1. 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.

2. PRE-OP X-RAYS

3. PRE-OP PHOTOS

4. 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..

5. 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,

6. RESULT

7. 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.

8. 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..

9. POST OP X-RAYS

10. POST OP RESULT  WALKING WITH MINIMAL SUPPORTIN NEXT FEW WITH 80-90 DEGREE FLEXION AT KNEE,  GOOD QUADRICEPS STRENGTH..