Total Knee Arthroplasty With Retained Tibial Implants: The Role of Minimally Invasive Hardware Removal

Patients with retained tibial implants may later undergo total knee arthroplasty (TKA) after tibial osteotomy or fracture. Previous knee surgery can increase the rate of complications of joint replacement. Surgical scars may not be in optimal position for hardware removal and arthroplasty. The need for multiple incisions or larger subcutaneous skin flaps in at-risk areas may increase the possibility of wound complications and infection. In this article, we report 3 cases in which a patient who had knee arthrosis and retained tibial implants underwent single-stage conversion to TKA. In each case, selected minimally invasive hardware removal was performed through small incisions under fluoroscopic guidance. For insertion of the tibial base plate, only screws were removed; the retained plates were not disturbed. This technique allowed the TKA to be performed without making significant secondary incisions or raising larger-than-normal skin flaps.