Ishibashi Teruya, Tomita Tetsuya, Tamaki Masashi, Fujito Toshitaka, Okada Seiji
Department of Orthopaedic Biomaterial Science, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
Morinomiya University of Medical Sciences, Graduate School of Health Sciences, Osaka, Japan.
Arthroplast Today. 2023 Jan 28;20:101099. doi: 10.1016/j.artd.2023.101099. eCollection 2023 Apr.
A 75-year-old woman presented with progressive bilateral knee pain and severe genu valgum. She could walk utilizing braces and T-canes, with a 20° flexion contracture and 150° of maximum flexion. During knee flexion, the patella laterally dislocated. Radiographs demonstrated severe bilateral lateral tibiofemoral osteoarthritis and patellar dislocation. She underwent posterior-stabilized total knee arthroplasty without patellar reduction. After implantation, the knee range of motion was 0°-120°. Intraoperative findings revealed that the affected patella was too small, low articular cartilage volume resulted in the diagnosis of nail patella syndrome with the tetrad of nail dysplasia, patella dysplasia, elbow dysplasia, and iliac horn. At the 5-year follow-up visit, she could walk without a brace and had a knee range of motion (10°-135°) with clinically favorable results.
一名75岁女性，出现双侧膝关节进行性疼痛和严重膝外翻。她借助支具和丁字拐行走，有20°的屈曲挛缩，最大屈曲度为150°。膝关节屈曲时，髌骨向外脱位。X线片显示双侧严重的外侧胫股关节炎和髌骨脱位。她接受了后稳定型全膝关节置换术，未进行髌骨复位。植入后，膝关节活动范围为0°至120°。术中发现患侧髌骨过小，关节软骨量低，诊断为指甲髌骨综合征，其特征为指甲发育异常、髌骨发育异常、肘部发育异常和髂骨角四联征。在5年随访时，她无需支具即可行走，膝关节活动范围为（10° - 135°），临床效果良好。
