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全膝关节置换术联合使用利兹-庆应韧带加强内侧髌股韧带治疗伴有同侧外翻畸形和永久性髌骨脱位的“风扫畸形”:一例报告及文献综述

Total knee arthroplasty combined with medial patellofemoral ligament augmentation using a Leeds-Keio ligament for 'Windswept deformity' with ipsilateral valgus deformity and permanent patellar dislocation: A case report and a literature review.

作者信息

Kumahashi Nobuyuki, Kuwata Suguru, Takuwa Hiroshi, Uchio Yuji

机构信息

Department of Orthopedics, Shimane University, School of Medicine, 89-1 Enya-cho, Izumo-shi, Shimane, 693-8501, Japan.

出版信息

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.

Abstract

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'.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90af/8556479/4985a4a01982/gr1.jpg

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