Total Knee Arthroplasty in a Stiff Knee Post Infection - A Case Report

Abstract

Purpose: This case report highlights the successful case of a fused knee to a functional joint through total knee arthroplasty (TKA) using a constrained hinge prosthesis in a 72-year-old male with a history of post-infectious ankylosis. Background: The patient developed septic arthritis following a platelet-rich plasma (PRP) injection, necessitating multiple debridements and long-term antibiotic therapy. Despite infection resolution, he experienced persistent stiffness, pain, and a minimal range of motion with knee (ROM) of 0–10°. Methods: Extensive preoperative planning confirmed the absence of infection and prepared for the challenges of fibrosis and bone deformity. The surgery utilized a medial parapatellar approach with extensive soft tissue release and constrained hinge prosthesis implantation. Outcomes: An intraoperative ROM of 0–90° was achieved, with postoperative radiographs confirming proper prosthetic alignment and fixation. Early rehabilitation helped maintain mobility, and no complications were observed in the early recovery phase. Conclusion: This report demonstrates the viability of constrained hinge prostheses in addressing complex cases of post-infectious knee ankylosis, emphasizing the importance of multidisciplinary care, meticulous planning, and early rehabilitation for favorable outcomes.