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Case Reports
. 2024 Mar;14(3):124-129.
doi: 10.13107/jocr.2024.v14.i03.4314.

Knee Arthrodesis Using Dual-Plate Construct is Following Failed Distal Femur Megaprosthesis-A Case Report

Sujit Kumar Tripathy  1 , Paulson Varghese  1 , Shahnawaz Khan  1 , Narayan Prasad Mishra  1 , Mantu Jain  1
Affiliations
Case Reports

Knee Arthrodesis Using Dual-Plate Construct is Following Failed Distal Femur Megaprosthesis-A Case Report

Sujit Kumar Tripathy et al. J Orthop Case Rep. 2024 Mar.

Abstract

Introduction: Knee arthrodesis following failed total knee arthroplasty is a viable limb salvage option, and this procedure is reserved for failed two-stage revision surgery in severe comorbid patients with irreparable extensor mechanism disruption, severe instability, and extensive soft tissue loss. Knee arthrodesis using a dual-plate construct has been scarcely reported. We report a case of knee arthrodesis using a dual-plate construct in a male in his 20s who presented to us with a broken distal femur megaprosthesis.

Case report: An anterior midline incision was given. The cement mantle and broken prosthetic components were removed. The bone surfaces were freshened up and fixed using two orthogonal locking plates. After 4 months, there was a solid fusion in the knee, and the patient started walking independently with a short limb gait. The patient was advised limb lengthening for a shortening of 3 cm, but he denied it and managed with a shoe raise. After 4 years, he was pain free, and radiographs revealed a solid knee fusion. The patient was fully satisfied with the procedure, and he resumed manual work.

Conclusion: This case report revealed that knee arthrodesis using a dual-plate construct is an economically viable salvage option for failed distal femur megaprosthesis.

Keywords: Megaprosthesis; broken; dual plating; knee arthrodesis.

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Conflict of interest statement

Conflict of Interest: Nil

Figures

Figure 1
Figure 1
Radiograph showing broken distal femur megaprosthesis.
Figure 2
Figure 2
Intraoperative picture shows (A) broken distal femur megaprosthesis at stem-shaft junction, (B) Tibial component removal using osteotome, (C) The retained femoral stem was extracted after removal of cement mantle using osteotome and chisel, and (D) The tibial surface was prepared after freshening of the sclerotic margin, the bony surface was sclerotic on the femoral side because of cement effects.
Figure 3
Figure 3
(a) Two plates (at 90°) were fixed to the medial and anterior surface for fusion, (b) the extracted prosthesis components, (c) Postoperative radiograph showing well apposed bony surfaces of tibia and femur.
Figure 4
Figure 4
Four years follow up radiograph shows complete osseous fusion at the knee joint.
See this image and copyright information in PMC

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