Overseas Vietnamese from the Netherlands Returns Home for Revision Knee Arthroplasty Following Failed Initial Surgery

Ms. Nguyen Thi Tuong V (55 years of age), residing and working in the Netherlands, had suffered from advanced knee osteoarthritis for several years. Following an extended course of conservative joint-preservation modalities that failed to provide clinical relief, she ultimately elected to undergo knee arthroplasty there.

Ms. V underwent her primary knee replacement in the Netherlands a year prior. Postoperatively, intractable pain persisted alongside severe flexion contracture and pronounced mobility impairment for six months. Consequently, she had to re-present to the hospital to address mechanical joint locking—an ordeal that proved profoundly distressing. “I would rather have given up; the agony was intolerable. My leg was severely swollen and racked with pain; I pleaded with my family to take me home immediately,” Ms. V recalled with great emotion.

Living with persistent, chronic pain prompted Ms. V to return to Vietnam more urgently than ever. Ms. V was referred by an acquaintance, a physician in Vietnam, to undergo treatment with Dr. Tang Ha Nam Anh at Sante Hospital; with Dr. Nam Anh's extensive expertise, she was certain that she would be cured, she recalled.

Following comprehensive clinical assessment, the patient was diagnosed with aseptic loosening of the knee prosthesis accompanied by mechanical flexion impingement. Additionally, Ms. V presented with bilateral chronic venous insufficiency of the lower extremities, gastritis, food allergies, hypertension, and diabetes mellitus. She was admitted immediately following evaluation to prepare for revision knee arthroplasty using a rotating-hinge prosthesis.

A cornerstone of this procedure's surgical success was a sophisticated multimodal analgesia protocol, integrating regional nerve blocks, local infiltration anesthesia, targeted intravenous and oral analgesics, and supportive physiotherapy modalities including cryotherapy, neuromuscular electrical stimulation, limb elevation, and therapeutic psychological support. Because postoperative pain was effectively managed, the patient achieved prompt early ambulation. Early postoperative rehabilitation substantially accelerates functional recovery and mitigates complications associated with prolonged immobilization, such as deep vein thrombosis and pressure injuries.

On postoperative day one, the patient was initiated on guided knee flexion exercises, with physical therapists assisting gentle ambulation using crutches or a walking frame over the ensuing days. The knee arthroplasty rehabilitation program encompasses tailored exercises designed to restore joint stability, promote weight-bearing equilibrium, and re-establish essential functional activities.