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Dislocation of an artificial knee component due to extraordinary function.

A rare complication, namely dislocation of a knee component without fracture of the prosthesis and not caused by a trauma, is described in a patient who was treated for osteosarcoma of the femur. Probably the dislocation, which occurred 2 years postoperatively, was caused by an extraordinary function of this prosthesis. A partial revision of the prosthesis was performed. The newly designed knee component, which prevents dislocation, is described.

Child↗

Dislocation of posteriorly stabilized total knee arthroplasties.

Two cases of dislocation of an Insall-Burnstein II knee are reported. They occurred when a rotational force was applied to the loaded knee positioned in extreme flexion. Both dislocations were reduced closed and were found to be stable in the reduced position. The patients did well, and revision surgery was not required. No case of dislocation of this particular posterior stabilized total knee system has been reported previously.

Aged↗

Management of the bilateral congential dislocation of the hip and knee: a case report.

Congenital dislocation of the knee (CDK) is a rare disease and may be associated with other congenital and musculoskeletal disorders. We report our result in the treatment of a patient with CDK and DDH that treated with serial casting and Pavlik harness. Early diagnosis of the CDK is very important non operative treatment usually provides more stabile, greater range of motion and much more quadriceps strength than the surgical treatment. Early reduction of dislocation prevents formation of the knee contracture.

Casts, Surgical↗

Dislocation of posterior-stabilized mobile-bearing knee prosthesis. A case report.

Spin-out of mobile-bearing knees is a significant early complication of mobile-bearing total knee arthroplasty. Dislocation of the cam-post mechanism of fixed-bearing posterior-stabilized knees occurs more rarely. We have observed an unusual case of dislocation of posterior-stabilized rotating-platform total knee arthroplasty, which has both a cam-post mechanism and rotating platform. A 65-year-old man with knee osteoarthritis and cervical spondylotic myelopathy underwent total knee arthroplasty using a mobile-bearing prosthesis. The dislocation, which occurred 4 days postoperatively, could not be reduced by closed manipulation. However, spontaneous reduction occurred 6 days after the dislocation, which did not recur. A gap mismatch or trapezoidal-shaped gaps may lead to dislocation or spin-out of the bearing insert. This case illustrates that dislocation of a posterior-stabilized mobile-bearing total knee arthroplasty can occur, and both quadriceps deficiency and ligament laxity may contribute to the risk of dislocation.

Aged↗

Management of recurrent dislocation of the patella following total knee arthroplasty.

Fifteen knees with patellar dislocation after total knee arthroplasty had realignment of the extensor mechanism using a modification of the Trillat procedure. The onset of dislocation occurred on average 4.7 months from the time of surgery. After total knee arthroplasty the patients had an average range of motion of 109 degrees. All patients had medialization of the tibial tubercle and lateral release. No patient had a recurrent dislocation after a minimum 2-year follow-up period. The average knee score was 82 and the average flexion arc was 112 degrees. All but one of the osteotomies healed uneventfully.

Aged↗

Revision surgery for patellar dislocation after primary total knee arthroplasty.

This study evaluated risk factors for patellar dislocation after primary total knee arthroplasty and determined functional outcomes in patients following revision. Thirty-nine knees in 39 patients averaging 68 years (range, 27-91 years) at the time of revision were evaluated at a mean of 3.2 years (range, 2-7 years). Mean Knee Society and Function scores significantly improved from 34 and 35 to 77 and 54, respectively. Patellar dislocation most commonly resulted from errors in technique such as soft-tissue imbalance and malaligned components that led to poor tracking of the patella. Patellar tracking only improved after soft-tissue realignment in combination with revision of malaligned or loose components. Although revision significantly improved active knee extension and Knee Scores, two thirds of the patients had residual disabilities and pain.

Adult↗