Knee balancing, joint line restoration and bone stock preservation are the main key issues in knee revision arthroplasties.
CLINICAL CASE: 57 – years old female
The patient, affected by medial osteoarthritis and internal post-meniscectomy, underwent unicompartimental knee replacement in 2003.
In 2004, due to persistent pain and loosening of the tibial component, the unicompartimental knee was replaced with a cemented tricompartimental knee. With the total knee prosthesis the patient had further complications such as algodystrophy and sepsis, treated in 2006. Four years on, the tibial component was in varus and she was still in severe pain.
In 2010 we decided to perform total knee revision surgery. The preoperative x-rays showed how complicated this case was, due to tibial and femoral misalignment. The patient required both tibial and femoral stems and management of excessive bone loss.
The chosen revision implant was CCK, belonging to the Multigen Plus Total Knee System (Lima Corporate).
The modularity of the Multigen Plus CCK system and the precise instrumentation enabled us to check the components’ correct alignment and, thanks to the 17mm liner, to restore the correct knee joint line.
Stem’s offset of 6mm was used to achieve the best tibial’s cortical bone coverage and, stem’s offset of 3mm was used to align the femoral component to the femoral canal.
Thanks to the Multigen Plus CCK system the patient is pain free, the postoperative ROM is of 0° - 100° therefore we can conclude that we have an excellent result for such a difficult case.
P. H. Charon, MD
Clinique des Franciscaines