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Year : 2023  |  Volume : 38  |  Issue : 1  |  Page : 100-105

Single-stage bilateral revision knee arthroplasty with unilateral tibial tubercle osteotomy: A rare case study in the management of bilateral aseptic loosening with literature review

Department of Orthopaedics, Max Super Specialty Hospital, Delhi, India

Correspondence Address:
Gaurav Govil
D-101, Sunshine Helios, Sector 78, Noida, Uttar Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jbjd.jbjd_42_22

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A revision total knee arthroplasty (Rev-TKA) for bilateral affection presents surgical complexities. Rev-TKA as a single stage has been rarely advocated. A 76-year-old woman presented with painful bilateral knees and a history of bilateral TKA done fourteen years ago. The right knee required unilateral tibial tubercle osteotomy with cerclage wire fixation to remove the incarcerated cemented tibial extension rod and extensile medial parapatellar approach for the left knee in single-stage. The osteotomy united at 14 weeks. At 2-year follow-up, range of movements improved, allowing pain-free walking without support and laxity. No radiological evidence of loosening or wear. Rev-TKA challenges include obtaining adequate joint exposure without compromising the integrity of the extensor mechanism. The crucial factors for achieving an uneventful single-stage surgery include thorough pre-operative planning, prophylactic thromboprophylaxis, measures to reduce blood loss, and meticulous execution of planned surgery. The bilateral Rev-TKA should be planned after the stratification of the risk-benefit ratio.

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