Visual Diagnosis in Emergency Medicine| Volume 57, ISSUE 4, e117-e118, October 2019

Not Another Twisted Knee

      A 64-year-old woman with a history of left-sided cruciate-sparing total knee arthroplasty (TKA) presented to the emergency department after developing acute onset of pain in her knee. She stated that after standing up, she felt a “pop” followed by pain. The physical examination revealed laxity of the knee posteriorly compared with the contralateral knee. There were no external signs of deformity or swelling and neurovascular status was intact. Radiographs were obtained (Figure 1).
      Figure thumbnail gr1
      Figure 1Plain radiographs (anteroposterior and lateral views) of the knee demonstrating malalignment of the femoral component that is posteriorly and laterally subluxed relative to the femoral component.
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        • Wang C.J.
        • Wang H.E.
        Dislocation of total knee arthroplasty: a report of 6 cases with 2 patterns of instability.
        Acta Orthop Scand. 1997; 68: 282-285
        • Ahn R.S.
        • Brown M.J.
        • Santilli M.D.
        Traumatic anterior knee dislocation after total knee arthroplasty.
        Arthroplast Today. 2015; 2: 97-99
        • Maderbacher G.
        • Keshmiri A.
        • Springorum H.R.
        • et al.
        Are we subluxating knees in total knee arthroplasty? A cadaveric investigation.
        J Arthroplasty. 2017; 32: 263-269
        • Parratte S.
        • Pagnano M.W.
        Instability after total knee arthroplasty.
        J Bone Joint Surg. 2008; 90: 184-194
        • Jethanandani R.G.
        • Maloney W.J.
        • Huddleston J.I.
        • et al.
        Tibiofemoral dislocation after total knee arthroplasty.
        J Arthroplasty. 2016; 31: 2282