Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 26, 2022; 10(6): 1903-1908
Published online Feb 26, 2022. doi: 10.12998/wjcc.v10.i6.1903
Modified treatment of knee osteoarthritis complicated with femoral varus deformity: A case report
Sheng-Ming Xu, Wei Li, De-Bao Zhang, Huang-Yi Bi, Gui-Shan Gu
Sheng-Ming Xu, Wei Li, De-Bao Zhang, Huang-Yi Bi, Gui-Shan Gu, Department of Orthopedic Surgery, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Author contributions: Xu SM and Gu GS designed the work. Gu GS, Xu SM, Zhang DB, and Li W performed the surgery; Xu SM, Zhang DB, Li W, and Bi HY performed the data acquisition; Xu SM analyzed and interpreted the patient data; Xu SM was responsible for the primary manuscript generation; Gu GS substantively revised it; all authors read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016)
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gui-Shan Gu, MD, Professor, Department of Orthopedic Surgery, The First Hospital of Jilin University, No. 71 of Xinmin Street, Changchun 130021, Jilin Province, China. gugs@jlu.edu.cn
Received: July 20, 2021
Peer-review started: July 20, 2021
First decision: October 16, 2021
Revised: October 29, 2021
Accepted: January 11, 2022
Article in press: January 11, 2022
Published online: February 26, 2022
Abstract
BACKGROUND

Surgical treatment of knee osteoarthritis (KOA) complicated by extra-articular deformity has always been controversial regardless of whether it is simultaneous or staged. Simultaneous total knee arthroplasty (TKA) combined with supracondylar osteotomy without plate for treatment of KOA complicated by femoral varus deformity has not been reported in the literature.

CASE SUMMARY

A 53-year-old Chinese woman complained of left knee pain for 6 years that worsened for 4 mo during her visit on April 3, 2020, accompanied by instability in walking, which seriously affected quality of life. According to her medical history and preoperative imaging, the patient was diagnosed with left KOA with varus deformity. We used the angular center of rotation principle for osteotomy of the femur deformity and placed a poststabilized femur prosthesis into the knee joint. At the same time, a 13 mm × 130 mm femur extension rod was used instead of a steel plate to fix the end of the femur osteotomy, reducing the possible complications caused by steel plate implantation and reducing the economic burden on patients. The operation successfully solved two major problems of KOA and varus deformity, and the clinical and imaging evaluation of postoperative follow-up were satisfactory.

CONCLUSION

TKA and supracondylar femoral osteotomy can be used for simultaneous KOA treatment and deformity correction.

Keywords: Knee osteoarthritis, Varus deformity, Same-stage, Total knee arthroplasty, Osteotomy, Case report

Core Tip: Knee osteoarthritis (KOA) with extra-articular deformities is a common disease, but the choice of surgical methods has always been controversial. The use of total knee arthroplasty alone to achieve the purpose of extra-articular osteotomy and treatment of KOA at the same stage has been rarely reported in the literature. After the operation, the varus deformity was well corrected and the force lines of lower extremities were basically aligned. The follow-up results showed that the prosthesis was firmly fixed and the unstable walking function was significantly improved. This method provides a feasible choice for the surgical treatment of KOA with extra-articular deformity.