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    ICJR CASES: Revising a Failed Total Knee Arthroplasty

    As moderator, Thomas L. Bradbury, MD, set a goal for faculty participating in the case-based panel discussion on revision total knee arthroplasty (TKA) at the recent 9th Annual ICJR South Hip & Knee Course: Highlight some of the key concepts and techniques surgeons should know about when they’re planning and performing revision procedures.

    Joining Dr. Bradbury at the podium for this always-popular session were 4 highly regarded surgeons who regularly revise failed TKAs: Walter B. Beaver Jr., MD; Gwo-Chin Lee, MD; William J. Long, MD, FRCSC; and H. Del Schutte Jr., MD.

    Click the image above to watch the presentation and hear what these experts had to say about these 3 challenging revision TKAs from Dr. Bradbury’s practice:

    Case 1

    • 62-year-old female patient presenting with a stiff TKA
    • Past medial history significant for medial unicompartmental knee arthroplasty 2 years prior and a TKA 1 year prior
    • Well-healed incision with no effusion
    • Significant flexor contracture on physical exam, with passive and active range of motion 40° to 115°

    Case 2

    • 60-year-old male patient presenting with a painful left TKA
    • Past medial history significant for bilateral patellectomies and bilateral TKA 20 years prior; positive for human immunodeficiency virus
    • Effusion, laxity, and antalgic gait noted on physical exam
    • Range of motion 0° to 125°

    Case 3

    • 52-year-old female patient presenting with a painful right TKA and knee swelling of 2 weeks’ duration; had been started on an oral antibiotic by her primary care provider
    • Past medical history significant for a periprosthetic tibial fracture sustained in a car accident 2 years prior; treatment included open reduction and internal fixation and a revision TKA
    • Past medial history also significant for irrigation and debridement 3 weeks after revision TKA due to an acute periprosthetic joint infection; patient has been on and off antibiotics for the past 2 years
    • Effusion, limp, and painful range of motion noted on physical exam

    Faculty Bios

    Walter B. Beaver Jr., MD, specializes in adult hip and knee reconstruction at the OrthoCarolina Hip & Knee Center, Charlotte, North Carolina. He is the head team physician for Hendrick Motor Sports and co-director of OrthoCarolina Motorsports. He is one of the course chairs of the ICJR South Hip & Knee Course.

    Thomas L. Bradbury, MD, is an Associate Professor in the Department of Orthopaedics at Emory University School of Medicine. He is also affiliated with the Emory Healthcare Network, specializing in adult hip and knee reconstruction. He is one of the course chairs of the ICJR South Hip & Knee Course.

    Gwo-Chin Lee, MD, is a Professor of Orthopaedic Surgery at the Presbyterian Medical Center of Philadelphia in Philadelphia, Pennsylvania. He is affiliated with Penn Medicine, specializing in adult hip and knee reconstruction.

    William J. Long, MD, FRCSC, is a board-certified Attending Orthopedic Surgeon at Hospital for Special Surgery in New York, New York. He specializes in adult hip and knee reconstruction, revision joint replacement, and sports injuries of the knee.

    H. Del Schutte Jr., MD, is Chief of Surgery at East Cooper Medical Center, Mount Pleasant, South Carolina, and the Medical Director of the hospital’s Comprehensive Joint Program. He is the founder and Director of the Charleston Institute of Advanced Orthopedics. He specializes in adult hip and knee reconstruction.

    Disclosures: The faculty have no disclosures relevant to this presentation.