Hanson Logan F, Hanson Cameron G, Barner Kyle L
Department Of Orthopaedic Surgery (Dr. L. F. Hanson), Beaumont Health, Farmington Hills, MI, and the College of Osteopathic Medicine (Mr. C. G. Hanson and Mr. Barner), Kansas City University of Medicine and Biosciences, Kansas City, MI.
J Am Acad Orthop Surg Glob Res Rev. 2018 Jul 17;2(7):e032. doi: 10.5435/JAAOSGlobal-D-18-00032. eCollection 2018 Jul.
Charcot arthropathy is an infrequent condition that primarily involves the foot and ankle; rarely, it has been reported to affect the knee. Risk factors for Charcot arthropathy are well described with diabetes being the most common cause. Idiopathic Charcot arthropathy without a secondary etiology is extremely rare, with only a few cases described involving the foot and shoulder. Clinically, idiopathic Charcot arthropathy presents a notable challenge because delayed diagnosis can lead to surgical complications and advancement of joint destruction. We report idiopathic Charcot arthropathy of the knee presenting as a bicondylar tibial plateau fracture successfully managed with total knee arthroplasty after failed open reduction internal fixation. We diagnosed the patient when the clinical/surgical presentation was indicative of Charcot arthropathy and after excluding all other diagnoses. This previously unreported case describes the complexity of idiopathic Charcot arthropathy with subsequent fractures and highlights the importance of patient history, presentation, and surgical intervention.
夏科氏关节病是一种少见的疾病，主要累及足和踝关节；很少有报道称其会影响膝关节。夏科氏关节病的危险因素已有详尽描述，其中糖尿病是最常见的病因。无继发病因的特发性夏科氏关节病极为罕见，仅有少数累及足部和肩部的病例报道。临床上，特发性夏科氏关节病是一个显著的挑战，因为诊断延迟会导致手术并发症和关节破坏的进展。我们报告了一例表现为双髁胫骨平台骨折的特发性膝关节夏科氏关节病，在切开复位内固定失败后，通过全膝关节置换术成功治疗。当临床/手术表现提示为夏科氏关节病且排除所有其他诊断后，我们对该患者进行了诊断。这个此前未报道的病例描述了特发性夏科氏关节病伴随后续骨折的复杂性，并强调了患者病史、临床表现和手术干预的重要性。
