1st Department of Orthopaedic Surgery, Laboratorio di Tecnologia Medica, Istituti Ortopedici Rizzoli, Bologna, Italy.
J Orthop Traumatol. 2011 Jun;12(2):107-10. doi: 10.1007/s10195-011-0137-z. Epub 2011 May 24.
Neuropathic arthropathy (Charcot's joint) is a degenerative process that affects peripheral or vertebral joints as a consequence of a disturbance in proprioception and pain perception. The knee is one of the most frequently affected joints, but even when the diagnosis is made at an early stage there is no consensus on the best treatment options. An early diagnosis of neurosyphilis was made in a 55-year-old woman presenting a delayed union of an asymptomatic Schatzker type IV fracture of the proximal tibia. A medial opening wedge tibial osteotomy was performed to achieve fracture healing, to correct the medial depression of the articular surface, and possibly to avoid an early arthritis typical of the disease. To our knowledge, a knee osteotomy has never been reported at an early stage of neuropathic arthropathy. Even though the clinical and radiographic evaluation performed at 4 months follow-up showed a good stage of healing of the osteotomy and no typical features of neuropathic joint degeneration, at 8 months follow-up the knee was markedly deranged.
神经关节病（夏科氏关节）是一种退行性病变，影响外周或脊椎关节，是本体感觉和痛觉紊乱的后果。膝关节是最常受影响的关节之一，但即使在早期做出诊断，对于最佳治疗方案也没有共识。一位 55 岁的女性出现了无症状的 Schatzker Ⅳ型胫骨近端骨折延迟愈合，早期诊断为神经梅毒。进行了内侧开口楔形胫骨截骨术以实现骨折愈合，纠正关节表面的内侧凹陷，并可能避免疾病典型的早期关节炎。据我们所知，神经关节病的早期从未报道过膝关节截骨术。尽管在 4 个月的随访时进行的临床和影像学评估显示截骨术有良好的愈合阶段，且没有神经关节退化的典型特征，但在 8 个月的随访时，膝关节明显紊乱。
