Posterior dislocation of a cruciate-retaining total knee arthroplasty following an acute bacterial infection.
BACKGROUND
We report a rare complication of posterior dislocation of a cruciate-retaining total knee arthroplasty following an acute bacterial infection. The mechanism of dislocation proved to be septic loosening of the femoral component and a tear of the posterior cruciate ligament near to the femoral insertion site. The tear arose during the treatment of acute septic arthritis following total knee arthroplasty when the patient attempted full weight-bearing with the affected limb in a semiflexion position and twisted the knee.


RESULTS
Successful treatment was provided with subsequent surgical debridement, removal of the loosened prosthesis, the application of systemic antibiotics, and a revision total knee arthroplasty utilizing a posteriorly stabilized prosthesis after adequate control of the infection.


CONCLUSIONS
Soft-tissue protection from full weight-bearing of the knee during the treatment of an acute infection following total knee arthroplasty and timely removal of the loosened total knee prosthesis are recommended in order to prevent such a complication.
Chu
Cheng-Mien
CM
Department of Orthopaedics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Wang
Shyu-Jye
SJ
Wu
Shing-Sheng
SS
D001170:Arthritis, Infectious / Q000150:complications; D019645:Arthroplasty, Replacement, Knee; D003646:Debridement; D005260:Female; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects; D008875:Middle Aged; D016119:Posterior Cruciate Ligament / Q000293:injuries; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000150:complications*; D012086:Reoperation; D012421:Rupture; D013203:Staphylococcal Infections / Q000150:complications*