Tsamassiotis Spiros, Windhagen Henning, Ettinger Max
Hannover Medical School, Department of Orthopaedic Surgery, Anna-Von-Borries Str. 1-7, 30625 Hannover, Germany.
Case Rep Surg. 2021 Jun 8;2021:9965640. doi: 10.1155/2021/9965640. eCollection 2021.
Charcot arthropathy of the knee is an extremely rare orthopedic disease that is very challenging for the treating physician and is associated with many complications, especially if it is occurring on both knees. Meanwhile, in the advanced stage, despite many potential complications, TKA is recognized as the gold standard. However, destruction of the medial tibial plateau is typical for the disease, which makes a stable anchorage of the prosthesis much more difficult. Therefore, we present a case in which sufficient primary stability could be achieved with an asymmetrical second-generation tibial cone with an anatomical design and implantation instruments adapted to the bony anatomy in the presence of severe tibial destruction on both sides. In the two-year follow-up, the patient showed good mobility and stability on both sides. In advanced Charcot arthropathy of the knee, the use of asymmetric tibial cones appears to be an appropriate solution for secure fixation and stability of the implant.
膝关节夏科氏关节病是一种极为罕见的骨科疾病，给治疗医生带来极大挑战，且伴有许多并发症，尤其是双膝发病时。同时，在疾病晚期，尽管存在诸多潜在并发症，但全膝关节置换术（TKA）仍被视为金标准。然而，内侧胫骨平台破坏是该疾病的典型特征，这使得假体的稳定锚固变得更加困难。因此，我们呈现了这样一个病例：在双侧胫骨严重破坏的情况下，使用具有解剖学设计的不对称第二代胫骨锥以及适配骨解剖结构的植入器械，实现了足够的初始稳定性。在两年的随访中，患者双侧膝关节均显示出良好的活动度和稳定性。在晚期膝关节夏科氏关节病中，使用不对称胫骨锥似乎是实现植入物牢固固定和稳定的合适解决方案。
