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Case Reports
. 2024 Feb 7;86(3):1641-1646.
doi: 10.1097/MS9.0000000000001085. eCollection 2024 Mar.

Catastrophic skin necrosis after total knee arthroplasty: a case report and review of the literature

Amir Human Hoveidaei  1 , Hamidreza Zafari  2 , Peyman Mirghaderi  2 , Ehsan Ghadimi  2 , Sm Javad Mortazavi  2
Affiliations
Case Reports

Catastrophic skin necrosis after total knee arthroplasty: a case report and review of the literature

Amir Human Hoveidaei et al. Ann Med Surg (Lond). .

Abstract

Introduction and importance: There have been few cases of post total knee arthroplasty (TKA) skin necrosis reported. Here, the authors present our patient with skin necrosis post TKA on account of its extreme rarity, considerable risk factors, and importance of its treatment.

Case: This is a cautionary report on the rule of including previous single longitudinal incision in surgical approach. The authors included previous medial incision in ours and performed arthroplasty through medial parapatellar incisions. After noticing skin necrosis in front of patella, reoperation including flap and skin graft was done, leading to complete recovery.

Clinical discussion: While skin necrosis post TKA is not common, it can be present in high-risk patients who should be considered for a decrease in their risk factors. Preoperatively, underlying diseases should be under control. Intraoperation risk factors, in particular incision selection, and considerations about lateral retinacular release are important.

Conclusion: A balance must be achieved between the ability to expose the knee through a prior incision and avoiding extensive undermining of the subcutaneous flaps in patients with previous knee surgery. It may be a better approach to ignore medial incisions and use the classic midline incision.

Keywords: arthroplasty; knee; necrosis; skin; wound complication.

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Conflict of interest statement

None.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Figures

Figure 1
Figure 1
Preoperation skin and knee deformity condition of the patient.
Figure 2
Figure 2
Preoperation knee X-ray, anterior and lateral views.
Figure 3
Figure 3
Preoperation knee angles.
Figure 4
Figure 4
Postoperation patients’ knee and its skin condition.
Figure 5
Figure 5
Postoperative soft tissue necrosis.
Figure 6
Figure 6
Healed wound and the condition of knee and skin 1-year postoperation.
See this image and copyright information in PMC

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References

    1. Scuderi GR. Avoiding postoperative wound complications in total joint arthroplasty. J Arthroplasty 2018;33:3109–3112. - PubMed
    1. Ries MD. Skin necrosis after total knee arthroplasty. J Arthroplasty 2002;17(4 suppl 1):74–77. - PubMed
    1. Patella V, Speciale D, Patella S, et al. . Wound necrosis after total knee arthroplasty. Orthopedics 2008;31:807. - PubMed
    1. Mirghaderi SP, Salimi M, Moharrami A, et al. . COVID-19 infection risk following elective arthroplasty and surgical complications in COVID-19-vaccinated patients: a multicenter comparative cohort study. Arthroplasty Today 2022;18:76–83. - PMC - PubMed
    1. R RB, Ramkumar S, Venkatramani H. Soft tissue coverage for defects around the knee joint. Indian J Plast Surg 2019;52:125–133. - PMC - PubMed

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