TITLE:
Mobile Bearing Plate Dislocation in Total Knee Arthroplasty Due to Muscle Spasm: A Case Report
AUTHORS:
Jean-Damien Nicodeme, Claus Löcherbach, Alexandre Terrier, Aurélien Gallice, Brigitte M. Jolles
KEYWORDS:
Dislocation; Femoral Nerve Block; Mobile Bearing Prosthesis; Muscle Spasm; Total Knee Arthroplasty
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.3 No.2,
June
6,
2013
ABSTRACT: An unusual case of early dislocation of a mobile
bearing posterior stabilized total knee arthroplasty in a 48-year-old Caucasian
woman is described. Dislocation occurred one day postoperatively, attributed to
a gap mismatch. Revision surgery reduced posterior dislocation, increased
bearing plate thickness and rebalanced ligaments. A second dislocation occurred
after revision surgery. The patient’s history was retaken and a hamstring spasm
disease identified. A new revision utilized a more constrained design, without
perioperative local nerve block. Two years following surgery, no further
dislocation had occurred. A numerical musculoskeletal model of the case and
implant configuration identified no trend to mobile bearing dislocation when
regular muscle forces were applied. Muscle spasm is a risk factor for mobile
bearing total knee arthroplasty dislocation, especially with femoral nerve
block.