Posterior Knee Dislocation Following Septic Arthritis of the Knee

Bonnaig, Nicolas S.; Casstevens, E. Christopher; Freiberg, Richard A.

doi:10.1177/2151458511430664

Cited by 4 publications

(4 citation statements)

References 8 publications

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“…So deterioration of cruciate ligaments is easier after infection in elderly patients. 8 , 9 These assertions explain the dislocation mechanism with a minor trauma in our elderly patient. Our patient similar to the other two cases did not have a major trauma.…”

Section: Discussionmentioning

confidence: 57%

“…Post-arthroscopic infection is previously well defined and discussed in the literature but there has been no report of knee joint dislocation following infection. Bonnaig et al 8 reported a case of non-traumatic posterior knee dislocation following septic arthritis in a 59-year old female with leukopenia secondary to sarcoidosis. This patient had undergone corticosteroid injection.…”

Section: Discussionmentioning

confidence: 99%

“…aureus in particular has been shown to release lysosomal enzymes to surrounding tissues, hastening destruction of cartilage and surrounding tissues. 7 Hence, regarding these issues Bonnaig et al 8 hypothesized that the soft tissues including the cruciate and collateral ligaments were made incompetent by enzymes from both the pathogenic organism and from the host immune cells and subsequent stretching with mobilization allowed the knee to dislocate without a direct traumatic event. The similar attribution was made by Chu et al 9 in a posterior dislocation of a cruciate-retaining total knee arthroplasty (TKA) following an acute bacterial infection.…”

Section: Discussionmentioning

confidence: 99%

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Total joint replacement for neglected posterior knee dislocation following septic arthritis after arthroscopy

Öztürkmen¹,

Akman²,

Ünkar³

et al. 2017

Acta Orthopaedica et Traumatologica Turcica

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This report presents the first case of a knee dislocation following septic arthritis after arthroscopy. A 65-year-old woman had an arthroscopy with irrigation and debridement (I&D) of the joint and microfracture for the chondral lesions. She had complaints of postarthroscopic infection but non-steroidal anti-inflammatory medication and local ice compression was recommended. She revisited her physician twice and at the last visit she had a large purulent effusion in her knee. The gram stain of the joint fluid aspirate demonstrated gram-positive cocci and the cultures grew methicilline-sensitive Staphylococcus aureus. She underwent arthroscopic assisted I&D and received intravenous antibiotics. I&D was repeated after two weeks. Intravenous antibiotherapy was continued for one more week and was changed to oral antibiotherapy for six weeks. At the third month visit's physical examination, a deformity at the knee was noticed and was referred to us for further treatment. A posterior knee dislocation with no neurovascular deficit was detected. The patient had a history of knee sprain but did not seek medical advice immediately. The blood samples showed no abnormality. The patient underwent a surgery with a cemented hinged revision total knee prosthesis following the exclusion of the active knee joint infection. Intraoperative frozen sections were also taken to exclude the active infection. The patient's knee is pain-free with full range of motion after 3 years. The objective of this report was to highlight the importance of early diagnosis, prompt appropriate treatment of septic arthritis following arthroscopy and the awareness of the knee dislocation as a rare dreadful complication of postarthroscopic infection particularly in elderly patients.

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Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Total joint replacement for neglected posterior knee dislocation following septic arthritis after arthroscopy

Öztürkmen¹,

Akman²,

Ünkar³

et al. 2017

Acta Orthopaedica et Traumatologica Turcica

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“…Similarly, Bonnaig et al . [ 5 ] reportof a spontaneous knee dislocation after septic arthritis, the patient’s risk factors such as sarcoidosis and leukopenia made the patient in greater risk of total knee prosthesis infection, therefore, making arthrodesis more favorable in their case. However, when eradication of infection is possible and the patient possesses no risk factors that may increase the risk of prosthesis infection, TKR would be a suitable management option as demonstrated in Oztürkmen et al .…”

Section: Discussionmentioning

confidence: 99%

Spontaneous knee dislocation: a rare and dreadful complication of septic arthritis

Alshahir

AlNaqa

Benmeakel

et al. 2023

Journal of Surgical Case Reports

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Spontaneous knee dislocation without a history of trauma is a rare entity to witness. Herein, we report a case of a patient who presented to the emergency department (ED) with a history of fever, chills and vomiting associated with progressive right knee swelling, pain and impaired range of motion (ROM). Physical exam of her right knee showed symmetrical swelling with diffuse tenderness and limited ROM due to pain. Joint aspirate and full septic workup confirmed the diagnosis of septic arthritis. Following her management and two events of irrigation and debridement of the septic knee, the patient was discharged. However, after 1-week from discharge, she presented to ED with right leg swelling and tenderness despite being bedbound for 3 months and denying any history of trauma with radiographs showing a posterior knee dislocation. This report aimed to shed a light on this dreadful complication of septic arthritis and highlights the importance of early recognition and management.

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