Bilateral Patellar Avascular Necrosis Following Total Knee Arthroplasties

A 79-year-old female with a history of bilateral knee osteoarthritis presented with severe knee pain, eight years post-bilateral total knee arthroplasties (TKAs). Notably, a lateral retinacular release had been performed alongside each arthroplasty. On examination, she displayed new painful prominences along the lateral aspects of both knees. Radiographs and CT scans revealed near-complete resorption of the bilateral patellae, indicating advanced avascular necrosis (AVN). After discussing treatment options, the patient opted for revision surgery to remove the patellar hardware, leading to significant improvements in pain, function, and mobility. This case underscores the need for close, long-term follow-up in patients who undergo TKA with concurrent lateral retinacular release, to monitor for potential complications like AVN.