Title : Skinted - A series of rare post operative complication post total knee replacement
Abstract:
Background:
Traumatic eczematous dermatitis, a neuropathic dermatitis specific to total knee arthroplasty (TKA), occurs around the healed surgical scar area due to injury to the infrapatellar branch of the saphenous nerve. This rare skin complication is scarcely documented in orthopedic literature. Here, we present a series of cases and estimate the incidence of this condition at our institute.
Methods:
From January 2018 to December 2018, we identified patients who had undergone TKA and subsequently developed skin lesions near the surgical site. Detailed histories were taken, and comprehensive clinical examinations were performed for all reported cases.
Results:
We identified a total of 9 lesions in 8 patients out of 203 consecutive TKAs performed during the study period, resulting in an estimated incidence of 4.4%. The mean age of affected patients was 64 years (ranging from 58 to 78 years). The average time from surgery to diagnosis was 4 months, with a range of 3 to 6 months.
Conclusions:
Dermatitis caused by surgical transection of the infrapatellar branch of the saphenous nerve during TKA is a rare cutaneous complication, with an estimated incidence of 4.4% in this study. Lesions typically appear lateral to the operative scar within an area of hypoesthesia. In all patients, the lesions improved after topical steroid therapy, with no recurrences noted upon further follow-up. It is essential for arthroplasty surgeons to recognize this benign complication to prevent unnecessary additional workup and alleviate patient anxiety.
Audience Take Away:
This study highlights the importance of recognizing traumatic eczematous dermatitis as a rare but benign complication of total knee arthroplasty. Understanding its incidence and effective treatment with topical steroids can help surgeons reassure patients and avoid unnecessary diagnostic procedures.
