Der Orthopäde
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Biography Historical Article
[Prof. Dr. Reinhard Graf : retirement from the editorial board of Der Orthopäde].
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A painful knee after total knee arthroplasty may have various causes. In addition to commonly occurring causes, such as infections, aseptic loosening, implant failure or typical anterior knee pain, rare causes also have to be taken into account. We report a previously unknown cause of knee pain after total knee replacement involving a non-resected medial meniscus, which was sandwiched between the medial condyle of the femur and the inlay of the prosthesis and caused pain typical for a medial meniscus. After arthroscopic meniscectomy the patient was symptom-free.
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Spontaneous spinal epidural hematomas are rare but are of differential diagnostic importance due to the potentially dramatic progression through to irreversible neurological deficits. At the beginning the clinical symptoms are non-specific and the development of neurological deficits leads to the diagnosis. We present the case of a 73-year-old female patient who initially reported uncharacteristic neck pain and developed incomplete quadriplegia during the next day as well as the case of a 78-year-old male patient, who complained of acute back pain and developed paraplegia a short time afterwards. Early microsurgery and spinal canal evacuation led to complete remission of the neurological deficits in both cases.
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We report on a case of complex nerve damage during total hip arthroplasty. The most severe clinical symptom was proximal leg paresis with diffuse sensory loss. ⋯ The treatment of retroperitoneal hemorrhage is controversial but in most instances a conservative approach is favored. The prognosis of neurological damage is sobering as only 20 % of victims are expected to achieve complete restitution.