Kumahashi Nobuyuki, Kuwata Suguru, Takuwa Hiroshi, Uchio Yuji
Department of Orthopedics, Shimane University, School of Medicine, 89-1 Enya-cho, Izumo-shi, Shimane, 693-8501, Japan.
Asia Pac J Sports Med Arthrosc Rehabil Technol. 2021 Oct 25;26:53-57. doi: 10.1016/j.asmart.2021.07.001. eCollection 2021 Oct.
We present a 'Windswept deformity' in patient who had osteoarthritis with a mild varus and very severe valgus with ipsilateral permanent patellar dislocation. An 83-year-old woman could not walk for the past a few years due to bilateral knee pain. The femorotibial angle was 196° in the right knee pre-operatively and 134° in the left knee with permanent patellar dislocation. She underwent a staged total knee arthroplasty (TKA) for the right knee, and a semi-constrained TKA for the left knee with medial patellofemoral ligament (MPFL) augmentation using a Leeds-Keio (LK) ligament. At the final follow-up three years after surgery, bilateral knee pain and the extension lag had disappeared and range of motion (ROM) was 0° in extension and 130° in flexion for both knees without patellar re-dislocation. This clinical case indicates that the unconstrained and semi-constrained type of TKA combined with the MPFL augmentation using an LK ligament is effective to treat a 'Windswept deformity'.
我们报告了一例患有骨关节炎的患者出现“风扫畸形”,其表现为轻度内翻和同侧非常严重的外翻,并伴有永久性髌骨脱位。一名83岁女性因双侧膝关节疼痛,在过去几年无法行走。术前右膝股胫角为196°,左膝为134°,伴有永久性髌骨脱位。她接受了分期全膝关节置换术(TKA)治疗右膝,并接受了半限制性TKA治疗左膝,同时使用利兹 - 庆应义塾(LK)韧带加强内侧髌股韧带(MPFL)。术后三年的最终随访时,双侧膝关节疼痛和伸直滞后消失,双膝伸直位活动范围(ROM)为0°,屈曲位为130°,且无髌骨再次脱位。该临床病例表明,非限制性和半限制性TKA联合使用LK韧带加强MPFL对治疗“风扫畸形”有效。