Szerksznis Witold, Tramś Ewa, Kamiński Rafał, Grzelecki Dariusz
Department of Orthopedics and Rheumoorthopedics, Centre of Postgraduate Medical Education, Konarskiego 13, 05-400, Otwock, Poland.
Department of Musculoskeletal Trauma and Orthopaedics, Centre of Postgraduate Medical Education, Gruca Orthopaedic and Trauma Teaching Hospital, Otwock, Poland.
Orthopadie (Heidelb). 2025 Sep 5. doi: 10.1007/s00132-025-04719-3.
Performing a one-stage periarticular osteotomy in conjunction with total knee arthroplasty (TKA) constitutes a technically complex procedure. In such demanding cases, a personalized approach utilizing patient-specific instrumentation (PSI) may serve as an advantageous option to achieve optimal precision in bone cuts, thereby enhancing both clinical and radiological postoperative outcomes.
We present a case report of a 22-year-old man with multiple epiphyseal dysplasia (MED) resulting in knee osteoarthritis with complex femoral deformity and restricted (passive at 30-120° and active at 80-120°) range of movement (ROM). Simultaneous TKA and triplanar osteotomy with the use of PSI stabilized with the prosthesis stem was performed.
The treatment resulted in correct limb and implant positioning. The functional improvement and bone union were confirmed 1 year after TKA. The patient did not report any pain in the operated joints and achieved passive 0-120° and active 10-120° ROM of the operated right knee.
Although the latest reports do not demonstrate improved clinical outcomes for PSI in periarticular osteotomies and TKAs separately, we highlight the benefits of PSI in complex deformities, particularly in patients requiring a combination of these two methods.
在全膝关节置换术（TKA）的同时进行一期关节周围截骨术是一项技术复杂的手术。在这种高要求的病例中，采用患者特异性器械（PSI）的个性化方法可能是一种有利的选择，以实现截骨的最佳精度，从而提高术后临床和影像学效果。
我们报告一例22岁男性，患有多发性骨骺发育不良（MED），导致膝关节骨关节炎，伴有复杂的股骨畸形和活动范围受限（被动活动范围为30 - 120°，主动活动范围为80 - 120°）。采用PSI进行同步TKA和三平面截骨术，并使用假体柄进行固定。
治疗使肢体和植入物位置正确。TKA术后1年证实功能改善且骨愈合。患者未报告手术关节有任何疼痛，手术的右膝关节被动活动范围达到0 - 120°，主动活动范围达到10 - 120°。
尽管最新报告并未分别证明PSI在关节周围截骨术和TKA中能改善临床结果，但我们强调了PSI在复杂畸形中的益处, 特别是在需要联合这两种方法的患者中。
