Key result
Chest physiotherapy alone resolves postoperative platypnoea-orthodeoxia syndrome within 6 months.
Why the study?
Platypnoea-orthodeoxia syndrome is a rare disorder with limited reported cases following left total knee replacement.
Case Report (n=1)
Platypnoea-orthodeoxia syndrome due to a PFO after knee replacement can sometimes resolve with conservative management such as chest physiotherapy.
May support conservative management in select post-knee replacement cases; leaves open whether resolution is spontaneous or physiotherapy-mediated.
Platypnoea-orthodeoxia syndrome (POS) is a rare disorder characterised by both dyspnoea (platypnoea) and arterial desaturation (orthodeoxia) in the upright position, with improvement in the supine position. We report an unusual case in which an 82-year-old woman developed severe hypoxaemia with POS after left total knee replacement. A significant difference in alveolar-arterial blood gas oxygen tension was demonstrated, and hypoxaemia failed to respond to 100% oxygen supply. A patent foramen ovale with a right-to-left shunt was evident on transoesophageal echocardiogram employing colour Doppler and agitated normal saline studies. Interestingly, the patient's symptoms resolved within 6 months with ongoing chest physiotherapy, without surgical or medical intervention.
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Almufti et al. (2019) conducted a case report in Platypnoea-orthodeoxia syndrome (n=1). Chest physiotherapy was evaluated on Symptom resolution. An 82-year-old woman who developed platypnoea-orthodeoxia syndrome after left total knee replacement experienced symptom resolution within 6 months with ongoing chest physiotherapy alone.
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