Total knee arthroplasty in a spinal cord-injured patient: A case report

• Published in: Annals of physical and rehabilitation medicine 2009-09, Vol.52 (7), p.588-593
• Main Authors: Koubaa, S, Ksibi, I, Lebib, S, Tlili, L, Salah, F.Z. Ben, Dziri, C, Zehi, K, Zouari, M
• Format: Article
• Language: English
• Subjects: Accidents, Occupational; Anti-Bacterial Agents - therapeutic use; Arthritis, Infectious - complications; Arthritis, Infectious - drug therapy; Arthritis, Infectious - surgery; Arthroplasty, Replacement, Knee; Arthroscopy; Biological and medical sciences; Blessé médullaire; Bone Transplantation; Combined Modality Therapy; Diseases of the osteoarticular system; Diseases of the osteoarticular system. Orthopedic treatment; Fracture Fixation, Internal; Humans; Hydarthrose; Hydrarthrosis; Hydrarthrosis - complications; Hydrarthrosis - surgery; Internal Medicine; Lumbar Vertebrae - injuries; Lumbar Vertebrae - surgery; Male; Medical sciences; Orthopedic surgery; Orthotic Devices; Osteoarthritis, Knee - complications; Osteoarthritis, Knee - surgery; Paraplegia - complications; Paraplegia - rehabilitation; Physical Medicine and Rehabilitation; Prothèse totale de genou; Quality of life; Qualité de vie; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Spinal Cord Injuries - complications; Spinal Cord Injuries - rehabilitation; Spinal cord injury; Spinal Fractures - complications; Spinal Fractures - surgery; Staphylococcal Infections - complications; Staphylococcal Infections - drug therapy; Staphylococcal Infections - surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Thoracic Vertebrae - surgery; Total knee arthroplasty; Treatment Outcome; Young Adult
• ISSN: 1877-0657; 1877-0665
• DOI: 10.1016/j.rehab.2009.06.008

Abstract Patients with spinal cord injuries are prone to knee hydrarthrosis (also known as “water on the knee”), which can cause pain, functional impairment and the restriction of social activities. Total knee arthroplasty is a potentially appropriate treatment. Here, we report on a patient presenting partial T12 AIS grade C paraplegia who was able to walk with two forearm crutches, an ankle-foot orthosis on the right leg and a knee-ankle-foot orthosis on the left leg. Thirteen years after the spinal cord injury, the patient presented with septic arthritis of the right knee, complicated by recurrent hydrarthrosis during standing and walking. Arthroscopy revealed advanced osteoarthritis. Total knee arthroplasty was performed, with very good functional and social outcomes two and half years after surgery.