Revision Knee Replacement in Stiff Knee Post Spacer by Dr Anoop Jhurani

Description

In this medical presentation, Anoop Jhurani discusses the complexities of managing a case of periprosthetic joint infection following total knee replacement in a young patient with a history of trauma. The patient developed an infection that led to the explantation of the joint and the placement of a spacer, which ultimately proved ineffective against the resistant infection caused by MRSA. Jhurani outlines the patient's symptoms, including a draining sinus and elevated inflammatory markers, and explains the procedural steps taken to manage the infection. Multiple surgical interventions are described, including debridement of the joint, placement of an intra-articular Hickman catheter for antibiotic delivery, and meticulous planning for a revision surgery to address the stiffness and limited range of motion in the knee. Throughout the presentation, key surgical techniques such as the rectus snip, lateral release, and careful assessment of flexion and extension gaps in the knee joint are emphasized. The use of offset components for proper alignment of the tibial and femoral stems is also highlighted. Ultimately, the patient achieves a stable knee with improved range of motion, though with some limitations given the chronic nature of the knee stiffness and previous surgeries. The presentation concludes with a summarization of the principles for effective management and successful reconstruction of complex knee cases.

DOI: 10.1302/3114-230037

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