[Total knee arthroplasty in the cardiac transplant patient--a case report]

We present a 66 year-old diabetic patient who 4 years ago underwent cardiac transplantation and 1 year ago was implanted a total knee arthroplasty due to arthrosis. In the literature and reference books the arthroplasty in such patients is mainly related to aseptic necrosis of the joints as a result of taking immunosuppressive therapy (corticosteroids). Our patient didn't have an aseptic necrosis but a classical arthrosis of the knee. Although our patient didn't have so strong pain as patients with aseptic necrosis, we decided to do the knee arthroplasty. The procedure went properly and postoperative time, recovery and knee function were excellent. Implantation of endoprosthesis in a cardiac transplant patient shouldn't be retained only for cases of aseptic necrosis of a joint, which occurs due to immunosuppressive therapy, but also for the cases of classical arthrosis. Good preoperative, perioperative and postoperative care and good surgery technic make this procedure safe in cardiac transplant patients as in nontransplanted patients. To the best of our knowledge this is the first case of implantation of knee endoprosthesis in a cardiac transplant patient in Croatia.