Knee surgery at Burjeel Hospital gives new lease to nonagenarian

MUSCAT: Burjeel Hospital in Al Khuwair has successfully conducted a complex Revision Total Knee Replacement surgery on a nonagenarian patient who developed infection of prosthetic joint.

The orthopaedic team at Burjeel Hospital led by Dr Harshavardhan Hegde did the complicated surgery on the 90-year-old patient who was brought to Burjeel Hospital with complaints of severe pain and swelling in left knee, which he has been suffering for about a year.

“He had undergone total knee replacement (TKR) surgery oneand-half years ago, but his left knee had started giving him trouble with in few months of surgery. He was treated with medications for the same which, however, didn’t give him any relief, so he was brought to us for further examination and treatment,” said Dr Hegde

On evaluation, he was found to be having deep-seated infection in his replaced left knee. Infection of prosthetic joint is a devastating and costly complication after primary TKR, and the reported incidence with modern surgical techniques and laminar theater facilities is just 1-2 %. He added, “Apart from the infection, we had other challenges too including the age factor, poor nutritional status, and an aggravated osteoporosis due to the prolonged status of immobility, hampered kidney function, and low haemoglobin.”

The team went for a two-stage revision. “In the first stage, done in February, the infected implants were removed along with the bone cement without causing much damage to the already softened bone ends. After a thorough cleaning of the raw surfaces and soft tissues, an antibiotic-impregnated spacer was placed in before closing the wound,” Dr Hegde said.

The second phase of the revision was done on 24th March, wherein the cement spacer was removed and replaced with a special variety of revision implant.

“The surgery took around two hours. Now the patient is stable, relieved of his pain and is regaining normalcy,” Dr Hegde added.