Postoperative bilateral knee prosthesis exposure due to trauma

Total knee arthroplasty (TKA) is an effective and commonly performed procedure in knee arthritis. The most common wound complications in TKA are erythema, infection, prolonged drainage, and skin necrosis. Disruption of the operative wound is a rare complication. This paper presents a case where knee prostheses were exposed 17 days after the knee replacement operation. A 67-year-old male patient was admitted to our hospital for bilateral osteoarthritis of the knee. Simultaneous bilateral total knee arthroplasty was applied. The postoperative hospital stay reached ten days, and with 90º of flexion and mobilization, the patient was discharged. 17 days after the operation the patient was re-admitted to hospital after having a fall. A physical examination revealed dehiscence of the wound and median parapatellar arthrotomy sutures. Both prostheses were exposed and visible. Under general anesthesia P/E was repeated and stress tests revealed medial collateral ligament injury on the right knee and a lateral collateral ligament injury on the left knee. The role of the extensor mechanism is important in knee prosthesis. Any weakness in the extensor mechanism may lead to  prosthetic instability and concurrent complications. If the strength of the quadriceps mechanism is not sufficient, it must be strengthened postoperatively, and rehabilitation and mobilization should be applied carefully until collagen maturation is complete.

Keywords:

Arthroplasty , exposure , knee , prosthesis