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Two-Stage Revision for Pseudomonas-Infected TKA in a Patient With Elephantiasis Nostras Verrucosa: A Rare Case Report
Sourav Lal Das1, Komalchand Gajbhiye, Ayush Sharma
1Department of Orthopaedics, Bharatratna Dr Babasaheb Ambedkar Memorial Hospital, Mumbai, India.
Case:
A 63-year-old woman presented with an infected left total knee arthroplasty (TKA) having pain, sinus, and cobblestone-like swelling due to elephantiasis nostras verrucosa (ENV). A two-stage revision was performed, with strict asepsis and wound management. At midterm 15-month follow-up, no infection or loosening was noted, and daily knee functions improved.
Conclusion:
No established guidelines exist for revision TKA in ENV. In ENV with structural lymphatic obstruction, infection control and meticulous soft-tissue protocols are essential, and long-term surveillance remains necessary.
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