| Title: | Three-stage total knee arthroplasty combined with deformity correction and leg lengthening using Taylor spatial frames and conversion to internal fixation for severe intra- and extra-articular deformities and hypoplasia in a patient with hemophilic knee arthropathy : A case report |
| Authors: | Fukushima, Akira Browse this author |
| Iwasaki, Koji Browse this author →KAKEN DB |
| Hishimura, Ryousuke Browse this author |
| Matsubara, Shinji Browse this author |
| Joutoku, Zenta Browse this author |
| Matsuoka, Masatake Browse this author |
| Endo, Tomoyuki Browse this author |
| Onodera, Tomohiro Browse this author →KAKEN DB |
| Kondo, Eiji Browse this author →KAKEN DB |
| Iwasaki, Norimasa Browse this author →KAKEN DB |
| Keywords: | Hemophiliac knee arthropathy |
| Total knee arthroplasty |
| Femoral osteotomy |
| Taylor spatial frame |
| Knee |
| Issue Date: | Jan-2023 |
| Publisher: | Elsevier |
| Journal Title: | Knee |
| Volume: | 40 |
| Start Page: | 90 |
| End Page: | 96 |
| Publisher DOI: | 10.1016/j.knee.2022.10.009 |
| Abstract: | Background: Hemophilic arthropathy is a cause of severe knee deformity, because chronic synovitis due to repeated hemarthrosis affects the area of the epiphyseal plates in juvenile cases. Total knee arthroplasty (TKA) is the standard treatment for end-stage knee arthropathy. However, it is difficult to perform one-stage TKA in patients with severe intra- and extra-articular deformities. Case presentation: We reported a case of hemophilic arthropathy in a 55-year-old male with leg length discrepancy of 4 cm, limited range of knee motion (40 degrees extension and 85 degrees flexion), intra-articular deformity (medial proximal tibial angle: 69 degrees; mechanical lateral distal femoral angle: 79 degrees), extra-articular deformity at the distal femoral metaphyseal (30 degrees valgus and 45 degrees flexion deformity), and varus malalignment (% mechanical axis: 33%). We planned a three-stage TKA. Firstly, we performed gradual correction and lengthening of the distal femur using Taylor spatial flame. Six months after surgery, we performed conversion surgery from external fixation to internal fixation. Finally, we performed TKA with rotating hinged type implant. Two years after surgery, physical examination showed a normal gait, leg length discrepancy of 2 cm (the right leg was shorter), improvement in the range of knee motion (0 degrees extension and 100 degrees flexion). Conclusion: To the best of our knowledge, this presents the first combination of three-stage TKA with correction of femoral deformity and leg lengthening using a Taylor spatial frame and conversion to internal fixation in a patient with hemophilic knee arthropathy and severe intra- and extra-articular deformities. |
| Rights: | © 2022, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| Type: | article (author version) |
| URI: | http://hdl.handle.net/2115/91062 |
| Appears in Collections: | 医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
|
