65yrs female k/c/o CAD,HTN,RA H/o bilateral TKR done in 2005. Presented to us with c/o pain in left knee with inability to bear weight over left lower limb and was wheel chair bound for the past 5 months .
On examination skin condition was normal , no sign of inflammation with mild effusion Varus instability present with Passive Rom 10 to 120 degree
Current xray shows tibial tray subsidence with loosening with varus collapse of proximal tibial bone Blood infection markers were within normal limits.
Plan for revision TKR left knee. Intraop medial defect was found on tibial side with uneven tibial surface after removal of the component Femur side component was also found to be loose with ligamentous imbalance. So RHK revision TKR was performed using medial half block on tibial side to augment the defect with stem extension and while on femur side normal component with stem extension used and inserted with cement.
After the surgery, the deformity of knee has been corrected and balanced and she has regained full and stable range of movement. She is walking comfortably.
