Follet Louis, Verhelst Luc, Ghijselings Stijn, Liekens Koren
Department of Orthopaedics, Resident UZ Leuven, Leuven, Belgium.
Department of Orthopaedics, AZ St. Lucas Gent, Ghent, Belgium.
J Orthop Case Rep. 2023 Jan;13(1):81-86. doi: 10.13107/jocr.2023.v13.i01.3524.
We present a case report of a total hip arthroplasty (THA) in a patient with ipsilateral knee arthrodesis. The direct anterior approach (DAA) was used, and to our knowledge, this has never been described previously in the literature. The purpose of this report is to highlight pre-, per-, and post-operative challenges using the DAA in these rare cases.
This case report presents the case of a 77 year old female patient with degenerative hip disease in the presence of an ipsilateral arthrodesis of the knee. The patient was operated using the DAA. No complications were found and the patient had an excellent follow-up with a forgotten joint score of 93.75 at 1 year. The difficulty in this case consists in finding the correct stem anteversion with the altered knee anatomy. Using pre-operative templating on X-rays, intraoperative fluoroscopy and the posterior femoral neck the hip biomechanics could be restored.
We believe that THA in presence of an ipsilateral knee arthrodesis can be safely performed through a DAA.
我们报告一例同侧膝关节融合患者行全髋关节置换术（THA）的病例。采用了直接前路入路（DAA），据我们所知，此前文献中从未有过相关描述。本报告的目的是强调在这些罕见病例中使用DAA时术前、术中及术后所面临的挑战。
本病例报告介绍了一名77岁女性患者，患有退行性髋关节疾病且同侧膝关节融合。患者采用DAA进行手术。未发现并发症，患者随访情况良好，1年时遗忘关节评分为93.75。该病例的难点在于在膝关节解剖结构改变的情况下找到正确的假体柄前倾角。通过术前X线模板测量、术中透视以及股骨颈后方，髋关节生物力学得以恢复。
我们认为，同侧膝关节融合患者的THA可通过DAA安全实施。
