Posts

Total Knee Arthroplasty in Bilateral Severe Fixed Flexion Deformity: A Case Report

Vol. 10 | Issue 1 | January-February 2022 | Page: 22-25 | Rajesh S, Supreeth D R, Hemant K. Kalyan

DOI:10.13107/jkoa.2022.v10i01.047


Authors: Rajesh S [1], Supreeth D R [1], Hemant K. Kalyan [1]

[1] Department of Orthopaedic Surgery, Manipal Hospital, Bengaluru, Karnataka, India

Address of Correspondence

Dr. Supreeth D R,
Department of Orthopaedic Surgery, Manipal Hospital, Bengaluru, Karnataka, India.
E-mail: 18supreethdr@gmail.com


Abstract


Background: Severe bilateral Fixed flexion deformity of the knees resulting from irreversible joint damage is a disabling complication of long-standing rheumatoid arthritis, associated with loss of ambulatory ability. While Total knee Arthroplasty is an effective treatment for such patients, it poses significant intra-operative technical demands and challenges with post-operative rehabilitation.
Method: We report a case of Severe Fixed flexion deformity of both knees in a 46-year-old male with long-standing rheumatoid arthritis, non-ambulatory since 5 years, treated by sequential total knee arthroplasty.
Results: Treating Severe bilateral Fixed flexion deformities in a non-ambulatory patient by sequential total knee Arthroplasty using standard implants yielded complete deformity correction and pain-free restoration of active range of motion in both knees with stable independent ambulation and complete restoration of lower limb function within 3 months of surgery.
Conclusion: Our case is particularly remarkable for complete restoration of stable, pain-free restoration of ambulation within 3months in a patient with severe bilateral knee fixed flexion deformities who had been non-ambulatory for 5 years preceding his bilateral sequential total knee arthroplasty.
Keywords: Fixed flexion deformity, Total knee arthroplasty, Common peroneal nerve, Rheumatoid arthritis.


References


1. Lu H, Mehdi G, Zhou D, Lin J: Simultaneous bilateral total knee arthroplasty for rheumatoid arthritis. Chin Med J (Engl). 1996, 109 (12): 937- 940.
2. Giles R. Scuderi,Robert B. Bourne,Philip C. Noble,James B. Benjamin,Jess H. Lonner, W. N. Scott:The New knee society Scoring system Clin Orthop Relat Res. 2012 Jan; 470(1): 3–19.
3. Scuderi GR, Kochhar T: Management of flexion contracture in total knee arthroplasty. J Arthroplasty. 2007, 22 (4 Suppl 1): 20-24.
4. Ito J, Koshino T, Okamoto R, Saito T: 15-year follow-up study of total knee arthroplasty in patients with rheumatoid arthritis. J Arthroplasty. 2003, 18 (8): 984-992. DOI,10.1016/S0883-5403(03)00262-6.
5. Abe S, Kohyama K, Yokoyama H, Shigeru M, Yasuhiro T, Natsuko N, Yasuhiro S, Hiroyuki F: Total knee arthroplasty for rheumatoid knee with bilateral, severe flexion contracture: report of three cases. Mod Rheumatol. 2008, 18 (5): 499-506. DOI. 10.1007/s10165-008-0079-3. 9.
6. Massin P, Petit A, Odri G, Ducellier F, Sabatier C, Lautridou C, Cappelli M, Hulet C, Canciani JP, Letenneur J, Burdin P, Sociétéd’orthopédie de l’oues: Total knee arthroplasty in patients with greater than 20 degrees flexion contracture. Orthop Traumatol Surg Res. 2009, 95 (4 Suppl 1): S7-S12.
7. Sarokhan AJ, Scott RD, Thomas WH, Sledge CB, Ewald FC, Cloos DW: Total knee arthroplasty in juvenile rheumatoid arthritis. J Bone Joint Surg Am. 1983, 65 (8): 1071-1080.
8. Knutson K, Leden I, Sturfelt G, Rosen I, Lidgren L: Nerve palsy after knee arthroplasty in patients with rheumatoid arthritis. Scand J Rheumatol. 1983, 12 (3): 201-205. DOI.10.3109/03009748309098533.
9. Omeroglu H, Ozcelik A, Turgut A: Bilateral peroneal nerve palsy after simultaneous bilateral total knee arthroplasty. Report of a case with rheumatoid arthritis. Knee Surg Sports TraumatolArthrosc. 2001, 9 (4): 225-227. DOI, 10.1007/s001670100211.
10. Figgie HE, Brody GA, Inglis AE, Sculco TP, Goldberg VM, Figgie MP: Knee arthrodesis following total knee arthroplasty in rheumatoid arthritis. ClinOrthopRelat Res. 1987, 224: 237-243. 33
11. Smilowicz M: Problems involved in total knee arthroplasty for rheumatoid arthritis patients. OrtopTraumatolRehabil. 2000, 2 (4): 27-31.


How to Cite this article:  Rajesh S, Supreeth DR, Kalyan HK | Total Knee Arthroplasty in Bilateral Severe Fixed Flexion Deformity: A Case Report | Journal of Karnataka Orthopaedic Association | January-February 2022; 10(1): 22-25.

 


 


                                          (Abstract Text HTML)      (Download PDF)