Abstract

GUIMARAES, Ana Cristina P.  and  SOUSA, Ricardo J.G.. Prótese total do joelho dolorosa: Abordagem diagnóstica. Rev. Port. Ortop. Traum. [online]. 2018, vol.26, n.4, pp.318-340. ISSN 1646-2122.

Knee arthroplasty is one of the procedures in Orthopaedics with better results. Therefore, its indications are more extensive leading to a rising incidence and prevalence of knee arthroplasties worldwide as well as a rise in the number of total knee arthroplasties (TKA) in risk of failure. Nevertheless, there is an important proportion of patients with deficient functional results which failure mechanism is not always obvious. This article does not aim to exhaustively analyse all failure mechanisms of a TKA but to review the diagnostic approach of a painful TKA providing an easy and reproducible explanation of the failure mechanism. The broached and harder to diagnose mechanisms are aseptic loosening, infection, instability and patellofemoral maltracking because of its sometimes eased presentation associated with unspecific knee pain. In these cases, besides anamnesis, it is important use imaging studies to better elucidate the failure mechanism despite not existing a gold standard method. It is also discussed in this article stiffness and other less common causes of painful TKA which have a more obvious diagnose.

Keywords : Total knee arthroplasty; diagnosis; aseptic loosening; infection; instability; patellofemoral maltracking; stiffness.

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