Simultaneous removal of retained metal hardware during primary knee Arthroplasty

Mustafa Elsagier; Abd algafor alsadi

المؤلفون

Mustafa Elsagier Head Division of orthopaedic Surgery Faculty of Medicine Misurata University and Misurata Medical Center Misurata, Libya
Abd algafor alsadi Department of Orthopaedics Tripoli Medical Centre Libya

الكلمات المفتاحية:

Total Knee Arthroplasty، Hardware Removal، Simultaneous Surgery

الملخص

Background:
Retained hardware is usually removed during TKR only if no infection is present. We follow clinical and lab criteria to rule out infection and proceed in one session.

Methods:
In 39 cases, hardware was removed during primary TKR. Most staplers were taken out through the main incision; blade plates needed separate lateral incisions. One tibial nail was partially removed: one DCS plate through lateral dissection.

Results:
No infections at 6 months. Dropout rate 5%. Over 10 years, no late complications, skin necrosis, or fractures were noted. No metallosis observed.

Conclusion:
Simultaneous hardware removal during TKR is safe and effective when infection is excluded, and proper planning is followed.

المراجع

. Cook SD, Renz EA, Barrack RL, Thomas KA, Harding AF, Haddad RJ Jr., Millicic M: Clinical and metallurgical analysis of retrieved internal fixation devices. Clin Orthop Res 1985, 235-247

. Papadopoulos, P., et al. (2012). Total knee arthroplasty after prior fracture and hardware placement: Outcomes and complications. Journal of Arthroplasty, 27(8), 1550-1556.

[Discusses the outcomes of TKR following internal fixation.]

. Jassim, S. S., et al. (2014). Total knee replacement following tibial plateau fractures: a systematic review. Journal of Knee Surgery, 27(03), 199-204.

[Systematic review of TKR outcomes after fractures that often involve hardware.]

. Lizaur-Utrilla, A., et al. (2014). Total knee arthroplasty in patients with retained femoral hardware: Is hardware removal necessary? The Journal of Arthroplasty, 29(6), 1143-1147.

[Explores whether removing hardware before TKR is needed.]

. Wright, D., et al. (2011). Outcomes of total knee arthroplasty after distal femoral fracture: Is prior hardware a risk? Orthopedics, 34(5), e240-e245.

[Analyzes TKR outcomes after distal femur fractures.]

. Saleh, K. J., et al. (2002). Total knee arthroplasty in post-traumatic arthritis: A review. Journal of Arthroplasty, 17(4), 567-572.

[Looks at post-traumatic arthritis requiring TKR, often related to previous hardware]