Revision Total Knee Arthroplasty for an Elderly Patient with Many Complications : Application of the Shoelace Technique

Abstract

In revision total knee arthroplasty, there are often several problems, including extensor mechanism disruption, intraoperative fracture, infection or delayed wound healing. We report a 76-year-old woman who sustained both tibial and fibular fractures after total knee arthroplasty (TKA). She was undergone revision TKA with the shoelace skin closure technique. She had severe swelling, fracture blisters, and ulcers because of many complications such as diabetes mellitus, liver cirrhosis and anemia. At revision TKA, we made an additional skin incision on the medial side of the knee joint for the shoelace technique to avoid any compartment syndrome including skin trouble. The additional incision was tightened and completely closed on postoperative day 8. We suggest that this option would be a good one in TKA when primary skin closure is difficult because of soft tissue damage.