Tibiofemoral Dislocation After Total Knee Arthroplasty

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Arthroplasty Research

Background:

• Tibiofemoral dislocation is a rare but serious complication following total knee arthroplasty (TKA).
• Limited case reports hinder understanding of its etiology, epidemiology, and management.
• This case series addresses these knowledge gaps by analyzing patient demographics, causes, and treatment challenges.

Purpose of the Study:

• To characterize demographic features of patients experiencing tibiofemoral dislocation post-TKA.
• To identify common etiologies and predisposing factors for tibiofemoral dislocation after TKA.
• To highlight management difficulties and complication rates associated with this rare event.

Main Methods:

• Retrospective review of 14 patients with tibiofemoral dislocation after TKA between 2005 and 2014.
• Exclusion of patients with isolated patellofemoral dislocation or subluxation.
• Analysis of patient demographics, dislocation frequency, time to intervention, etiologies, and complications.

Main Results:

• The majority of patients (12/14) were female with a high mean BMI (33 ± 10 kg/m²).
• Common causes included polyethylene damage (4 patients) and ligamentous incompetence (5 patients).
• High complication rates observed: infection (3), multiple dislocations (7), popliteal artery laceration (2), with 1 fusion and 1 amputation.

Conclusions:

• Tibiofemoral dislocation post-TKA predominantly affects obese females and carries a high risk of complications.
• Polyethylene wear and ligamentous insufficiency are key etiological factors.
• Closed reduction alone is insufficient, with re-dislocation being common; surgical intervention is often necessary.