Article

Knee arthroplasty is an efficient solution for osteoarthrosis in
amputees. However, because of overload on the implant, it is apparently more
subject to failure than in the non-amputated population. The aim of this case
report is to show a failure of primary total knee arthroplasty contralateral to
transfemoral amputation that required revision involving a tissue bank because of
severely compromised knee bone. Surgical strategies, rehabilitation, and
postoperative care for the operated limb and the contralateral prosthesis were
demonstrated. CASE DESCRIPTION AND METHODS: A 60-year-old patient with early
failure of total knee arthroplasty contralateral to transfemoral amputation
underwent arthroplasty revision in which a graft from a tissue bank was used.
After the revision, prosthesis length adjustment and exercise therapy were
fundamental to the rehabilitation. FINDINGS AND OUTCOMES: The patient progressed
well after the revision of the arthroplasty, with increases on the Knee Society
Score and 36-Item Short Form Health Survey scales. CONCLUSION: Knee arthroplasty
in amputees should be planned differently to that of the general population. For
the procedure to be successful, there should be greater attention to implant
stability, equalization of leg length, and a postoperative regimen including
muscle strengthening and range of motion exercises to achieve the required knee
flexion. CLINICAL RELEVANCE: This case report is important because it presents a
challenging case of a unilateral transfemoral amputee with failed arthroplasty
over the years in the contralateral limb. To our knowledge, such a case has not
been described in the scientific literature. It would be helpful for surgeons and
rehabilitation professionals to chart out a treatment protocol and also to
prevent premature failure of the joint.
CI - (c) The International Society for Prosthetics and Orthotics 2013.

Langue : ANGLAIS