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

Fukushima, Akira; Iwasaki, Koji; Hishimura, Ryousuke et al.

Knee, 2023, 40, 90-96

Permalink : https://hdl.handle.net/2115/91062

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論文情報

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アクセス権
open access
URI
https://hdl.handle.net/2115/91062
タイトル
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
著者
Fukushima, Akira ; Iwasaki, Koji ; Hishimura, Ryousuke ; Matsubara, Shinji ; Joutoku, Zenta ; Matsuoka, Masatake ; Endo, Tomoyuki ; Onodera, Tomohiro ; Kondo, Eiji ; Iwasaki, Norimasa
著者名
Fukushima, Akira
e-Rad_Researcher
40771895
著者名
Iwasaki, Koji
著者名
Hishimura, Ryousuke
著者名
Matsubara, Shinji
著者名
Joutoku, Zenta
著者名
Matsuoka, Masatake
著者名
Endo, Tomoyuki
e-Rad_Researcher
70547174
著者名
Onodera, Tomohiro
e-Rad_Researcher
60374724
著者名
Kondo, Eiji
e-Rad_Researcher
30322803
著者名
Iwasaki, Norimasa
言語
英語
キーワード
Hemophiliac knee arthropathy
Total knee arthroplasty
Femoral osteotomy
Taylor spatial frame
Knee
発行日
2023-01
出版者
Elsevier
収録物名
Knee
巻(号)
40
ページ
90-96
抄録
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.
資源タイプ
学術雑誌論文
出版タイプ
Accepted Manuscript
権利情報
Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
権利情報
© 2022, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/
PISSN
0968-0160
関連情報 (isVersionOf)
出版社版DOI
https://doi.org/10.1016/j.knee.2022.10.009