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General Orthopaedics

TOTAL KNEE ARTHROPLASTY PLANED WITH PATIENT MATCHED INSTRUMENT WITH A COMPLICATION OF POLIOMYELITIS AFTER LANGENSKILD METHOD AND HIGH TIBIAL OSTEOTOMY

The International Society for Technology in Arthroplasty (ISTA), 27th Annual Congress. PART 2.



Abstract

A 51 years old female who experienced difficulty in gait ambulation due to secondary osteoarthritis of knee showed knee instability caused by paralysis associated with poliomyelitis and scoliosis. At the first medical examination, right knee range of motion was 0° to 90°, and spino malleolar distance (SMD) showed 72cm for the right leg, 78cm for the left leg, and the bilateral comparison of SMD indicated the leg length discrepancy of 6cm. The patient has a history of surgeries with an anterior – posterior instrument for the treatment of scoliosis, and with Langenskiöld method for the paralyzed right knee at the age of seventeen. The patient also experienced varus degeneration at the age of twenty seven, which was surgically treated with high tibial osteotomy. In this case, a reoperation of her right knee was performed due to the reoccurrence of the knee pain. Preoperative planning was performed using Patient-matched instrument (Signature; Biomet) which was created based on computed tomography data. Each part of osteotomy followed the resection guide by Signature, and a total knee arthroplasty was carried out using the Rotating Hinge Knee System (Zimmer, warsaw. Inc). Two week after the operation, the patient showed the ability to walk without any assistance, and has been in a good condition.


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