Xu Sheng-Ming, Li Wei, Zhang De-Bao, Bi Huang-Yi, Gu Gui-Shan
Department of Orthopedic Surgery, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China.
World J Clin Cases. 2022 Feb 26;10(6):1903-1908. doi: 10.12998/wjcc.v10.i6.1903.
Surgical treatment of knee osteoarthritis (KOA) complicated by extra-articular deformity has always been controversial regardless of whether it is simultaneous or staged. Simultaneous total knee arthroplasty (TKA) combined with supracondylar osteotomy without plate for treatment of KOA complicated by femoral varus deformity has not been reported in the literature.
A 53-year-old Chinese woman complained of left knee pain for 6 years that worsened for 4 mo during her visit on April 3, 2020, accompanied by instability in walking, which seriously affected quality of life. According to her medical history and preoperative imaging, the patient was diagnosed with left KOA with varus deformity. We used the angular center of rotation principle for osteotomy of the femur deformity and placed a poststabilized femur prosthesis into the knee joint. At the same time, a 13 mm × 130 mm femur extension rod was used instead of a steel plate to fix the end of the femur osteotomy, reducing the possible complications caused by steel plate implantation and reducing the economic burden on patients. The operation successfully solved two major problems of KOA and varus deformity, and the clinical and imaging evaluation of postoperative follow-up were satisfactory.
TKA and supracondylar femoral osteotomy can be used for simultaneous KOA treatment and deformity correction.
膝关节骨关节炎(KOA)合并关节外畸形的手术治疗,无论是同期还是分期进行,一直存在争议。同期全膝关节置换术(TKA)联合无钢板髁上截骨术治疗合并股骨内翻畸形的KOA,文献中尚未见报道。
一名53岁中国女性,主诉左膝疼痛6年,在2020年4月3日就诊时疼痛加重4个月,伴有行走不稳,严重影响生活质量。根据病史和术前影像学检查,患者被诊断为左膝KOA伴内翻畸形。我们采用股骨畸形旋转中心角原理进行截骨,并将后稳定型股骨假体植入膝关节。同时,使用一根13mm×130mm的股骨延长杆代替钢板固定股骨截骨端,减少了钢板植入可能引起的并发症,减轻了患者的经济负担。手术成功解决了KOA和内翻畸形两大问题,术后随访的临床及影像学评估结果满意。
TKA与股骨髁上截骨术可同期用于治疗KOA及矫正畸形。