Sekeitto Allan Roy, van der Jagt Kaeriann, Sikhauli Nkhodiseni, van der Jagt Dick Ronald
Arthroplasty Unit, Division of Orthopaedic Surgery, Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, South Africa.
Arthroplasty. 2021 Apr 2;3(1):4. doi: 10.1186/s42836-020-00061-5.
A review of the literature revealed that only 9 total knee replacements were performed on patients with osteogenesis imperfecta (OI), with one being a revision procedure of a periprosthetic fracture. Of the 9 primary procedures, all used cemented prostheses, and 3 patients had an osteotomy at the same procedure. Our patient required a hinged prosthesis because of collateral ligament incompetence and is the first such case reported in the literature.
Presented here is a total knee replacement performed on a 52-year-old patient with osteogenesis imperfecta (OI) who injured her left knee and ruptured her anterior cruciate ligament. Her right knee suffered from severe degenerative changes with an incompetent medial collateral ligament. It was decided to replace the right knee before addressing the left knee injury. A hinged revision prosthesis was used. The smallest components available were used because of the small anatomical bony dimensions.
This is the first reported case of a hinged prosthesis and highlights the soft tissue component of osteogenesis imperfecta. We also highlight the technical problems with these patients, including mal-alignment, small bony dimensions and bone fragility.
文献回顾显示，仅对9例成骨不全（OI）患者进行了全膝关节置换术，其中1例为假体周围骨折的翻修手术。在这9例初次手术中，均使用了骨水泥固定假体，3例患者在同一手术中进行了截骨术。我们的患者因侧副韧带功能不全需要使用铰链式假体，这是文献中报道的首例此类病例。
本文介绍了一例对一名52岁成骨不全（OI）患者进行的全膝关节置换术，该患者左膝受伤，前交叉韧带断裂。她的右膝患有严重的退行性改变，内侧副韧带功能不全。决定在处理左膝损伤之前先置换右膝。使用了铰链式翻修假体。由于解剖学上的小骨尺寸，使用了可用的最小部件。
这是首例报道的铰链式假体病例，突出了成骨不全的软组织成分。我们还强调了这些患者的技术问题，包括对线不良、小骨尺寸和骨质脆弱。
