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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Knee Arthroplasty in Severe Varus Advanced Knee Osteoarthritis with Proximal Tibia Malunion: a case report
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Knee Arthroplasty in Severe Varus Advanced Knee Osteoarthritis with Proximal Tibia Malunion: a case report

机译：膝关节关节置换术在严重的Varus先进的膝关节骨关节炎，胫骨胫骨近端麻木：案例报告

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Alignment is crucial for successful knee arthroplasty.1 Tibia malunion will make arthroplasty more challenging. In this case, we present advanced knee osteoarthritis with tibia vara due to malunion that needs corrective osteotomy during knee arthroplasty. Case Presentation: A 70 years old female presented to our office complaining pain in both knees markedly on the left, profoundly felt during walking. She has a history of being hit by motorcycle 15 months ago and left knee was more bent since then. Physical examination of the left knee showed severe varus, mild effusion, tenderness on medial tibial condyle, otherwise normal. Plain radiographs showed advanced bilateral knee osteoarthritis with left proximal tibia malunion. Patient underwent left knee arthroplasty with corrective tibia and fibula osteotomy. Solutions and Outcome: Patient underwent closed wedge tibial osteotomy together with fibula osteotomy followed by knee arthroplasty with posterior-stabilized implant and tibial stem extension in a single surgery. Tibial osteotomy was reinforced using plate and screws. Partial weight bearing was achieved in second postoperative day and discharged on the third day. Patient able to walk with painless left knee after 1 month. Discussion: Severe deformity that causes huge malalignment makes knee arthroplasty difficult. Some methods are available to correct malalignment.1 In this case, the surgeon chose to do closed wedge tibial osteotomy reinforced with plate and screws to correct the proximal tibia malunion. Arthroplasty was done using posterior-stabilized implant and tibial stem extension. Patient shows good result in alignment and function. Conclusion: Correcting the associated deformity is crucial in achieving good alignment in knee arthroplasty. Even in our case of severe genu varus due to proximal tibia malunion, correcting proximal tibia varus deformity prior to knee arthroplasty shows good alignment and function. References: Mullaji AB, Padmanabhan V, Jindal G. Total Knee Arthroplasty for Profound Varus Deformity. 2005;20(5):550–61.
机译：对齐至关重要，成功膝关节成形术.1胫骨千原野洋将使关节造身术更具挑战性。在这种情况下，我们由于在膝关节置换术期间需要矫正骨质切开术而需要胫骨Vara先进的膝关节骨关节炎。案例介绍：70岁女性向我们的办公室呈现给我们的办公室，在左侧左侧抱怨疼痛，在左侧，深刻地感受到。她有15个月前由摩托车袭击的历史，从那时起，左膝就更加弯曲。左膝的体力检验显示严重的毒性，温和的积液，内侧胫骨髁的柔软，否则正常。普通射线照片显示出晚期双侧膝关节骨关节炎，左侧胫骨左侧胫骨骨质。病人接受了左膝关节形成术，矫正胫骨和腓骨骨质图。解决方案和结果：患者接受封闭的楔形骨质剖面术，与腓骨截骨术一起，其次是膝关节形成术，单个手术中的后稳定植入物和胫骨干延伸。使用板材和螺钉加强了胫骨骨质图。部分重量轴承在术后一天中实现，并在第三天出院。患者能够在1个月后用无痛的左膝关惯。讨论：严重的畸形，导致巨大的恶性肿油使膝关节置换术变得困难。一些方法可用于纠正恶性否则.1在这种情况下，外科医生选择闭合楔形骨质切除术，用板材和螺钉加固，以校正近端胫骨癣。使用后稳定的植入物和胫骨杆延伸完成关节成形术。患者在对齐和功能方面显示出良好的结果。结论：校正相关的畸形对于在膝关节置换术中实现良好的对准至关重要。即使在胫骨近端胫骨患者术后的严重现真差别的情况下，膝盖关节成形术之前纠正了近端的胫骨瓦鲁斯畸形显示出良好的对准和功能。参考文献：Mullaji AB，Padmanabhan V，Jindal G.全膝部关节置换术，用于深刻的缺斑畸形。 2005; 20（5）：550-61。

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