No abstract

The five ligaments studied act with a symphonic harmony to provide stability to the knee. The SMCL was of major importance in medial knee stability. The other ligament which provided the most dramatic contribution to knee stability was the PC. It was the only ligament which when sectioned resulted in a significant posterior anterior drawer instability and on three occasions produced a jerk test.

Although technical malfunction should always be suspected when all intraoperative somatosensory-evoked potential waveforms are initially seen and subsequently lost, one should also consider the possibility that intraoperative ischemia due to limb positioning could be the etiology.

Case: A 61-year-old woman with an asymptomatic hip presented acutely with a swollen lower limb 15 years after a metal bearing surface total hip replacement (THR). A large intrapelvic pseudotumor was discovered compressing her femoral and iliac vessels. Collaboration between an orthopaedic and vascular surgeon led to a 2-stage surgical procedure with resection of the pseudotumor, followed by revision of the THR implant 3 months later. Conclusion: This case demonstrates the importance of long-term follow-up of patients with metal bearing surface implants, early recognition of an unusual presentation of a common problem, and the utility of collaboration between orthopaedic and vascular surgeons.