Huge calf swelling associated with a failed total knee replacement: A case report

Authors : Muhammed Nazeer, Rohith Raveendran, Bharat C Katragadda, Muhammed Ehsan N

DOI : 10.18231/j.ijos.2020.047

Volume : 6

Issue : 3

Year : 2020

Page No : 254-258

Introduction: In patients who have undergone a total knee arthroplasty (TKA), any swelling occuring in
or adjacent to the joint needs thorough investigation and a wear debris-induced cyst or pseudotumor should
be suspected.
Case History: A 75-year-old man, who underwent primary TKA for osteoarthritis three years back,
presented with a swelling in the popliteal fossa extending into calf region of his left knee. Radiographs
showed medial space narrowing, component loosening and osteolysis. Magnetic resonance imaging showed
a popliteal cyst communicating with the knee joint and extending into the calf. A two stage procedure was
done, excision of cyst followed by revision TKA after three weeks. At one year follow-up, the patient had
a painless knee without cyst recurrence.
Conclusion: Long term follow-up is critical for patients with TKA for early detection of occult
polyethylene wear and prosthesis loosening. Joint effusion and synovial cyst formation should be
considered a preceding sign of periprosthetic osteolysis.

Keywords: Calf, Loosening, Polyethylene wear, Revision, Synovial cyst, Total knee arthroplasty.


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