ICJR CASES: Why Did These Knee Replacements Fail?
A 62-year-old female patient who is 2 years post-total knee arthroplasty presents with pain on weight-bearing. Her knee “never felt right” and “gives way,” especially going up and down the stairs. She has mild pain, moderate swelling, and a significant amount of anteroposterior and varus-valgus laxity in the knee.
A 46-year-old female presents with a 5-year history of knee pain. She has a high level of anxiety about surgery but agrees to undergo unicondylar knee arthroplasty to treat isolated medial compartment osteoarthritis. A year later, she has radiographic signs of early tibial component subsidence.
A 22-year-old male patient presents with a significant history of surgeries to treat a gunshot wound of his left knee, as well as an infection in the knee that required 2 weeks of oral antibiotics. He reports significant pain with standing and he is unable to bend the knee. After undergoing total knee arthroplasty, he has signs and symptoms suggesting that the knee is re-infected, even though he’d had no symptoms of infection at the time of surgery.
These cases were presented by David F. Dalury, MD; Gregory G. Polkowski II, MD, MSc; and Ran Schwarzkopf MD MSc, respectively, during a session on why knee replacements can fail at ICJR’s 12th Annual Winter Hip & Knee Course. They provide an opportunity to find out how top surgeons manage difficult cases and what lessons can be learned from their failures.
Click the image above to hear more about these cases, including how they were resolved.