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Updated: Feb 11, 2026

Knee Arthrocentesis in Adults
Published on: February 25, 2022
Knee joint instability after total knee replacement in a patient with Ehlers-Danlos syndrome: the role of insert
Ajmal Farid1, Stefan Beekhuizen1, Joris van der Lugt1
1Orthopaedic Surgery, HagaZiekenhuis, The Hague, The Netherlands.
Abstract:
Treatment of knee joint instability in patients with hypermobile Ehlers-Danlos syndrome (EDS) can be challenging. A 53-year-old woman with hypermobile EDS underwent bilateral total knee replacement (TKR) due to valgus osteoarthritis. During follow-up, she developed hypermobility of both knee replacements. Revision of the insert resolved the issue in her left knee; however, the right TKR required two insert exchanges and unfortunately instability persisted. Therefore, a revision to a constrained prosthesis was performed. Insert exchanges in an unstable TKR can give short-term benefits, but for the long-term, we would recommend a constrained prosthesis.
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