A total knee prosthesis consists of three components: a femoral component, a tibial component and a patellar component. It is designed to mimic the function of the native human knee joint and replace diseased or damaged articular structures. Knee joint prosthesis are categorized by the scope of replacement into cruciate-retaining (CR) designs and posterior-stabilized (PS) designs. Total knee arthroplasty can relieve pain, enhance joint stability, improve knee range of motion, restore natural knee kinematics, and recover patients’ mobility.
Clinical Case Sharing-Knee Joint Replacement
Patient: Mrs Huang, Female, 62 years oldPatient Condition: Bilateral knee pain for over 10 years, aggravated pain with limited joint motion for 3 months.History of Present Illness: The patient reported insidious bilateral knee pain and soreness starting more than 10 years ago. Pain was exacerbated during stair climbing and squatting, and partially relieved by rest. She received repeated outpatient treatments at local hospitals, including physical therapy and intra-articular sodium hyaluronate injections. Symptoms alleviated temporarily but recurred persistently, with gradual development of bilateral genu varum deformity. Approximately 3 months prior to admission, the knee pain worsened without obvious inducement, accompanied by knee flexion contracture, more severe on the right side. She presented to our hospital and was admitted under the diagnosis of bilateral knee osteoarthritis.
Special Physical Examination: The patient ambulated into the ward with crutches. Physiological spinal curvatures were preserved; pelvic examination was unremarkable. Bilateral genu varum deformity was noted, more prominent on the right knee. The overlying skin was intact without erythema, swelling, warmth or tenderness. Tenderness was positive over the medial compartment of both knees, with palpable osteophytes around the knee joints. Severe limitation of knee motion was observed: left knee range of motion 10° to 80°, right knee range of motion 20° to 25°. Bilateral lower limbs were equal in length. Lateral stress test, drawer test and patellar float test were negative bilaterally. McMurray’s test was positive on both sides. Muscle strength of bilateral lower limbs was normal, with no diminished cutaneous sensation. Bilateral knee and ankle reflexes were symmetric and elicitable; no other pathological signs were detected.Diagnosis: Bilateral knee osteoarthritis with flexion and varus deformitySurgical Procedure: Right total knee arthroplasty (TKA)
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