Patella Infera in an HIV Positive Patient Following Total Knee Arthroplasty

Georg Matziolis*, 1, Lars Morawietz 2, Doerte Matziolis 1, Carsten Perka 1
1 Orthopaedic Department, Center for Musculoskeletal Surgery, Berlin, Germany
2 Institute for Pathology, Charité - University Medicine Berlin, Germany

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© Matziolis et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Orthopaedic Department, Center for Musculoskeletal Surgery, Charité - University Medicine Berlin, Charitéplatz 1, D-10117 Berlin, Germany; Tel: +49 – 30 – 450 615093; Fax: +49 – 30 – 450 515922; E-mail:


A lowering of the patella after total knee arthroplasty is accompanied by pain and a restriction of the range of motion. With its etiology being unclear at present, a multifactorial genesis is under discussion. For the first time, we present a case report describing an HIV infection as a possible cause of patella infera.

A 54-year-old HIV-positive woman developed patella infera (Insall-Salvati ratio 0.6) with a painful restriction of motion 18 months after implantation of a bicondylar surface prosthesis. By changing to a partially coupled endoprosthesis, distalization of the joint line and partial patellar resection, the patient was free of symptoms with a ROM of 0°/0°/110°.

All risk factors known from the literature could be excluded in this case, so that the presence of an HIV infection has to be discussed as a possible cause.

Keywords: Total knee arthroplasty, human immunodeficiency virus, patella infera.