Sonkusale Aashay, Kishore Kondreddy Vijay, Patel Kunal
Apollo Hospital Greams Road, Chennai, Tamil Nadu, India.
J Clin Orthop Trauma. 2025 May 24;68:103073. doi: 10.1016/j.jcot.2025.103073. eCollection 2025 Sep.
Anterior tibio-femoral dislocation following total knee replacement (TKR) is a dreaded complication. We present a case of a 43-year-old lady who presented to us 3 months after a domestic ground level fall with pain, deformity and, inability to bear weight on her right knee. She had undergone a successful TKR 3 years ago with no complaints up until the fall. On examination, the limb was well perfused with no neurologic damage. A vascular surgery opinion was taken and arterial doppler showed good flow at and below the level of the knee. Radiologic assessment revealed a complete anterior dislocation of the prosthetic knee and a bone avulsion of medial epicondyle (ME). With an aim to add to current literature, we focus on the challenges faced intra-operatively and have described excision of the ME with excellent functional outcome at six months in such long-standing cases of dislocation. The patient was revised to constraint hinge knee with a rotating platform. At a 6-month follow-up, patient made a good functional recovery and had a stable knee with an Oxford knee score of 41. Informed consent has been taken from the patient as per CARE guidelines.
全膝关节置换术（TKR）后发生胫股关节前脱位是一种可怕的并发症。我们报告一例43岁女性病例，她在一次家庭地面跌倒3个月后前来就诊，右膝疼痛、畸形且无法负重。她3年前成功接受了全膝关节置换术，跌倒前一直无不适。检查时，肢体血运良好，无神经损伤。咨询了血管外科意见，动脉多普勒显示膝关节及以下血流良好。影像学评估显示人工膝关节完全前脱位，内侧髁上（ME）骨撕脱。为丰富现有文献，我们重点关注术中面临的挑战，并描述了在这种长期脱位病例中，切除内侧髁上骨后6个月时功能恢复良好的情况。患者接受了带旋转平台的限制性铰链膝关节翻修术。在6个月的随访中，患者功能恢复良好，膝关节稳定，牛津膝关节评分为41分。已按照CARE指南获得患者的知情同意。
