ABSTRACT
Femoral component fracture is a rarely reported complication in cemented total knee arthroplasty. We present a case of new- onset acute unresolving knee pain caused by fatigue fracture of the medial condyle of the femoral component 11 years after primary total knee replacement. This was identified and subsequently revised with a revision prosthesis. The patient had an uneventful recovery, and his symptoms resolved. Considering that the aging population and the rate of obesity are increasing and that there is an exponential increase in the number of joint arthroplasties; this case sheds light on a rare cause of acute non-traumatic knee pain following knee arthroplasty that could be present with or without evidence of osteolysis. We also review the literature of cases of fractured cemented and uncemented knee replacements and discuss the causes proposed.
Subject(s)
Arthralgia/diagnosis , Arthroplasty, Replacement, Knee/adverse effects , Fractures, Stress , Osteoarthritis, Knee/surgery , Postoperative Complications , Reoperation/methods , Arthroplasty, Replacement, Knee/methods , Diagnosis, Differential , Fractures, Stress/diagnosis , Fractures, Stress/etiology , Fractures, Stress/physiopathology , Fractures, Stress/surgery , Humans , Knee Joint/diagnostic imaging , Knee Joint/physiopathology , Knee Joint/surgery , Male , Middle Aged , Osteoarthritis, Knee/diagnosis , Osteoarthritis, Knee/physiopathology , Postoperative Complications/diagnosis , Postoperative Complications/physiopathology , Postoperative Complications/surgery , Radiography , Severity of Illness Index , Treatment OutcomeABSTRACT
PURPOSE: Our aim was to determine whether the administration of intravenous tranexamic acid is a safe and effective means of reducing blood loss associated with hip and knee replacement surgery. METHOD: Sequential cohort study analysing hemoglobin titers, transfusion rates, and the occurrence of venous thromboembolism in patients undergoing hip and knee replacements with and without the administration of tranexamic acid at the time of induction. Finally, a cost benefit analysis was performed. RESULTS: Two hundred and seventy-three patients were included in our study. We demonstrated that 1 gram of tranexamic acid administered intravenously at the time of induction significantly reduces operative blood loss and transfusion rates (p < 0.05). Moreover, the use of tranexamic acid reduces the costs associated with surgery. CONCLUSIONS: The administration of 1 gram of intravenous tranexamic acid is a safe and effective means of reducing operative blood loss and blood transfusion rates in patients undergoing hip and knee replacements.
