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Knee Joint

Knee Joint

The knee joint is the most complicated joint in the body. It consists of three articulations– two tibiofemoral and one patellofemoral. As is characteristic of synovial joints, the knee joint has a thin articular capsule that partially surrounds this joint cavity. Additionally, several ligaments, muscles, and cartilaginous structures support the movement of the knee.
A total of seven ligaments support the knee joint. The patellar ligament, which is also attached to the quadriceps femoris...

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The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve

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Acute, recurrent total knee dislocation: Polyethylene dislocation and malreduction.

Samuel F Thompson¹, Blake E Peterson², Ajay Aggarwal²

¹University of Missouri School of Medicine, Columbia, MO, USA.

Arthroplasty Today

|March 23, 2017

Summary

This summary is machine-generated.

Repeated closed reductions of a dislocated mobile-bearing total knee arthroplasty (TKA) may cause the polyethylene insert to spin 180°. This complication can lead to further knee instability and necessitate revision surgery.

Keywords:

Polyethylene insert spinout Posterior dislocation Total knee arthroplasty

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Area of Science:

Orthopedic Surgery
Biomedical Engineering

Background:

Total knee arthroplasty (TKA) is a common procedure for end-stage knee arthritis.
Mobile-bearing prostheses offer increased range of motion but may have unique complications.
Acute dislocations post-TKA are rare but can be challenging to manage.

Observation:

A 62-year-old male patient experienced recurrent acute knee dislocations four days after mobile-bearing TKA.
Multiple closed reduction attempts were performed externally prior to presentation.
Surgical exploration revealed a complete 180° spinout of the polyethylene insert.

Findings:

The polyethylene insert of the mobile-bearing prosthesis had completely dislodged and rotated 180°.
Clinical suspicion for infection led to a two-stage exchange recommendation.
The dislocation and insert spinout occurred despite initial closed reduction attempts.

Implications:

Closed reduction of posterior dislocations in mobile-bearing TKAs may risk insert spinout.
This complication can compromise joint stability and necessitate revision surgery.
Careful management and surgical technique are crucial for mobile-bearing TKA outcomes.