Challenges in a neglected case of traumatic anterior dislocation after total knee replacement: A case report

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-05-24 DOI:10.1016/j.jcot.2025.103073

Aashay Sonkusale , Vijay Kishore Kondreddy , Kunal Patel

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引用次数: 0

Abstract

Anterior tibio-femoral dislocation following total knee replacement (TKR) is a dreaded complication. We present a case of a 43-year-old lady who presented to us 3 months after a domestic ground level fall with pain, deformity and, inability to bear weight on her right knee. She had undergone a successful TKR 3 years ago with no complaints up until the fall. On examination, the limb was well perfused with no neurologic damage. A vascular surgery opinion was taken and arterial doppler showed good flow at and below the level of the knee. Radiologic assessment revealed a complete anterior dislocation of the prosthetic knee and a bone avulsion of medial epicondyle (ME). With an aim to add to current literature, we focus on the challenges faced intra-operatively and have described excision of the ME with excellent functional outcome at six months in such long-standing cases of dislocation. The patient was revised to constraint hinge knee with a rotating platform. At a 6-month follow-up, patient made a good functional recovery and had a stable knee with an Oxford knee score of 41. Informed consent has been taken from the patient as per CARE guidelines.

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一例被忽视的全膝关节置换术后外伤性前脱位的挑战：一例报告

全膝关节置换术（TKR）后胫股前脱位是一种可怕的并发症。我们报告一位43岁的女士，她在家中地面跌倒3个月后出现疼痛、畸形和右膝无法承重。3年前，她接受了成功的TKR手术，直到秋天才有任何抱怨。经检查，肢体灌注良好，无神经损伤。血管外科意见和动脉多普勒显示良好的血流在膝盖水平和以下。放射学评估显示假膝完全前脱位和内上髁骨撕脱。为了补充现有文献，我们关注术中面临的挑战，并描述了在此类长期脱位的病例中，在6个月时切除ME并获得良好的功能结果。患者采用旋转平台改良为约束铰链膝关节。在6个月的随访中，患者功能恢复良好，膝关节稳定，牛津膝关节评分41分。根据CARE指南，已取得患者的知情同意。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.