胫骨髁外翻截骨术治疗髋关节置换术后同侧膝骨性关节炎。

IF 0.4 Q4 ORTHOPEDICS Case Reports in Orthopedics Pub Date : 2021-10-29 eCollection Date: 2021-01-01 DOI:10.1155/2021/6443618
Daisuke Fukuhara, Hiroaki Inoue, Shuji Nakagawa, Yuji Arai, Kenji Takahashi
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摘要

我们报告一例胫骨髁外翻截骨术(TCVO)治疗髋关节置换术后同侧膝骨关节炎(OA)。一位58岁的女性在一个月大时患了右侧脓性髋关节关节炎,并在16岁时接受了右侧髋关节融合术。她在57岁时因右膝关节疼痛加重而来我科就诊。右膝屈伸活动范围分别为80°和-5°,内侧负重疼痛。x线平片示右膝关节终末期膝关节炎伴胫骨内骨缺损,胫骨平台形状为宝塔型。应力摄影显示右膝明显不稳定,外翻9°,内翻7°。她在右膝上进行了TCVO,手术后四周允许全负荷。术后9个月计算机断层扫描显示骨愈合。术后2年无矫正损失,可独立行走,无疼痛感。一般来说,全膝关节置换术(TKA)适用于终末期膝关节OA;然而,也存在一些问题,如髋关节OA后由于膝关节机械负荷增加而导致的早期松动。在本例中,由于获得了良好的疗程,TCVO被认为是髋关节置换术后终末期膝关节OA的治疗选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Tibial Condyle Valgus Osteotomy for Ipsilateral Knee Osteoarthritis after Hip Arthrodesis.

We report a case of tibial condylar valgus osteotomy (TCVO) for ipsilateral knee osteoarthritis (OA) after hip arthrodesis. A 58-year-old woman developed right purulent hip arthritis at one month of age and underwent right hip fusion at 16 years old. She visited our department at the age of 57 because her right knee joint pain worsened. The range of motion for her right knee was 80° and -5° of flexion and extension, respectively, and she experienced medial weight-bearing pain. A plain X-ray image showed that the right knee joint had end-stage knee OA with a bone defect inside the tibia, and the tibial plateau shape was the pagoda type. There was a marked instability in her right knee with a valgus of 9° and varus of 7° on stress photography. She underwent TCVO on her right knee and was allowed full load four weeks after surgery. Computed tomography imaging showed bone union nine months after surgery. Two years after the operation, there was no correction loss, and she could walk independently without pain. In general, total knee arthroplasty (TKA) is indicated for end-stage knee OA; however, there are problems, such as early loosening due to the increased mechanical load on the knee after hip OA. In this case, since a good course was obtained, TCVO is considered a treatment option for terminal knee OA after hip arthrodesis.

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