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Knee Replacement Complications

Jan
08
2012

Total Knee Replacement
How many things can go wrong?

In the medical journal Orthopedics, researchers gave a list of things that could go wrong following total knee replacement. Here is what they said: Instability is one of the most common causes of failure of total knee arthroplasty (TKA).

The presentation can vary from pain to frank dislocation with the etiologies just as varied.

Instability after TKA can be classified by where the instability occurs in the knee’s arc of motion as well as the chronicity of the problem.

Acute instability is related to intraoperative injuries or excessive release of important coronal stabilizers such as the medial collateral ligament in extension or the posterolateral corner in flexion.

Chronic instability in extension is often related to varus/valgus malalignment.

Chronic instability in flexion can be related to an undersized femoral component, excessive tibial slope, or excessive elevation of the joint line affecting the isometry of the collateral ligaments in midflexion.

When addressing instability after TKA, it is critical to determine the root cause of the problem as well as evaluate for other causes of pain such as infection or aseptic loosening.

When revision surgery is warranted, it should follow the basic principles of restoring a neutral mechanical alignment, setting the appropriate component rotation, balancing the flexion and extension spaces, and restoring the height of the native joint line.

That is a lot of complication
Del Gaizo DJ, Della Valle CJ. Instability in primary total knee arthroplasty. Orthopedics. 2011 Sep 9;34(9):e519-21. doi: 10.3928/01477447-20110714-46.

There are more complications and alternatives to Total Knee Replacement. We have devoted many articles to the why Prolotherapy, Platelet Rich Plasma Therapy, and stem cell injection therapy should be considered first before something as radical as TKA – that is total knee replacement.

2 Comments

  1. Doroothy Hoey says:

    Some two and a half years after having TKR (right knee) I have now been diagnosed and informed that the tibia is loose. I was refered by the Consultant who diagnosed this to a further Consultant who specialises in “re-doing” knees but have to wait some 14 weeks before I even get a primary appointment.
    I am in terrible pain – but this pain is mostly in the groin and more painful in the left groin than the one with the loose tibia. I am wheelchair bound outside of the home and need two crutches to get around the home. I have very little quality to my life – my husband, who himself suffers from COPD is having to look after me and to say this is not ideal is putting it mildly.
    As a matter of interest the first consultant referred me to the other consultant as a “matter of urgency”. If a 14 week wait is urgent, then I dread to think how long I would have had to wait had it been a non-urgent case.
    I have even written to the first consultant, some three weeks ago, but have had no reply.
    What do you suggest?
    Thank you

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