Dislocation of posterior-stabilized mobile-bearing knee prosthesis. A case report.

Abstract

Spin-out of mobile-bearing knees is a significant early complication of mobile-bearing total knee arthroplasty. Dislocation of the cam-post mechanism of fixed-bearing posterior-stabilized knees occurs more rarely. We have observed an unusual case of dislocation of posterior-stabilized rotating-platform total knee arthroplasty, which has both a cam-post mechanism and rotating platform. A 65-year-old man with knee osteoarthritis and cervical spondylotic myelopathy underwent total knee arthroplasty using a mobile-bearing prosthesis. The dislocation, which occurred 4 days postoperatively, could not be reduced by closed manipulation. However, spontaneous reduction occurred 6 days after the dislocation, which did not recur. A gap mismatch or trapezoidal-shaped gaps may lead to dislocation or spin-out of the bearing insert. This case illustrates that dislocation of a posterior-stabilized mobile-bearing total knee arthroplasty can occur, and both quadriceps deficiency and ligament laxity may contribute to the risk of dislocation.