Waszczykowski Michal, Niedzielski Kryspin, Radek Maciej, Fabis Jaroslaw
From the Department of Arthroscopy, Minimally Invasive Surgery and Sports Traumatology, Medical University of Lodz, Poland (MW, JF); Department of Neurosurgery and Peripheral Nerve Surgery, Medical University of Lodz (MR); Department of Pediatric Orthopaedy and Traumatology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland (KN).
Medicine (Baltimore). 2016 Jan;95(3):e2540. doi: 10.1097/MD.0000000000002540.
Arthrodesis of the knee joint is a mainly a salvage surgical procedure performed in cases of infected total knee arthroplasty, tumor, failed knee arthroplasty or posttraumatic complication.The authors report the case of 18-year-old male with posttraumatic complication of left knee because of motorbike accident 1 year before. He was treated immediately after the injury in the local Department of Orthopaedics and Traumatology. The examination in the day of admission to our department revealed deformation of the left knee, massive scar tissue adhesions to the proximal tibial bone and multidirectional instability of the knee. The plain radiographs showed complete lack of lateral compartment of the knee joint and patella. The patient complained of severe instability and pain of the knee and a consecutive loss of supporting function of his left limb. The authors decided to perform an arthroscopic-assisted fusion of the knee with Ilizarov external fixator because of massive scar tissue in the knee region and the prior knee infection.In the final follow-up after 54 months a complete bone fusion, good functional and clinical outcome were obtained.This case provides a significant contribution to the development and application of low-invasive techniques in large and extensive surgical procedures in orthopedics and traumatology. Moreover, in this case fixation of knee joint was crucial for providing good conditions for the regeneration of damaged peroneal nerve.
膝关节融合术主要是一种挽救性手术,用于治疗感染性全膝关节置换术、肿瘤、膝关节置换失败或创伤后并发症等情况。作者报告了一例18岁男性患者,因1年前的摩托车事故导致左膝创伤后并发症。受伤后他立即在当地骨科和创伤科接受了治疗。入院当天在我们科室的检查发现左膝变形,大量瘢痕组织与胫骨近端骨粘连,膝关节多向不稳定。X线平片显示膝关节外侧间室和髌骨完全缺失。患者主诉膝关节严重不稳定和疼痛,左下肢连续丧失支撑功能。由于膝关节区域存在大量瘢痕组织以及既往膝关节感染,作者决定采用Ilizarov外固定架进行关节镜辅助下的膝关节融合术。在54个月的最终随访中,获得了完全骨融合、良好的功能和临床结果。该病例为骨科和创伤学中大型广泛手术的微创技术发展和应用做出了重要贡献。此外,在该病例中膝关节的固定对于为受损腓总神经的再生提供良好条件至关重要。