Total Knee Arthroplasty under Local Anaesthesia - Surgical Technique and Clinical Results: A Case Report
Abstract
Total knee arthroplasty (TKA) is usually performed under general or spinal anaesthesia. This report presents the case of an 82-year-old female patient with severe osteoarthritis of both knees who underwent right knee TKA under local anaesthesia. The initial plan was to perform surgery on both lower extremities one week apart. The left TKA was completed in 3 hours and 5 minutes with a blood loss of 20mL, and the post-operative course was uneventful. However, severe deep vein thrombosis developed in left lower limbs, and general anaesthesia was deemed impossible due to bilateral pleural effusion. The patient was on anticoagulant therapy with a PT-INR of 7.63, and nerve block anaesthesia was also not feasible. Despite these challenges and the patient’s decreased activities of daily living, the right TKA was performed 30 days after the left TKA. Surgery took 2 hours and 18 minutes with a blood loss of 140mL. The patient was able to walk immediately after surgery and was discharged two weeks later. During a two-year follow-up, no significant limitations in walking or stair climbing were observed. This case demonstrates the efficacy of TKA under local anaesthesia in high-risk patients.
Abstract | Reference
