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TKA Extensor Mechanism Rupture
Posted: May 4 2022 #(C102051)
A

TKA Extensor Mechanism Disruption in 61F

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TKA Extensor Mechanism Disruption in 61F

HPI

A 61-year-old female presents for evaluation of left knee pain. She had a primary left TKA done in December 2010 and presented 10 years later with acute onset knee pain after a fall in March 2020. She was initially seen at an outside hospital which recommended conservative management, but the patient reports she is debilitated and can not walk.

PMH

PMH: hyperlipidemia, hypertension, obesity (BMI 39), restless leg syndrome, stress incontinence, and GERD. Social: Retired CNA, She does not use tobacco products.

PE

Focused physical examination of the left knee shows 1+ knee effusion with diffuse tenderness to palpation. Range of motion is 0-120º with a 45º extensor lag. She is unable to perform a straight leg raise and has global instability in the coronal and sagittal planes. Her gait is antalgic and favors the contralateral side. She is neurovascularly intact Labs: -ESR: 5, CRP: 7.6 (elevated) -Aspiration: 163 WBC, 41% PMNs, Cx negative

Poll
1 of 1
1. In addition to the plain film radiographs, would you obtain any further imaging to guide your treatment?
No - current radiographs are sufficient
46%
354/766
    • Yes - additional x-rays (i.e full limb length alignment XRs)
    3%
    25/766
    • Yes - CT of the knee (CT)
    16%
    129/766
    • Yes - Metal-subtraction MRI of the knee (MRI)
    15%
    115/766
    • Yes - bone scan
    1%
    10/766
    • Yes - XR + CT
    1%
    15/766
    • Yes - XR + MRI
    2%
    20/766
    • Yes - XR + Bone scan
    0%
    6/766
    • Yes - CT + MRI
    4%
    33/766
    • Yes - CT + Bone scan
    1%
    13/766
    • Yes - MRI + Bone scan
    1%
    13/766
    • Yes - 3 or more of the above
    1%
    10/766
    • Outside my area of expertise - best if I don't vote
    3%
    23/766
    • PROCEDURE #1

    TKA Revision and Extensor Mechanism Reconstruction (Marlex mesh)

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