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单阶段初次全膝关节置换术中蛋壳样髌骨缺损的表面置换——病例报告

Resurfacing Egg-shell Patellar Defect in a Single-staged Primary total Knee Arthroplasty - A Case Report.

作者信息

Supreeth Sam, Yukata Kiminori, Suetomi Yutaka, Yamazaki Kazuhizo, Sakai Takashi, Fujii Hiroshi

机构信息

Department of Orthopaedic Surgery, Ogori Daiichi General Hospital, Yamaguchi, Japan.

Department of Orthopaedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan.

出版信息

J Orthop Case Rep. 2022 Sep;12(9):1-5. doi: 10.13107/jocr.2022.v12.i09.2990.

Abstract

INTRODUCTION

Patellofemoral biomechanics are a very critical factor for patient satisfaction after total knee arthroplasty. Patellar defects in a primary total knee arthroplasty are rare. We present a rare case of valgus deformed knee with an eroded egg-shell like patella managed with primary knee arthroplasty.

CASE REPORT

A 58-year-old female with bilateral knee pain for 35-years presented to us with a bilateral valgus knee. The knee range of movement was restricted more on the left side and severely restricting her activities of daily living. She had an egg-shell like eroded patellar defect in an osteoarthritic knee for which, she underwent primary total knee arthroplasty and patellar resurfacing with autologous bone graft harvested from the tibial cut bone.

CONCLUSION

We have presented a rare case of a combination of patellar defect in an Osteoarthritic knee which was managed by modified gapbalancing technique of TKA with a novel method of patellar resurfacing in a single stage with good functional results at 1-year postoperatively. This case improves our understanding of the management of such complex scenarios and, more importantly raises the questions our understanding and need of classification of such patellar defects in a primary arthritic knee.

摘要

引言

髌股生物力学是全膝关节置换术后患者满意度的一个非常关键的因素。初次全膝关节置换术中的髌骨缺损很少见。我们报告一例罕见的膝外翻畸形且髌骨呈蛋壳样侵蚀的病例,采用初次膝关节置换术进行治疗。

病例报告

一名58岁女性,双侧膝关节疼痛35年,前来就诊时存在双侧膝外翻。左侧膝关节活动范围受限更明显,严重限制了她的日常生活活动。她患骨关节炎的膝关节存在蛋壳样侵蚀性髌骨缺损,为此她接受了初次全膝关节置换术,并使用从胫骨截骨处获取的自体骨移植进行髌骨表面置换。

结论

我们报告了一例罕见的骨关节炎膝关节合并髌骨缺损的病例,通过改良的全膝关节置换间隙平衡技术和一种新颖的单阶段髌骨表面置换方法进行治疗,术后1年取得了良好的功能效果。该病例增进了我们对这类复杂情况治疗的理解,更重要的是,引发了我们对原发性关节炎膝关节中此类髌骨缺损的理解和分类需求的思考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fbb2/9983415/af860edcd434/JOCR-12-1-g001.jpg

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