Sarvodaya Hospital, Sector 8, Faridabad

Abstract

Ankylosing spondylitis (AS) is characterized by the osteoproliferation-induced axial skeleton and sacroiliac joint damage that leads to spinal deformity and functional disability; up to 70% of patients have knee and other joint involvement and may require total joint replacement despite adequate pharmacological support Total knee arthroplasty (TKA) is an effective procedure in an AS patient but very little has been reported on the outcomes. However the peculiar gait pattern due to ankylosed joints, which do not improve substantially after TKA, increases the incidence of falls, leading to complications. An 80-year-old Asian male with primary TKA suffers extensor mechanism disruption and medial collateral ligament injury after a fall and undergoes rotating-hinge knee and patellar tendon repair augmented with semi–T graft. The patient could initially achieve early weight-bearing with splint support, and later with the cylindrical cast. Rotating-hinge knee is a viable option in low-demand patients with good outcomes in patients with collateral ligament rupture. Semi–T augmented PT repair reinforced with suture anchors gives the relatively best result.