Buckelew Programs

More than 600,000 total knee arthroplasties are performed in the United States every year1. Superficial wound complications occur infrequently, and the overall appearance of the incision is important to judge appropriate healing. Ecchymosis about the knee is common postoperatively and typically resolves within the first few weeks. Persistent skin changes around the incision and knee are rare, and they prompt additional investigation regarding the etiology. We report on a seventy-four-year-old woman who had undergone an uncomplicated right total knee arthroplasty and, almost three and one-half years later, developed an atraumatic ecchymotic-appearing lesion involving the superior aspect of the incision. She was diagnosed with biopsy-proven pigmented purpuric dermatosis (PPD). To our knowledge, this is the first such case reported in the orthopaedic literature. The patient was informed that data concerning the case would be submitted for publication, and she provided consent. A seventy-four-year-old woman with a past medical history of hypertension, hypothyroidism, and a prior left total knee arthroplasty presented for a right total knee arthroplasty. She underwent femoral and sciatic nerve blocks followed by general anesthesia. A posterior cruciate ligament-retaining total knee prosthesis (Vanguard; Biomet, Warsaw, Indiana) was implanted uneventfully. The patella was resurfaced, and a lateral release was performed. She did well in the postoperative period with regard to …

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