The document discusses a revision total knee replacement (TKR) surgery for a 65-year-old obese patient who had their initial surgery one year ago. They presented with inability to walk or bear weight and an exam finding of instability. Workup included testing for prosthetic joint infection (PJI) which guided intraoperative synovial fluid sampling. During surgery, a fracture was discovered and addressed. Key learning points emphasized preparation, following PJI guidelines, and teamwork.

1. Revision TKR
Ahmed Alqatub
4th year ICMS Ortho

2. Causes of Revision Surgery
• Loosening and wear.
• InfecCon.
• Instability.
• SCffness.
• Patellofemoral maltracking.
• Fracture.

3. History
• 65 yo.
• Obese.
• Index surgery one year ago.
• Can’t walk.
• Can’t call any trauma. (may be denial)
• On examinaCon:
– Instability.

4. Work up
• PJI.
• X-rays.

5. X-ray

7. Surgery
• Incision.
• Quad. Snip.
• Safety pin.
• Synovial sampling sent to lab during surgery.
• Five Cssue samples.
• Femur.
• Tibia.
• CCK.

8. Fracture

11. lucky

13. Learning points
• Prepare everything for surgery.
• Follow the PJI guideline.
• Team work.