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SCREW MIGRATION IN TOTAL KNEE ARTHROPLASTY: CLINICAL REPORT
Fernando Fonseca1, José Tomé2, Manuel Barreto3
1Auxiliary Professor. Head of the Knee Sector, Hospitals of the University of Coimbra, Portugal.
Revista Brasileira De Ortopedia
|March 30, 2016
Summary
Complications from total knee arthroplasty (TKA) are rare. A polyethylene screw migrated into the knee joint, requiring revision surgery to remove the screw and replace components.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Medical Device Engineering
Background:
- Total knee arthroplasty (TKA) is a common procedure to alleviate pain and restore function in patients with knee osteoarthritis.
- While generally safe, complications can arise from implanted materials, with polyethylene wear being the most frequent issue.
- Intra-articular migration of fixation components is an exceptionally rare complication.
Observation:
- This report details an unusual case of intra-articular migration of a polyethylene safety screw following a TKA procedure.
- The specific implant involved was the TKA Performance system, which sacrifices the posterior cruciate ligament.
- The migrated screw presented as a foreign body within the knee joint cavity.
Findings:
- The polyethylene safety screw migrated from its original position into the intra-articular space of the knee.
- This migration necessitated a secondary surgical intervention.
- The revision surgery involved the removal of the migrated screw, replacement of the polyethylene insert, and insertion of a new fixation screw.
Implications:
- This case highlights a rare but significant complication associated with TKA implants, emphasizing the importance of meticulous surgical technique and implant component integrity.
- It underscores the need for vigilance in diagnosing and managing unexpected foreign body migration within the knee joint post-arthroplasty.
- The findings may inform future implant design and surgical protocols to minimize the risk of such rare complications.
