Complication case - Knee pain 6 months after a TKA

• 58 year old man
• History of high tibial osteotomy followed by osteitis 9 years ago, and medial collateral ligament insufficiency 
   

Pre-op X-rays

Post-op X-rays

• A total knee arthroplasty is performed
• The evolution is good for 6 months

• At 6 months post-op, the patient complains of knee pain and effusion
• The markers of inflammation are negative

• A CT-scan is prescribed

• A labelled leucocytes scintigraphy shows a suspicion of infection around the femoral implant and a loosening of the tibial plateau
• The joint aspiration turns negative

Management strategy

• A revision is performed. The tibial implant is found broken between the stem and the plate
• The tibial implant is removed and replaced
• The samples taken during the surgery are negative

Post-op X-rays