Abstract

CONSTANTINO, Hugo et al. Artroplastia total do joelho dolorosa. Rev. Port. Ortop. Traum. [online]. 2013, vol.21, n.3, pp.419-424. ISSN 1646-2122.

Total Knee Arthroplasty (TKA) has been assumed as the most common surgical option in the treatment of patients with degenerative changes in the knee joint as a result of excellent outcomes in functional improvement and pain. However, the proportion of patients with pain after this procedure achieves very significant values in some reports, ranging between 10 and 20%. In some cases the pain is not easily explained and represents a challenge for the surgeon. The authors report a case of a 71 year old patient who underwent primary TKA in the context of idiopathic degenerative pathology associated with varum axial deviation. The pain complaints were located in anteriorexternal knee surface at the level of the joint line and started postoperatively associated with the gradually increased mobility. Due to the presence of a mechanical activity associated symptom, several assumptions were placed including the possibility of a conflict with intra-articular fragments of the outer compartment of the knee. The patient underwent arthroscopy of the knee joint, which revealed the existence of a meniscal fragment that caused the conflict between the external condyle of the arthroplastic femoral component and the polyethylene at the maximum extension of the knee. We proceeded to arthroscopic removal of the fragment with complete relieve of the symptoms. The authors intend to demonstrate with this case the importance of the diagnostic investigation for the treatment of unexplained pain in TKA and the therapeutic value of arthroscopy in cases of probable conflict.

Keywords : Total knee arthroplasty; arthroscopy; meniscus.

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