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Revision Total Knee Arthroplasty in a Patient with Bilateral Below-the-Knee Amputation: A Case Report
M G Williams1, J Phillips, K Eyres
1PEOC, Royal Devon and Exeter Hospital, Barrack Road, Exeter, Devon EX25DW, United Kingdom.
Update:
This article was updated on January 27, 2016. The byline, which had previously read "M.G. Williams, MBChB, and J. Phillips, MBBS, FRCS," now reads "M.G. Williams, MBChB, J. Phillips, MBBS, FRCS, and K. Eyres, MD, FRCS(Tr&Orth)." In addition, the name, address, and e-mail address for Dr. Eyres have been added to the address block at the end of the article.An erratum has been published: JBJS Case Connect. 2016 Mar 23;6(1):e22.
Case:
We report the case of a patient with bilateral below-the-knee amputation who had a periprosthetic fracture around a total knee arthroplasty. The fracture was managed with a revision total knee arthroplasty. We discuss the rationale for revision surgery, the surgical techniques, and the postoperative rehabilitation. Follow-up at one year demonstrated maintenance of the pretrauma functional status.
Conclusion:
In selected patients with a periprosthetic fracture, we believe that revision of a total knee arthroplasty may be considered as an option rather than an above-the-knee amputation or an arthrodesis.
Insights
Revision total knee arthroplasty can be a viable option for managing periprosthetic fractures in patients with below-the-knee amputations. This approach may help maintain pre-trauma functional status, avoiding more extensive procedures.
Area of Science:
- Orthopedic Surgery
- Arthroplasty
- Trauma Management
Background:
- Periprosthetic fractures present complex challenges, particularly in patients with lower limb amputations.
- Managing these fractures often requires careful consideration of limb salvage versus amputation.
Purpose of the Study:
- To evaluate the efficacy of revision total knee arthroplasty for periprosthetic fractures in a patient with bilateral below-the-knee amputation.
- To discuss the surgical rationale, techniques, and outcomes of this management strategy.
Main Methods:
- Case report of a patient with bilateral below-the-knee amputation and a periprosthetic fracture around a total knee arthroplasty.
- Management involved revision total knee arthroplasty.
- Surgical techniques, rationale, and postoperative rehabilitation were detailed.
Main Results:
- One-year follow-up demonstrated maintenance of the patient's pre-trauma functional status.
- The revision total knee arthroplasty successfully addressed the periprosthetic fracture.
Conclusions:
- Revision total knee arthroplasty is a potential treatment option for selected patients with periprosthetic fractures.
- This approach can be an alternative to above-the-knee amputation or arthrodesis.
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