62 year old gentleman had undergone total knee replacement in 2011 for arthritis of both knees (operated elsewhere). Following this surgery patient had persistent pain, inability to bear wt. On right leg and fever. Multiple surgeries were done with no relief and patient also noticed loss of extension of knee post operatively. Repair of extensor mechanism and a two staged revision knee replacement was done in Chicago but none of the symptoms improved.
With these symptoms patient presented to our OPD and investigations were done which suggested patient had persistent infection of right. Knee joint and extensor mechanism failure. Patient was planned for a two staged procedure and it was explained to the patient. In the first stage the implant was removed and extensor mechanism was repaired and an antibiotic impregnated cement spacer was used to fill the defect.
After 4 months when markers of infection were normal patient was taken for a second stage procedure and special knee replacement implants were imported to overcome the bony defect left after revision procedure. Patient was walking with walker on second post-operative day; he is relieved of the earlier pain and is extending the knee normally.
