TKA extensor mechanism failure and low grade infection in 82F

HPI

An 82-year-old female presents with progressive knee pain, persistent wound secretion, and an inability to perform a straight leg raise following a distal femur replacement revision for a periprosthetic distal femur fracture (TKA) and osteotomy of the tibial tuberosity performed three months ago. She denies any recent history of trauma. Aspiration of the joint revealed the presence of sensitive Staphylococcus epidermidis.

PMH

No major medical comorbidities

PE

Physical examination of the lower extremity reveals a healed incision with a small dehiscence at the distal pole and serous secretion without erythema or warmth. There is moderate knee effusion. The patient is unable to perform a straight leg raise and exhibits tenderness with palpable screws inferior to the patella. Neurovascular status is intact.