The goal of this clinical case is to discuss the diagnostic work-up of a painful and stiff medial unicompartmental knee arthroplasty (UKA), the role of arthrogenic muscle inhibition (AMI) in a persistent extension deficit, and the indications for revision to total knee arthroplasty (TKA).
I am an orthopedic surgeon specialized in knee surgery. I practice at the University Hospital of Toulouse in the University Sports Clinic located in the Pierre Paul Riquet Hospital.
In addition to teaching at the Faculty of Medicine, I participate in courses for the professional societies to which I belong such as the SFA, ESSKA and SOFCOT.
My clinical activity (more than 800 surgeries per year) is exclusively focused on knee surgery. An important part of my surgeries is related to sports traumatology, in particular anterior cruciate ligament injuries (350+ ACL reconstructions per year).
My research activity is also focused on the knee. I have contributed to more than 110 publications in international journals. I am developing an à la carte approach in order to propose a personalized surgery to the patient. In the context of degenerative activity, the aim is to better analyze the variability of the anatomy in order to be able to propose prostheses adapted to the patient's anatomy. In the context of sports traumatology, it is a question of improving the dismemberment of all the lesions in order to propose an adequate therapy.
Since May 2022, I am a member of the board of ESSKA (European Society of Sports Traumatology Knee Surgery and Arthroscopy) as treasurer.
- 66 y.o. man
- Right medial UKA performed 3 years ago (abroad)
- Persistent anterior knee pain since surgery
- Extension deficit and stiffness, main complaint
PHYSICAL EXAMINATION:
- 1m85, 80kg (BMI 23.4)
- Extension deficit of 5° to 10°
- Knee stable in all planes
- VMO activation deficit
- Anterior knee pain
Pre-operative right knee X-rays
Pre-operative right knee X-rays: skyline view
