An 80-year-old female presents with disabling bilateral knee pain and relies on two crutches for mobility.
Ten days post-surgery, she reports a deficit in active extension, particularly after using her operated, "least painful" leg to rise from the toilet.
Based on the imaging, what is your diagnosis? How would you explain this complication? What would be your approach for further management?
- 80 Y.O female
- complains of disabling bilateral knee pain
- Walks with 2 crouches
10 days after the index surgery, the patient complains of a deficit of active extension after getting up from the toilet by forcing especially with her operated leg which is the "least painful" one.
Which is your diagnosis?
- ✔️Tibial patellar tendon avulsion
How do you explain that complication?
- ✔️Increase in the lever arm of the patella on the trochlea in a patient with troclear displasia
How would you treat this patient?
- ✔️Tibial tubercle reinsertion
- ✔️Patellar tendon reconstruction with hamstrings
At 6 weeks post-op, the patient was walking with a total weight bearing with crouches because of the pain of the other knee. The right knee replacement is now scheduled 6 months later and a preventive reinforcement of the patellar tendon with hamstrings is planned.
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