1North Rehabilitation Center, Vila Nova de Gaia, Portugal
2São João University Hospital Center, Portugal
*Corresponding author: André Varandas-Borges, North Rehabilitation Center, Vila Nova de Gaia, Avenida Infante Sagres, 22, Valadares, Portugal
Submission: October 23, 2022; Published: November 18, 2022
ISSN: 2637-7934Volume 3 Issue 5
Total Knee Arthroplasty (TKA) is one of the most performed orthopedic procedures. However, it is not hassle-free. Posterior dislocation is an infrequent complication, although it has multiple clinical and functional implications. We present this case highlighting the importance of this diagnosis in Physical Medicine and Rehabilitation (PMR) clinical practice. A 72-year-old woman with disabling left knee pain and gait unsteadiness was diagnosed with severe osteoarthritis and proposed to TKA. There was no report of complications during or immediately after the surgery. Three weeks later, the patient was admitted to a Rehabilitation Center (RC) to ensure proper functionality reestablishment. On the fourth day at the RC, a sudden irreducible 90-degree left knee flexion position was stated, together with significant knee deformity. After clinical and imaging testing, a posterior TKA dislocation was diagnosed. Surgical revision, with TKA replacement, was performed. TKA posterior dislocation is an uncommon complication after TKA. Nevertheless, the high clinical and functional burden requires special care from the clinician. Traumatic events, low-energy falls, and forced knee hyperflexion are described as the main mechanisms of injury. Besides, it is thought that obesity, knee varus or valgus deformity, flexion contracture, and either peripheral or central neurological impairments play a significant predictive role in this TKA complication. We report a patient whose main risk factors were obesity and knee varus deformity, even though no precise mechanism of injury was depicted.
Keywords: Total knee arthroplasty; Prosthesis dislocation; Orthopedics complications; Rehabilitation