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

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.

Total Knee Arthroplasty in Patients with Spinal Cord Injury: Impact on Medical Complications, Hospital Costs and Length of Stay

“…Periprosthetic infection risk had been reported to be higher in the SCITKA patients because of the higher prevalence of UTI in these patients. 9 , 12 , 14 , 24 , 26 Our study showed that the risk of periprosthetic joint infection was almost 4 times higher in the SCITKA patients, but it failed to show statistical significance. It is not uncommon for PP to have pressure ulcers that fail to heal after several years of treatment.…”

“…There are only two case reports on patients with paraplegia undergoing TKA: the age of the patient in the study by Koubaa et al was 42 years and the age of the patient in the study by Zietek et al was 47 years. 24,25 By contrast, the mean age of our patient population is older than the case reports and may be related to the large sample size.…”

“…There is an absolute paucity of studies comparing the rates of complications in TKA patients with SCI with motor impairment compared with those without SCI. 24 , 25 This study aims to assess the postoperative outcomes after TKA in patients with SCI using the National Inpatient Sample (NIS) database.…”