypropylene (Prolene) sutures, and the other with staples. The wound was assessed independently by two assessors using Hollander’s score; lower score means a worse outcome. All data was entered and analyzed using STATA version 16. Results: Thirty patients who underwent bilateral total knee replacement were included in the analysis, among which 71.8% were female. The average age of participants was 57.3 (± 7.5) years. The mean incision length on the right knee was 17.6 ± 1.1 cm, while on the left the incision length was 18.3 ± 1.2 cm. Overall, the mean Hollander score was significantly different among participants in the sutures and staples group in both the right (p-value=0.001) and left knees (p-value=0.001). The score was significantly higher in knees closed with sutures as compared to staples. Also, the mean Hollander score is significantly higher in females than males in both the right knee (B=0.56, p-value=0.049) and the left knee (B=0.38, p-value=0.044). Conclusion: The study has shown that Hollander’s score was significantly higher in knees closed with sutures as compared to the patients in whom staples were used for wound closure. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5782 How to cite this:Khan MA, Memon MW, Chinoy A, Javed S, Barkat R, Jiwani A. Wound closure after total knee replacement: Comparison between staples and sutures. Pak J Med Sci. 2022;38(2):340-344. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5782 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Failed knee replacement: incorrect indication?

BMJ Case Reports ◽

10.1136/bcr-2019-230829 ◽

2019 ◽

Vol 12 (9) ◽

pp. e230829

Author(s):

George Ampat ◽

Emma Tixerant

Keyword(s):

Total Knee Replacement ◽

Knee Replacement ◽

Surgical Intervention ◽

Tissue Injury ◽

Soft Tissue Injury ◽

X Rays ◽

Surgical Interventions ◽

Mri Scans ◽

Total Knee ◽

The Right

A 52-year-old woman sustained a direct soft tissue injury to the right knee following a fall onto the right knee. X-rays did not identify any bony injury. Physiotherapy decreased pain but instability persisted. MRI scans identified early degeneration. An orthopaedic opinion recommended total knee replacement. Following a total knee replacement, the pain has worsened and she remains functionally impaired 2 years following the surgical intervention. Knee replacements are commonly performed successful surgical interventions. The increased numbers of replacements might be due to the lowered threshold in recommending surgical intervention by health professionals. This may increase the failure rate. It also raises the question whether adequate non-operative measures were attempted?

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Morphometric study of upper end of tibia and its implications in total knee replacement

Indian Journal of Clinical Anatomy and Physiology ◽

10.18231/j.ijcap.2021.048 ◽

2021 ◽

Vol 8 (3) ◽

pp. 213-218

Author(s):

Md. Jawed Akhtar ◽

Raag Reeti ◽

Binod Kumar ◽

Rajiv Ranjan Sinha ◽

Avanish Kumar

Keyword(s):

Total Knee Replacement ◽

Knee Replacement ◽

Morphometric Parameters ◽

Morphometric Study ◽

Transverse Diameter ◽

Lateral Condyle ◽

Cross Sectional ◽

Medial Condyle ◽

Total Knee ◽

The Right

: Knee deformities can be reliably assessed by using morphometric parameters of upper end of tibia. Total knee arthroplasties are done to treat many types of arthritis and injuries involving knee joint. So, there is a need to have data of various morphometric parameters of upper end of tibia in order to have better surgical outcomes. The present study was attempted to provide values of different parameters in the population of Bihar.: The present study was a cross-sectional and prospective study conducted on 50 tibia of unknown gender and age in the Department of Anatomy, Indira Gandhi Institute of Medical Sciences, Patna. Fully ossified, dried, macerated and thoroughly cleaned tibia were taken to measure different parameters of upper end with the help of digital vernier calliper. The data thus obtained were tabulated and analysed statistically using Microsoft excel software.: It was found that the diameters of medial condyle were more than the lateral condyle. The antero-posterior diameter was more than the transverse diameter in case of both the condyles. But the difference between the right and the left side was not statistically significant.: The present study will help in providing a baseline data for designing of the prosthesis used in total knee replacement surgeries. It will also be helpful to anthropologists and forensic experts.

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Thromboembolic Diseases and the Use of Vena Cava Filters

Journal of Perioperative Practice ◽

10.1177/175045891702700405 ◽

2017 ◽

Vol 27 (4) ◽

pp. 87-89

Author(s):

S De Silva

Keyword(s):

Total Knee Replacement ◽

Knee Replacement ◽

Postoperative Period ◽

Pulmonary Embolus ◽

Vena Cava ◽

Left Knee ◽

Vena Cava Filters ◽

Spinal Anaesthetic ◽

Total Knee ◽

The Right

Mr GW is a 77-year-old gentleman who is hoping to have a total knee replacement of his left knee. He underwent a knee replacement on the right in 2011 under spinal anaesthetic, where his postoperative period was complicated by a saddle pulmonary embolus (PE).

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Diagnosis and treatment of bullous pemphigoid that developed twice after total knee replacement arthroplasty: a case report

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04000-6 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Yong-Beom Kim ◽

Hyung-Suk Choi ◽

Hyung-Ki Cho ◽

Gi-Won Seo

Keyword(s):

Total Knee Replacement ◽

Skin Biopsy ◽

Bullous Pemphigoid ◽

Knee Replacement ◽

Left Knee ◽

Replacement Arthroplasty ◽

Knee Replacement Arthroplasty ◽

Total Knee ◽

The Right ◽

Symptom Progression

Abstract Background Total knee replacement arthroplasty (TKA) is frequently performed in South Korea. Simple swelling-associated blistering around the periphery of the operative wound is a well-known adverse effect. However, in rare cases, the blisters are bullous pemphigoid (BP). Case presentation A 75-year-old male presented with knee pain that had not improved despite 5 years of medication. We performed TKA of the left knee, placing a Stryker posteriorly stabilized prosthesis. Three days later, blisters developed near the buttocks and thighs and, on day 10 after surgery, around the operative site. A skin biopsy revealed BP. Commencing on day 14 after surgery, prednisolone 10 mg was administered twice daily. The symptoms improved by 3 weeks after surgery and were healed at 4 months. After 1 year, we performed TKA of the right knee. On day 2 after surgery, as formerly, blisters developed on the buttocks and an immediate biopsy revealed BP. Commencing on day 3 after surgery, prednisolone 10 mg was administered twice daily. On day 10 after surgery, the blisters on the buttocks had improved and no blisters were observed at the surgical site. All symptoms had resolved by 2.5 months after surgery. Conclusions After TKA surgery, generalized BP may develop, diagnosed via skin biopsy. A quick diagnosis is important because early treatment can prevent symptom progression and shorten treatment.

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