Overcoming the Technical Challenges of Total Knee Arthroplasty in Patients Affected by Hereditary Multiple Exostoses: a Case Report and Literature Review
نویسندگان
چکیده
Abstract Hereditary multiple exostoses (HME), also known as familiar osteochondromatosis or diaphyseal aclasis, are an autosomal dominant inherited genetic pathology that is characterized by the presence of benign osteochondromas. Knee deformity common in patients with HME, nearly a third developing genu valgus. Total knee arthroplasty (TKA) has been used to correct valgus deformities advanced osteoarthritis (OA). However, concomitant limb and altered anatomy make this surgery particularly challenging. We present case report mini-review literature on topic. 50-year-old Caucasian woman, affected hereditary exostoses, who came our attention for progressive pain right knee. Upon further examination, had prominent alignment, instability, flexion contraction. The patient was treated total using semi-constrained design. re-evaluated at 24-month follow-up, there were no signs implant loosening, function improved significantly, very satisfied. Given recurring technical difficulties such procedure these patients, we describe experience well need preoperative planning, use appropriate constraint when required, high frequency ligament bony defects, patellar maltracking. TKA must be considered necessary, good excellent clinical results can achieved maintained, allowing significant improvements quality life. Core Tips - HME-affected carries specific but manageable challenges. Due bone frequent severe should even younger patients. Revision implants provide flexibility necessary fixation, not always achievable primary implants. Bigger size components may HME compared same height. Lateral releases often due long-standing deformity. If stability cannot achieved, hinged considered. Cementation metaphysis sleeves additional rotational implant.
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ژورنال
عنوان ژورنال: SN Comprehensive Clinical Medicine
سال: 2022
ISSN: ['2523-8973']
DOI: https://doi.org/10.1007/s42399-022-01333-8