Heterotrophic ossification post total knee arthroplasty in a patient with rheumatoid arthritis: a case report
Keywords:Heterotrophic ossification, Total knee arthroplasty, Physiotherapy
Even though minor degrees of heterotrophic ossification are common in total knee arthroplasty, it is of little clinical significance. But severe degrees of heterotrophic ossification are very rare after total knee arthroplasty. Here we discuss about a 70 years old woman who initially had excellent post-operative range of movements after cemented total knee arthroplasty, but later presented with knee pain, swelling and loss of range of movements after 3 months. X ray showed severe heterotrophic ossification around knee near the quadriceps tendon. She was treated conservatively with non-steroidal anti inflammatory drugs and physiotherapy. After a period of 3 months of physiotherapy, patient regained the lost range of movements and is currently under follow up for the past 1 year. Hence this case instantiates that even in cases of severe Heterotrophic Ossification after total knee arthroplasty, non-operative treatments such as physiotherapy with anti-inflammatory drugs should be the primary option to treat the stiffness before considering surgery.
Alturki AA, Aldeghaither SA, Alhandi AA. Severe heterotopic ossification post Total Knee Arthroplasty in a patient with rheumatoid arthritis: a case report. J Surg Case Rep. 2020;2020(3):rjz390.
Dodds AL, Keene GCR. Severe Heterotopic Ossification following Total Knee Replacement. Case Rep Orthop. 2014;2014:1-3.
Total Knee Arthroplasty improves both knee function and disease activity in patients with rheumatoid arthritis: Modern Rheumatology. Available at: https://www.tandfonline.com/doi/abs /10.1080/14397595.2016.1265705. Accessed on 4 June 2021.
Furia R, Pellegrini VD. Heterotopic Ossification Following Primary Total Knee Arthroplasty. 2002;1:7-10.
Baroudi M, Derome P, Malo M. Severe heterotopic ossification and stiffness after revision knee surgery for a periprosthetic fracture.
Dalury DF, Jiranek WA. The incidence of heterotopic ossification after Total Knee Arthroplasty. J Arthroplasty. 2004;19(4):447-52.
Kachewar S, Sankaye S. Heterotopic ossification following total knee replacement surgery. J Mahatma Gandhi Inst Med Sci. 2013;18(2):122.