Recurrent dislocation following total knee arthroplasty managed with a hinged revision prosthesis

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Knee Biomechanics

Background:

• Postoperative instability is a significant complication following total knee arthroplasty (TKA).
• Managing recurrent instability after TKA is challenging, demanding precise mechanical alignment and soft-tissue balance.
• Knee dislocation is a severe manifestation of TKA instability.

Purpose of the Study:

• To present a case of recurrent knee dislocation after primary TKA.
• To illustrate the management of complex instability following TKA.
• To highlight the role of specific prosthetic designs in addressing severe TKA instability.

Main Methods:

• A case report of a patient experiencing recurrent dislocations after primary TKA.
• Initial management involved tibial insert exchange.
• Definitive treatment utilized revision TKA with a rotating hinge knee prosthesis.

Main Results:

• The patient experienced recurrent dislocations even after tibial insert exchange.
• Revision TKA with a rotating hinge knee prosthesis successfully resolved the instability.
• The case demonstrates a successful outcome for complex TKA instability.

Conclusions:

• Appropriate implant selection is crucial for managing TKA complications.
• Constrained prosthetic designs, such as rotating hinge knee implants, are vital for treating recurrent or severe instability after TKA.
• This case emphasizes the importance of considering advanced prosthetic solutions for challenging TKA instability cases.