Abualross Osamah, Samargandi Ramy, Nail Louis-Romée Le, Berhouet Julien
Department of Orthopedic Traumatology Department Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia.
Department of Orthopedic Traumatology, Université de Tours, Faculté de Médecine de Tours - CHRU Trousseau Orthopedic Traumatology Department, Chambray-les-Tours, France.
J Orthop Case Rep. 2024 Aug;14(8):61-65. doi: 10.13107/jocr.2024.v14.i08.4646.
A popliteal cyst, or Baker's cyst, is often associated with joint diseases such as osteoarthritis and rheumatoid arthritis (RA). It is rare for these cysts to develop following total knee arthroplasty (TKA), but understanding when and why they might can optimize patient care. Presented here is a unique case of a massive, chronically recurring infected popliteal cyst in a patient with RA and prior TKA, shedding light on an unusual complication worth attention in the orthopedic literature.
In this case, the patient had longstanding, difficult-to-treat RA. Following left TKA, the patient developed a painful popliteal cyst, leading to hospitalization in 2023. Microbiological analysis identified as the infectious agent despite negative mycobacterial and mycological cultures. Surgical intervention involved a one-stage procedure, encompassing resection of the extensive thigh cyst and prosthesis replacement. Notably, the cyst reached an unprecedented size, measuring 32 cm at its peak, presenting a unique challenge in management.
This case report contributes significantly to orthopedic literature by highlighting the intricate interplay between joint pathologies, surgical interventions, and infections. It highlights the importance of multidisciplinary collaboration in managing complex musculoskeletal conditions. The rarity of a massive and infected popliteal cyst post-TKA emphasizes the need for heightened vigilance in patient care post-surgery. Furthermore, this case report serves as a valuable addition to the understanding of potential complications associated with TKA, offering insights that may inform future treatment strategies and optimize patient outcomes in orthopedic practice.
腘窝囊肿,又称贝克囊肿,常与骨关节炎和类风湿关节炎(RA)等关节疾病相关。这些囊肿在全膝关节置换术(TKA)后发生较为罕见,但了解其发生时间和原因有助于优化患者护理。本文介绍了一例独特病例,一名患有RA且曾接受TKA的患者出现了巨大、慢性复发性感染性腘窝囊肿,这一不寻常的并发症值得骨科文献关注。
在该病例中,患者患有长期难以治疗的RA。左膝TKA术后,患者出现疼痛性腘窝囊肿,于2023年住院治疗。尽管分枝杆菌和真菌培养结果为阴性,但微生物分析确定了感染病原体。手术干预采用一期手术,包括切除广泛的大腿囊肿并更换假体。值得注意的是,囊肿达到了前所未有的大小,最大直径为32厘米,给治疗带来了独特挑战。
本病例报告通过突出关节病变、手术干预和感染之间的复杂相互作用,对骨科文献做出了重要贡献。它强调了多学科协作在管理复杂肌肉骨骼疾病中的重要性。TKA术后出现巨大感染性腘窝囊肿的罕见性强调了术后患者护理中提高警惕性的必要性。此外,本病例报告为理解TKA相关潜在并发症提供了有价值的补充见解,可为未来治疗策略提供参考,并优化骨科实践中的患者预后。