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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo)
DOI: 10.1055/s-0041-1739173
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An Unusual Complication of Intramedullary Pin Migration during Total Knee Arthroplasty – A Case Report

Article in several languages: português | English
Sanjay Bhalchandra Londhe 
1   Departamento de Ortopedia, Holy Spirit Hospital, Mumbai, Maharashtra, Índia
,
Ravi Vinod Shah 
2   Departamento de Ortopedia, Criticare Superspeciality Hospital, Mumbai, Maharashtra, Índia
,
Paras Banka 
1   Departamento de Ortopedia, Holy Spirit Hospital, Mumbai, Maharashtra, Índia
› Author Affiliations Financial Support The authors have no funding source to declare.
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Abstract

Total knee arthroplasty (TKA) is one of the most effective operations to relieve pain and improve function in the end stage of osteoarthritis (when bone on bone contact occurs). The intraoperative complications of TKA include fracture, tendon or ligament injury, and nerve or vascular complications. We herein describe an unusual complication of intramedullary pin migration within the femoral canal during TKA. A 72-year-old male patient underwent TKA with a posterior stabilization system with sacrifice of the posterior cruciate ligament. The distal femur was sectioned and balance was checked in extension. Then to make anterior, posterior, chamfer and notch cuts, the five-in-one anteroposterior (AP) cutting block was placed on the distal femur and the cuts were initiated. As there was a medial overhang of the cutting block, it was shifted laterally. While doing so, the pins had to be shifted too, and one of them was inadvertently hammered into the previously-created medullary canal opening of the femur. As usual orthopedic instruments, like the long straight artery forceps and pituitary rongeurs, failed to remove the migrated pin, an extralong laparoscopic grasper was used under fluoroscopy control to locate, grasp, and remove the migrated pin.

Keywords

arthroplasty, replacement, knee - intraoperative complications - bone nails - orthopedic procedures

Informed Consent

Informed consent was obtained from all individual participants included in the study.




Publication History

Received: 22 June 2021

Accepted: 13 August 2021

Article published online:
16 December 2021

© 2021. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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