Mobile Bearing Plate Dislocation in Total Knee Arthroplasty Due to Muscle Spasm: A Case Report

Jean-Damien Nicodeme, Claus Löcherbach, Alexandre Terrier, Aurélien Gallice, Brigitte M. Jolles

Department of Orthopaedic Surgery and Traumatology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.
Laboratory of Biomechanical Orthopedics, Interinstitutional Center of Translational Biomechanics, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.

DOI: 10.4236/ojo.2013.32013                

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.

Keywords

Dislocation; Femoral Nerve Block; Mobile Bearing Prosthesis; Muscle Spasm; Total Knee Arthroplasty

Conflicts of Interest

The authors declare no conflicts of interest.

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