Arthroplasty Case Studies

DOI: 11/5/2003. This is a case of a 72 -year-old male press operator who sustained a work-related injury from a fall. Operative report dated 05/03/2016 revealed that the patient underwent replacement with a 3 femur with a stem of a 15 x 150 using a 75mm tibial base with a stem of 10 x 90, both were cemented in place. The patient is subsequently diagnosed with failed total knee arthroplasty, left. As per medical report dated 8/4/16 by Dr. Gary Moscarello, the patient came in who feels substantially better. He still has some sutures in his leg, which I took them all out. His would are completely healed He is walking just with cane, although he can walk without the cane. Physical examination revealed that his range of motion is fairly good. He …show more content…
After removal we put some Band-aids. Of note, X-ray AP and lateral of the patient’s left knee demonstrates he has a rotating hinge well seated and well fixed. Final diagnosis is post revision of the left knee with subsequently large hematoma which got infected. The provider notes that the INR is back to appropriate level, 2.8. The patient is on Coumadin only and off of the Lovenox which cause a lot of problems and severe bleeding post-operatively. The patient is on a dose of Clindamycin 600 mg twice a day which he is going to be on for probably the rest of his life. He is going to take that along with his Coumadin. His wound is fortunately completely close. Sutures are all out. So, at this point, my plan is just going to maintain him on the low dose of antibiotics because the only other choice is take the entire prosthesis out and put a spacer in, and have an IV antibiotics and then re-insert. It was further notes that because the patient is on substantial blood thinners because of the cardia valve, he bleeds and when he does bleed especially around the knee, the pocket of blood with lead to an infection. The provider also notes that the patient needs an extension of physical