Sahoo Madan Mohan, Mahapatra Sudhir Kumar, Sethi Gopal Chandra, Dash Sunil Kumar
SCB Medical College, Cuttack, India.
Acta Orthop Traumatol Turc. 2014;48(3):367-70. doi: 10.3944/AOTT.2014.3245.
Ochronotic arthropathy mainly involves the spine and large joints. Along with blackening of the joint, degeneration rapidly progresses mostly in the knee, resulting in symptoms by the 4th or 5th decade. As the role of medical treatment and joint conservation surgeries are limited in the early stages, joint replacement is the only effective option in one third of patients. We present a case of the unique complication of patellar ligament rupture during total knee replacement (TKR) of an ochronotic joint. A 51-year-old male presented with bilateral severe tricompartmental osteoarthritis with varus deformities and restriction of motion. Bilateral TKR was performed. At the 28-month follow-up, the patient was walking pain free with acceptable position of implants in radiographs. To our knowledge this is the first report of rupture of the patellar ligament during TKR of an ochronotic joint. We propose appropriate preoperative preparation and greater care in the handling of the tendon during TKR of an ochronotic joint in order to avoid complication.
褐黄病性关节病主要累及脊柱和大关节。随着关节变黑，退变大多在膝关节迅速进展，到第四或第五个十年会出现症状。由于在早期阶段药物治疗和关节保留手术的作用有限，三分之一的患者中关节置换是唯一有效的选择。我们报告一例褐黄病性关节全膝关节置换术（TKR）期间髌韧带破裂的独特并发症。一名51岁男性，表现为双侧严重的三关节间室骨关节炎伴内翻畸形和活动受限。进行了双侧全膝关节置换术。在28个月的随访中，患者行走时无疼痛，X线片显示植入物位置可接受。据我们所知，这是褐黄病性关节全膝关节置换术期间髌韧带破裂的首例报告。我们建议在褐黄病性关节全膝关节置换术期间进行适当的术前准备，并在处理肌腱时更加小心，以避免并发症。
