63 yrs old female was operated with bilateral Total Knee Replacement in 2011 complaints of pain in left knee for the past 2 yrs with difficulty in walking and sitting.
X-Rays showed the loosening of tibial component while femoral side was alright. Her blood parameters were within normal limits and skin shows no signs of infection. Thus planned for revision TKR with both femoral and tibial components.
Post operation X-Rays showing revision TKR with stem extension on both sides with medial distal augmentation was done on femoral side Now patient is walking comfortably.
42 years old gentleman presented to us with pain in both hip joint for the past 4 years with limp. On examination Range of motion both hip joint were painful and restricted terminally and was unable to walk without support.
He had undergone uncemented Total Hip Replacement for both hips (same stage). He is walking comfortably with the walker.
75 years old lady History of trauma to left hip region in the form of fracture acetabulum which was surgical intervened in March 2018.
After 3 months patient developed pain and limp in left hip region with difficulty in walking. On examination flexion deformity at left hip with restricted rotation and shortening was about 2.5cm.
Pre-Op x-ray shows medialization of femoral head and secondary osteoarthritis.
We did Tripolar ( Dual Mobility) uncemented Total hip Arthroplasty.
Patient is walking with walker with no complications on table.
65yrs female k/c/o CAD,HTN,RA H/o bilateral TKR done in 2005. Presented to us with c/o pain in left knee with inability to bear weight over left lower limb and was wheel chair bound for the past 5 months .
On examination skin condition was normal , no sign of inflammation with mild effusion Varus instability present with Passive Rom 10 to 120 degree
Current xray shows tibial tray subsidence with loosening with varus collapse of proximal tibial bone Blood infection markers were within normal limits.
Plan for revision TKR left knee. Intraop medial defect was found on tibial side with uneven tibial surface after removal of the component Femur side component was also found to be loose with ligamentous imbalance. So RHK revision TKR was performed using medial half block on tibial side to augment the defect with stem extension and while on femur side normal component with stem extension used and inserted with cement.
After the surgery, the deformity of knee has been corrected and balanced and she has regained full and stable range of movement. She is walking comfortably.
84 yrs /f had underwent bilateral TKR in 2014. Left side knee got infected after 6 months postoperative period for which multiple debridement done but infection didn’t subside so stage 1 revision left sided done using cement sapcer in 2018. Infection subsided and patient was planned for stage 2 revision TKR using Link Locking Prosthesis after 6 months of antibiotic free period with no infection at surgical site
- Stage 2 revision done with using Link Locking hinge knee Link prosthesis with cement and closure done in layers
- After the surgery, the deformity of knee has been corrected and she has regained full and stable range of movement. she is walking comfortably.
- Revision TKR in the scenario of infection is challenging. At our center we have successfully managed many such cases.