University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
Trauma and Orthopaedic Surgery, Ninewells Hospital and Medical School, Dundee, UK.
BMJ Case Rep. 2022 Dec 5;15(12):e252080. doi: 10.1136/bcr-2022-252080.
We present the case of a man in his 60s with a transtibial amputation (TTA) undergoing total knee replacement (TKR) for symptomatic osteoarthritis (OA). It is unusual to develop OA in the ipsilateral knee to TTA; and while it is postulated that this is because patients preferentially load their unaffected limb to protect the TTA-sided knee, there is also the ability to offload specific knee compartments through prosthetic adjustment. When planning TKR in such patients, it is important to consider several technical challenges in order to prevent a poor outcome. The literature is sparse with evidence to guide decision-making, and this case report and literature review aims to summarise our preoperative planning and intraoperative technique, which ultimately resulted in a good outcome.
我们报告了一例 60 多岁的男性患者，因症状性骨关节炎（OA）接受全膝关节置换术（TKR）。在同侧膝关节发生创伤性膝关节切除（TTA）后发生 OA 是不常见的；虽然有人推测这是因为患者更喜欢使用未受影响的肢体来保护 TTA 侧膝关节，但也可以通过假体调整来减轻特定膝关节腔的负荷。在对这类患者进行 TKR 规划时，需要考虑一些技术挑战，以防止手术效果不佳。相关文献证据有限，难以指导决策，本病例报告和文献复习旨在总结我们的术前规划和术中技术，这些措施最终带来了良好的手术效果。
