Case Report: Total Knee Arthroplasty in Ipsilateral Below-Knee Amputee.

INTRODUCTION: Total knee arthroplasty (TKA) has the highest annual incidence among all joint replacement surgeries. Below-knee amputation (BKA) is another common procedure to treat lower-limb-threatening pathologies. These two procedures are commonly performed individually, but an ipsilateral TKA performed on a BKA patient is rare. While ipsilateral amputation is not a contraindication for TKA, it presents orthopaedic surgeons with a unique case and necessitates thoughtful pre-operative planning regarding proper positioning, alignment determination, surgical technique, and rehabilitation for the best outcome.

OBJECTIVES: We present a case of a patient with a BKA who underwent ipsilateral TKA.

CASE REPORT: This patient has a history of osteoarthritis (OA) of the right knee and diabetic neuropathy and underwent a right BKA after sustaining second-degree thermal burns to the bilateral forefeet. The patient was scheduled to undergo elective TKA prior to these injuries but was forced to postpone due to their severity. Following the BKA, the patient regained his ability to ambulate independently with prosthesis but continued to suffer from OA symptoms. The patient was then scheduled for surgery, and a TKA was performed.

CONCLUSION: The patient underwent a TKA and tolerated the surgery well without complications. Appropriate positioning was achieved using a popliteal post. Alignment and tibial cut were checked using fluoroscopy. All components were cemented into position, and the patella was resurfaced. The patient did well postoperatively and was using his prosthesis and ambulating independently at the final follow-up.