Early failure of a knee replacement in a neuropathic joint. A case report

Total knee arthroplasty in neuropathic (Charcot) joints is technically demanding. Most studies report significant improvement in knee function, despite a high incidence of complications. We present a case of idiopathic, unilateral neuropathic arthropathy of the knee treated with a modular stemmed, constrained total knee arthroplasty. Unscrewing of the stem of the tibial component was detected a year following surgery. The tibial component was revised to a custom made monobloc stemmed implant. Satisfactory knee function was noted at short-term follow-up. This case highlights a potential problem of using modular long-stem implants in neuropathic joints and emphasises the need for close follow-up of these difficult cases.