Madan Fatema, Alsooreti Ahmed, Guatteri Gianluca Cusma
Orthopedic Surgery Department, Salmaniya Medical Complex, Manama, Bahrain
Radiology Department, Salmaniya Medical Complex, Manama, Bahrain.
BMJ Case Rep. 2023 Apr 3;16(4):e252550. doi: 10.1136/bcr-2022-252550.
Post-traumatic arthritis can result in significant pain and difficulty in managing daily life activities. Multiple factors are weighed in selecting the proper surgical intervention, with patient age and level of activity being most important. Isolated osteoarthritis is a well-known indication for unicompartmental knee arthroplasty, where a better range of motion, preservation of natural knee kinematics and less invasive resection of knee joint bone are used. Moreover, the high improvement rate and long-term results after anterior cruciate ligament (ACL) reconstruction and restoration of knee stability can make the combined procedure favourable, particularly for young active patients.We report on an active man in his 30s presenting with isolated medial compartment advanced arthritis after sustaining distal femur intra-articular fracture. He was initially treated with partial unicompartmental knee replacement combined with ACL reconstruction, delivering a good short-term follow-up outcome.Though this case involves just a single patient, the positive outcome suggests that combined partial unicompartmental knee replacement with an ACL reconstruction should be considered for young and active patients diagnosed with isolated advanced medial compartment osteoarthritis.
创伤后关节炎可导致严重疼痛并给日常生活活动带来困难。在选择合适的手术干预措施时需要权衡多个因素，其中患者年龄和活动水平最为重要。孤立性骨关节炎是单髁膝关节置换术的一个众所周知的适应症，该手术具有更好的活动范围、保留自然膝关节运动学以及对膝关节骨进行侵入性较小的切除等优点。此外，前交叉韧带（ACL）重建后较高的改善率和长期效果以及膝关节稳定性的恢复，使得联合手术成为一种不错的选择，特别是对于年轻活跃的患者。我们报告了一名30多岁的活跃男性，在发生股骨远端关节内骨折后出现孤立性内侧间室重度关节炎。他最初接受了单髁膝关节置换联合ACL重建治疗，短期随访结果良好。虽然该病例仅涉及一名患者，但积极的结果表明，对于诊断为孤立性重度内侧间室骨关节炎的年轻活跃患者，应考虑单髁膝关节置换联合ACL重建手术。
