Case challenges in knee surgery: What would you do?☆,☆☆
Section snippets
Case presentation
A 48-year-old farmer presents with recalcitrant medial joint line pain of the left knee. He has had a prior arthroscopy and several intra-articular corticosteroid injections (Fig. 1).
Dialogue
Hanssen: Dr. Romagnoli, what would you do?
Romagnoli: Was there a previous tibial fracture?
Hanssen: No, the patient did have a prior femoral shaft fracture and a proximal fibular fracture (Fig. 2).
Case presentation
A 58-year-old man who had a TKA 18 months previously complains of knee instability but has excellent knee range of motion (Fig. 4).
Dialogue
Hanssen: Dr. Maloney, what would you do?
Maloney: One should perform a good physical examination for collateral ligament and anteroposterior stability. Some of these patients have midflexion instability. In patients with posterior cruciate ligament insufficiency, hanging the leg over the table to
Case presentation
A 58-year-old man fell after a having a TKA and sustained a periprosthetic fracture of the distal femur. It has been fixed twice, and the patient presents because of persistent pain and motion at the nonunion site (Fig. 7).
Dialogue
Hanssen: Dr. Kurosaka, what would you do?
Kurosaka: Well, this is a tough problem. What is the knee range of motion?
Hanssen: It is difficult to assess how much knee motion the patient has because of the
Case presentation
A 78-year-old woman weighing 100 lb. presents with progressive loss of ambulatory ability primarily as a result of left knee instability. She does not complain of severe pain (Fig. 9).
Dialogue
Hanssen: Dr. Ranawat, what would you do?
Ranawat: First, we find out if she has Charcot's disease.
Hanssen: The neurologists have evaluated her and do not believe she has a Charcot joint because she does not have diabetes or other predisposing
References (2)
- et al.
Total knee arthroplasty in neuropathic arthropathy
- et al.
Total knee arthroplasty in Charcot and Charcot-like joints
Clin Orthop
(1986)
Cited by (2)
UKR surgical technique: Pearls and pitfalls
2013, Small Implants in Knee ReconstructionNavigated total knee arthroplasty in a patient with severe diaphyseal deformities
2007, Acta Orthopaedica Belgica
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No benefits or funds were received in support of this study.
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Reprint requests: Arlen D. Hanssen, MD, Department of Orthopedics, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.