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Myasthenia Gravis leads to painless fatigable weakness of specific muscles in the body. It is often associated with comorbidities. A major surgery like total knee replacement in such a patient can lead to myasthenic crisis and many other complications. The success of this surgery depends upon the strength of various groups of muscles. A 66 years old, short, obese, female, with Myasthenia Gravis, Rheumatoid Arthritis and Hypothyroidism was operated for bilateral total knee replacement in single stage. A good preoperative evaluation of the case, anaesthesia and surgical procedure related intraoperative care and a careful postoperative pharmacological and physiotherapy protocol led to a satisfactory recovery during the hospital stay. A comprehensive perioperative care with a team-based approach can lead to a successful outcome after a total knee replacement surgery in a patient with Myasthenia Gravis and other comorbidities.

Total knee replacement in a patient with myasthenia Gravis: A challenge that demands comprehensive perioperative care