KNEE CASE  58 yrs old foreign national and x army man, c/o pain and deformity of both knees with abnormal mobility at rt. Knee and difficulty in walking.

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Presentation transcript:

KNEE CASE  58 yrs old foreign national and x army man, c/o pain and deformity of both knees with abnormal mobility at rt. Knee and difficulty in walking with rt. Knee since last 1-2 yrs,  h/o RTA 7 yrs back with bilat. Mid shaft and rt. Lower end femur fracture treated…but rt. Distal end femure went in nonunion with already underwent6-7 surgeries for union and fracture fixation.

PRE-OP X-RAYS

PRE-OP PHOTOS

PLANNING ???  Patients wish:---big factor in decision making..  In first hand wants to get lt. knee replaced and on rt. Side wants normal or semi-constrained implant..

PLANNING 1. LT. SIDE NEXGEN INSTRUMENTS KEPT READY, 2. RT.SIDE IMPLANT REMOVAL, LOCKING PLATE AND CCK TYPE IMPLANT KEPT READY, 3. ALL CHEMICAL MARKERS OF INFECTION NORMAL PRE-OPERATIVELY,

RESULT

ITRA-OP PROBLEMS  AFTER LT. TKR DONE, RT. SIDE IMPLANT REMOVED, NON UNION TISSUE EXCISED,  AT RT. KNEE LEVEL THERE WAS NOT A SINGLE DEGREE MOVEMENT AT KNEE JT. KNEE WAS VERY STIFF EVEN AFTER TRYING FREE HAND CUTS AT PROXIMAL TIBIA AND DISTAL FEMURE, NO MOVEMENT WAS ACHIEVED.  SO PROCEDURE ABONDENED AND PLATED AND GRAFTED…  INTR-OP SAMPLES SEND FOR C/S.

SECOND STAGE  AFTER 4 WEEKS RT. KNEE REVISION SURGERY PLANNED AFTER CHEMICAL MARKERS WERE NORMALIZED.  PERFORMED RT.KNEE REVISION SURGERY WITH LYNK ENDOMODULE CEMENTED HINGED IMPLANT..

POST OP X-RAYS

POST OP RESULT  WALKING WITH MINIMAL SUPPORTIN NEXT FEW WITH DEGREE FLEXION AT KNEE,  GOOD QUADRICEPS STRENGTH..