A Rare Case: Revision Knee Arthroplasty After 1 Year

Following the primary total knee arthroplasty, the patient presented to Sante Hospital for revision knee replacement due to inability to ambulate accompanied by persistent pain.

Ms. Com (75 years old), presented with Knee Osteoarthritis underwent artificial knee replacement surgery 1 year ago at another hospital. After 3 months, she felt the pain returning along with difficulty walking. Despite this, she and her family had no suspicions and only used medication to cope and relieve pain.

Until recently, when she felt the pain was unbearable, severely compromising quality of life due to loss of mobility. She was brought by her family to Sante Hospital, clinically examined by Dr. Tang Ha Nam Anh and was diagnosed with artificial knee loosening; due to poor surgical technique, a large gap was created between the two joint components, and the surrounding soft tissues and ligaments were also severely damaged after the previous surgery. In addition, the patient also had medical conditions such as hypertension, goiter, venous insufficiency, and onychomycosis…

Primary knee replacement is already a complex procedure, and revision total knee arthroplasty is significantly more challenging, demanding extensive clinical experience and high-level medical expertise from the surgical team. Dr. Tang Ha Nam Anh and the consulting physicians conducted a clinical consultation and indicated that the patient required revision knee arthroplasty using Hinged knee joint (one of the most advanced types of knee prostheses available today).

• Outstanding advantages of hinge knee joint …is to deliver a significantly enhanced range of motion compared to standard implants. Postoperatively, patients can achieve knee flexion of up to 155 degrees—nearly 40 degrees greater than conventional artificial joints—along with approximately 20 degrees of axial rotation. This enables patients to comfortably perform pivoting and rotational movements during athletic pursuits, an agility rarely attained with conventional prostheses.
• Hinged knee joint particularly useful in complex revision knee arthroplasty cases, cases with severe damage to knee collateral ligaments, knee instability, and significant bone defects requiring reconstruction.
• When using Hinged knee joint in primary knee replacement, the periarticular soft tissues and ligaments are relieved of significant pressure, thereby minimizing damage.

Ms. Com's case is considered rare in Vietnam to date, with very few similar cases. Prior to undergoing this major surgery, Ms. Com was still in high spirits, sharing: “I'm not afraid of surgery, I trust Doctor Nam Anh, an acquaintance of mine was recently operated on successfully by Doctor Nam Anh and recovered very quickly, they are even older than me” – she laughed heartily.

Dr. Tang Ha Nam Anh shared that one of the most touching aspects for medical professionals like him is the trust of patients, which serves as a tremendous source of motivation to continuously improve and update their knowledge to apply the most optimal methods for patients.

Images from the operating room for the patient

On the 5th postoperative day, thanks to early physical therapy and multimodal analgesia, the patient was pain-free, ambulating comfortably, and processed for discharge. At the 15-day follow-up, Ms. Com happily shared: “Currently, I can walk normally, no longer have knee joint pain, and can sweep the floor, cook, walk normally, and climb up and down stairs.”

With nearly 30 years of extensive experience, Dr. Tang Ha Nam Anh, MD, PhD, is one of the leading musculoskeletal specialists in Ho Chi Minh City. Not only possessing deep expertise and extensive experience in complex surgeries, Dr. Tang Ha Nam Anh, MD, PhD, has also made significant contributions to Vietnamese medicine through numerous valuable and highly practical research projects.

Sante Hospital adopts and applies surgical and treatment methods for musculoskeletal diseases professionally to achieve optimal efficacy, helping patients relieve pain and quickly regain their best quality of life.