Journal List > J Korean Orthop Assoc > v.44(2) > 1012899

Park, Choi, Lee, and Park: Posterior Instability after Posterior Cruciate Ligament Substituted TKA - Case Report -

Abstract

Posterior instability after a posterior ligament substituted total knee replacement is considered impossible due to the cam and post mechanism. Therefore, it has not been considered easily as a problem necessitating revision surgery. We report two cases of posterior instability after a fixed bearing posterior cruciate ligament substituted total knee replacement with a review of relevant literature.

Figures and Tables

Fig. 1
Knee lateral radiograph after slip down injury shows slight anterior displacement of tibial polyethylene insert. The arrow indicates for radiolucent tibial polyethylene that has been anterior displaced.
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Fig. 2
Knee posterior-drawer stress radiograph after injury shows marked posterior displacement of tibia more than 12 mm compared to contralateral side.
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Fig. 3
Intra-operative photograph during revision surgery shows anterior dislodge of tibial polyethylene insert.
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Fig. 4
Knee lateral radiograph at a year follow-up after reinsertion surgery shows well-maintained tibial polyethylene insert.
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Fig. 5
Knee lateral radiograph of a 69-year-old woman who has been done TKR since 5 years ago shows nonspecific abnormality.
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Fig. 6
Knee posterior-drawer stress radiograph after injury shows marked posterior displacement of tibia more than 10 mm compared to contralateral side.
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Fig. 7
Intra-operative photograph during revision surgery shows post breakage of tibial polyethylene insert.
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Fig. 8
Removed polyethylene prosthesis. The post of tibial polyethylene insert was broken at base and showed deformity at anterior aspect of post.
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References

1. Callaghan JJ, O'Rourke MR, Goetz DD, Schmalzried TP, Campbell PA, Johnston RC. Tibial post impingement in posterior-stabilized total knee arthroplasty. Clin Orthop Relat Res. 2002. 404:83–88.
2. Chiu YS, Chen WM, Huang CK, Chiang CC, Chen TH. Fracture of the polyethylene tibial post in a NexGen posterior-stabilized knee prosthesis. J Arthroplasty. 2004. 19:1045–1049.
crossref
3. Galinat BJ, Vernace JV, Booth RE Jr, Rothman RH. Dislocation of the posterior stabilized total knee arthroplasty. A report of two cases. J Arthroplasty. 1988. 3:363–367.
4. Gebhard JS, Kilgus DJ. Dislocation of a posterior stabilized total knee prosthesis. A report of two cases. Clin Orthop Relat Res. 1990. 254:225–229.
5. Mariconda M, Lotti G, Milano C. Fracture of posterior-stabilized tibial insert in a Genesis knee prosthesis. J Arthroplasty. 2000. 15:529–530.
crossref
6. Mestha P, Shenava Y, D'Arcy JC. Fracture of the polyethylene tibial post in posterior stabilized (Insall Burstein II) total knee arthroplasty. J Arthroplasty. 2000. 15:814–815.
crossref
7. Pagnano MW, Hanssen AD, Lewallen DG, Stuart MJ. Flexion instability after primary posterior cruciate retaining total knee arthroplasty. Clin Orthop Relat Res. 1998. 356:39–46.
crossref
8. Sharkey PF, Hozack WJ, Booth RE Jr, Balderston RA, Rothman RH. Posterior dislocation of total knee arthroplasty. Clin Orthop Relat Res. 1992. 278:128–133.
crossref
9. Su YP, Chiu FY, Chen TH. Posterior dislocation after posterior stabilization TKA. J Chin Med Assoc. 2003. 66:120–122.
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