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Persistent knee instability following revision total knee arthroplasty
K H Lin1, S S Sathappan, H P Wong
1Department of Orthopaedic Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433. blkh@mail2world.com
Singapore Medical Journal
|January 6, 2009
Summary
Instability after total knee arthroplasty (TKA) can stem from ligament issues. Revision TKA with constrained implants effectively addressed persistent deformity and instability due to medial collateral ligament deficiency.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Knee Biomechanics
Background:
- Instability is a significant cause of failure in total knee arthroplasty (TKA).
- Optimal knee stability is crucial in both coronal and sagittal planes for successful TKA outcomes.
- Ligamentous integrity, particularly the medial collateral ligament (MCL), is vital for maintaining knee joint stability.
Observation:
- A case of failed revision TKA in a 71-year-old Chinese woman presented with persistent deformity and instability.
- The instability was attributed to a deficient medial collateral ligament (MCL).
- This case highlights the challenges associated with significant ligamentous compromise during revision TKA.
Findings:
- Revision knee arthroplasty was performed using constrained implants.
- The patient achieved a good clinical result following the revision surgery with constrained implants.
- This demonstrates the efficacy of constrained implants in managing severe instability.
Implications:
- Thorough assessment of knee stability during both primary and revision TKA is critical.
- Constrained prostheses are a valuable option for revision TKA in cases of significant ligamentous deficiency.
- This approach can help restore stability and improve function in complex TKA revisions.
