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[Atraumatic dislocation in mobile-bearing total knee arthroplasty: two case reports]
1Research Unit Orthopädie und Chirurgie, Klinikum Neumarkt, Lehrkrankenhaus der Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany. alexander.schuh@klinikum.neumarkt.de
Zentralblatt Fur Chirurgie
|October 2, 2007
Summary
Dislocation after mobile-bearing total knee arthroplasty (TKA) is rare but serious. Reserve mobile-bearing TKA for patients with strong quadriceps function to prevent complications.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
Background:
- Atraumatic dislocation is a rare complication of total knee arthroplasty (TKA), particularly with mobile-bearing components.
- Mobile-bearing TKA offers improved range of motion but carries a risk of dislocation and polyethylene insert failure.
- Potential severe complications include neurovascular damage, compartment syndrome, and amputation.
Observation:
- Two cases of atraumatic dislocation following mobile-bearing TKA are presented.
- Both patients exhibited preoperative quadriceps muscle weakness.
- Revision surgery revealed significant scratching and damage to the polyethylene onlay, predominantly on the tibial side.
Findings:
- Dislocation in mobile-bearing TKA can lead to severe polyethylene damage.
- Preoperative quadriceps strength appears to be a critical factor in the stability of mobile-bearing TKA.
- Conversion to a fixed-bearing component resulted in an uneventful recovery in the presented cases.
Implications:
- Surgical revision is recommended for polyethylene onlay damage to prevent wear progression.
- Mobile-bearing TKA should be carefully considered and potentially reserved for patients with adequate quadriceps muscle function.
- This highlights the importance of patient selection and biomechanical considerations in TKA implant choice.