Challenges in a neglected case of traumatic anterior dislocation after total knee replacement: A case report

Anterior tibio-femoral dislocation following total knee replacement (TKR) is a dreaded complication. We present a case of a 43-year-old lady who presented to us 3 months after a domestic ground level fall with pain, deformity and, inability to bear weight on her right knee. She had undergone a successful TKR 3 years ago with no complaints up until the fall. On examination, the limb was well perfused with no neurologic damage. A vascular surgery opinion was taken and arterial doppler showed good flow at and below the level of the knee. Radiologic assessment revealed a complete anterior dislocation of the prosthetic knee and a bone avulsion of medial epicondyle (ME). With an aim to add to current literature, we focus on the challenges faced intra-operatively and have described excision of the ME with excellent functional outcome at six months in such long-standing cases of dislocation. The patient was revised to constraint hinge knee with a rotating platform. At a 6-month follow-up, patient made a good functional recovery and had a stable knee with an Oxford knee score of 41. Informed consent has been taken from the patient as per CARE guidelines.