a rare case of tka with nonunion tibia plating

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A case of Osteoarthritic knee and nonunion tibia

• Dr. Krishna Swamy
• Fellow in Arthroplasty

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• A 53 yr old female, R. Sarada came with
  ostearthritis of rt knee and post operative
  nonunion mid-shaft right tibia with locking
  compression plate insitu
• History Closed Fracture Shaft of Right tibia in
  a RTA at tirupathi being operated with
  intramedullary ILN 2years back.

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• After a period of 2 months patient started
  weight bearing and the implant failed (bent nail)
  with nonunion.
• One and half year back she underwent left total
  knee replacment at a pvt hospital, tirupathi.
• Subsequently, she was operated for the implant
  failure with nail removal, ORIF with locking
  compression plate and Bone grafting at the same
  hospital.

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• The patient was started weight bearing on the
  immediate 2nd post operative day when the
  locking compression plate failed causing nonunion
  at the fracture site
• But the patient was able to walk with the help of
  a walker stand.

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Pre operative x rays
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• After all investigations and Anaesthetic Fitness,
  she was posted for Right Total knee arthroplasty
  and implant removal, wedge osteotomy at fracture
  site, LCP fixation and bone grafting.

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