Samborski S Andrew, Quinzi David, Balkissoon Rishi
Department of Orthopaedics and Physical Performance, University of Rochester Medical Center, Rochester, NY, USA.
Arthroplast Today. 2020 Oct 1;6(4):830-834. doi: 10.1016/j.artd.2020.08.004. eCollection 2020 Dec.
Total knee arthroplasty (TKA) in the setting of previous hip fusion is rare with a paucity of evidence in the orthopaedic literature. Traditionally, TKA is performed supine, with the aid of knee-positioning devices allowing for hip flexion and range of motion of the knee to facilitate ease of surgical intervention. However, TKA using traditional positioning would not be possible in the presence of ipsilateral hip arthrodesis preventing hip motion. This case report describes a TKA performed for a 72-year-old woman with end-stage osteoarthritis of the right knee, ipsilateral hip arthrodesis, and leg-length discrepancy as the sequelae of slipped capital femoral epiphysis. We describe novel surgical positioning to be used to facilitate TKA in the absence of ipsilateral hip motion with bed modifications and the use of an extremity positioning device.
在既往有髋关节融合的情况下进行全膝关节置换术（TKA）很罕见，骨科文献中相关证据匮乏。传统上，TKA在仰卧位进行，借助膝关节定位装置，使髋关节能够屈曲，膝关节能够活动，以利于手术操作。然而，在同侧髋关节融合导致髋关节无法活动的情况下，采用传统定位进行TKA是不可能的。本病例报告描述了为一名72岁女性进行的TKA手术，该患者患有右膝终末期骨关节炎、同侧髋关节融合以及作为股骨头骨骺滑脱后遗症的腿长差异。我们描述了一种新颖的手术定位方法，通过床的改造和使用肢体定位装置，在同侧髋关节无法活动的情况下便于进行TKA。
