73 years old gentleman with advanced osteoarthritis knee came to us with complaints of pain and swelling since 6 months. He is unable to walk or stand. On Clinical examination he had severe varus deformity left knee and restricted range of motion was noticed. Preoperative X-Ray showed arthritic of knee joint with varus deformity and large medial tibial defect. These complex deformities need meticulous surgical planning in terms of bone cuts, defects management and ligaments balancing with revision constrained knee prosthesis.
The patient underwent total knee replacement surgery with constrained prosthesis and bone defect augmentation with wedge.
Post-operative X-Ray shows well balanced knee with constrained prosthesis (LCCK) with stemmed components and medial wedge (tibial side) to augment the defect. Now patient is comfortable and walking with support.
DEC, 2014 : NP 51 years old gentleman presented with deformed knee. Whenever the patients try to walk he would give way. As a result the patient almost became bedridden for the last 1 yr. Patient had a history of trauma 22 years back and uncontrolled diabetes. Because of the trauma the ligaments which give stability to the joint had been completely damaged. Thus he could not undergo conventional Total Knee Replacement. Previously such patients were advised a knee fusion in which patient is unable to move the knee. This patient underwent Left Total Knee Replacement with special implant (Rotating Hinge Knee). With this special implant we have relieved him of pain as well as given him a good range of movement of the knee. Patient is comfortable and walking pain free with full weight bearing.
Sep-2014 : Kamala Devi 57 Years old lady presenting with pain and inability to bear weight on right lower limb. Patient developed intraoperative supracondylar fracture of the femur during Total Knee Replacement(TKR) in Feb 2011 . 4 days later Open Reduction Internal Fixation with Retrograde Intramedullary Nailing was done. Implant failed and revision surgery (ORIF with DFLP + Bone Grafting) done in Aug 2013. Augmentation with local BMP also done in Oct 2013 but fracture did not unite. Distal Femoral Locking Plate was removed and Revision Total Knee Replacement with Rotating Hinge knee was done. Post operatively patient is comfortable and walking with the walker.
Total Knee Replacement 60 years old lady has been suffering from Rheumatoid arthritis for last 30 years. Both her knees got deformed and became painful because of Rheumatoid Arthritis. Her left knee became stiff in a bent posture as a result of which it would not touch the ground. She managed on the painful right knee for last 5 years because she thought that the condition was untreatable. Due to excess load and the arthritis the right knee became very painful and stopped taking load. Because of this she became bedridden . One of her friends who had undergone Total Knee Replacement at Parmanand brought her to us. She successfully underwent replacement of both her knees at the same time. SpecializedKnee replacement implants and latest surgical techniques helped us to make her knees mobile and straight again. She is now proudly standing on both her feet after months. She came on a stretcher and was able to walk back to the exit of the hospital. Another proud moment for all of us at Sant Parmanand Hospital.