Case ReportPostoperative Wound Breakdown Caused by Pyoderma Gangrenosum After Bilateral Simultaneous Total Knee Arthroplasty
Section snippets
Case Report
An 80-year-old woman underwent bilateral simultaneous cemented total knee arthroplasty in November 2003 for primary tricompartmental osteoarthritis (Fig. 1) using the PFC posterior cruciate-retaining prosthesis (Depuy, Inc, Leeds, UK). She had no previous significant medical history and had undergone previous gynecologic surgery with no complications. The immediate postoperative period was uneventful, and a standard postoperative regimen of 2 doses of intravenous cefuroxime and knee
Discussion
A MEDLINE search for pyoderma gangrenosum returned 1300 articles. Of these, there were only 18 articles per case reports related to postoperative pyoderma gangrenosum of which only 2 case reports 2, 3 (3 cases) have been described in the orthopedic literature. The most frequent occurrence of postoperative pyoderma gangrenosum is after breast surgery [4], but it has also been described after thoracotomy, hernia surgery, abdominal surgery, and orbital surgery. The orthopedic literature describes
References (10)
- et al.
Pyoderma gangrenosum complicating bilateral breast reduction
Br J Plast Surg
(2004) - et al.
A surgical wound infection?
Lancet
(2000) - et al.
- et al.
Pyoderma gangrenosum. A diagnosis not to be missed
J Bone Joint Surg Br
(1999) - et al.
Pyoderma gangrenosum mimicking postoperative infection in the extremities. A report of two cases
J Bone Joint Surg Am
(1999)
Cited by (32)
Pyoderma Gangrenosum After Bilateral Total Knee Arthroplasty
2021, Arthroplasty TodayTotal hip arthroplasty for femoral neck fracture with pyoderma gangrenosum patient: A case report
2017, International Journal of Surgery Case ReportsCitation Excerpt :Pyoderma gangrenosum may occurs after surgery or trauma such as the surgery of breast or abdomen. It is very rare but do occurred after orthopedic surgery such as total hip replacement [2] and total knee arthroplasty [3]. Such disease is strikingly similar to the manifestation of infection.
Postoperative Pyoderma Gangrenosum: A Clinical Review of Published Cases
2016, Mayo Clinic ProceedingsCitation Excerpt :This investigation was compliant with the US Health Insurance Portability and Accountability Act. Case reports of 156 unique patients were reviewed, and 140 cases were selected (Supplemental Table 1, available online at http://www.mayoclinicproceedings.org).3-5,13-130 Publications of 18 patients had no English translation or did not meet the inclusion timeline (Supplemental Table 2, available online at http://www.mayoclinicproceedings.org).9,131-146
Successful treatment of wound breakdown caused by pyoderma gangrenosum after total knee arthroplasty
2011, KneeCitation Excerpt :However, it very rarely occurs after orthopedic limb procedures. In fact, there have only been five previous cases, which followed total hip arthroplasty [5], tarsal tunnel release [6], surgery on a rheumatoid hand [6], total knee arthroplasty [7], and knee arthroscopy [8]. All cases were initially misdiagnosed as wound infection.
Pyoderma gangrenosum: A report of a rare complication after knee arthroplasty requiring muscle flap cover supplemented by negative pressure therapy and hyperbaric oxygen
2011, Journal of Plastic, Reconstructive and Aesthetic SurgeryCitation Excerpt :Cutaneous trauma can lead to lesions in up to 30% of patients with PG – a concept termed pathergy. Only four cases following knee arthroplasty1–4 and two following hip arthroplasty have been reported in the literature.5,6 We describe a case where suppurative PG following knee arthroplasty required large soft tissue defect coverage.
No benefits or funds were received in support of the study.