Complications - OtherTibiofemoral Dislocation After Total Knee Arthroplasty
Section snippets
Methods
Between January 2005 and December 2014, 14 patients presented to our institution (a large tertiary care center) with a tibiofemoral dislocation after TKA (Table 1). Informed consent was obtained from all patients. Patients were not included in this study if they had patellofemoral dislocation or subluxation without a tibiofemoral dislocation or less than 1 year of follow-up. We retrospectively reviewed patient demographics, including age, gender, and body mass index (BMI) as well as date of
Results
During the studied period, the estimated percentage of all revision TKAs in our practice performed for a tibiofemoral dislocation was 2.1% of all revised TKAs at our institution. Of 14 patients, 12 were women (86%). The mean age of the patients at the time of the first tibiofemoral dislocation was 68 ± 15 years (range, 53-96). The mean BMI at the time of tibiofemoral dislocation was 33 ± 10 kg/m2. Comorbidities were present with all patients, but most notably 3 patients had diabetes mellitus, 2
Discussion
Tibiofemoral dislocation after TKA is a rare complication. It is challenging to identify an accurate incidence for this problem. Although we are able to calculate the percentage of revision TKAs performed for tibiofemoral dislocation, it is impossible to determine the incidence of tibiofemoral dislocation after primary TKA with the data available in this study since many of the patients had their primary TKAs performed at outside hospitals. However, the percent of revision TKAs performed for
Conclusions
Patients presenting with a tibiofemoral dislocation after TKA are predominantly obese, female, and at a high risk for complications. They dislocate predominantly because of polyethylene damage or because of ligamentous incompetence. Furthermore, they frequently re-dislocate if treated with closed reduction alone. Careful monitoring of these patients for complications (particularly neurovascular compromise and infection) is paramount to preventing further morbidity. Overall, the outcome of these
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Outcomes of Total Knee Arthroplasty Revisions in Obese and Morbidly Obese Patient Populations
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2022, KneeCitation Excerpt :Spinout was defined as a dislocation of the PE insert [18]. Femorotibial dislocation was defined as dislocation of the femoral and tibial components [19]. At each regular follow up visit, all complications were evaluated with physical findings and plain radiographs of the knee by each surgeon.
Traumatic Lateral Knee Dislocation of a Well-Functioning Total Knee Arthroplasty: A Case of Medial Collateral Ligament Rupture
2021, Arthroplasty TodayCitation Excerpt :Rouquette et al. performed a systematic review of tibiofemoral dislocations after primary TKA and found that displacement was posterior in 87.3% of cases, anterior in 11.4%, and lateral in 1.3% [7]. Jethanandani et al. reported that 86% of their TKA tibiofemoral dislocation cohort required revision surgery, although the authors emphasized polyethylene damage and ligamentous insufficiency as causes of dislocation rather than traumatic injury [12]. There is a paucity of literature regarding traumatic tibiofemoral dislocation in the setting of a previously well-functioning TKA.
Not Another Twisted Knee
2019, Journal of Emergency MedicineCitation Excerpt :Revision of the prosthesis is dependent on comorbidities and baseline mobility. Polyethylene wear warrants revision TKA whereas in the case of ligamentous instability, increasing constraint during revision TKA is necessary (5). Complications are rare and include loss of motor and sensory function, arterial occlusion or dissection, venous thrombosis, acute limb ischemia, and compartment syndrome.
Letter to the Editor on ‘Tibiofemoral Dislocation After Total Knee Arthroplasty’
2017, Journal of Arthroplasty
One or more of the authors of this paper have disclosed potential or pertinent conflicts of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. For full disclosure statements refer to http://dx.doi.org/10.1016/j.arth.2016.03.010.