Computer-assisted total bilateral knee arthroplasty for a patient with severe hyperextension in residual poliomyelitis: a case report

Abstract

Background. Total knee arthroplasty in patients in the residual stage of poliomyelitis is a technically difficult job. The reasons for this are anatomical features and therefore difficulties in an implant choice and conflicting results. In the present case report, we describe a unique method of a computer-navigated installation of a rotating-hinge implant in a non-standard position for a patient with residual poliomyelitis.

The aim of the study is to demonstrate a method of a computer-navigated installation of rotating-hinge knee implants in a patient with severe hyperextension and valgus deformity in the residual stage of poliomyelitis.

Case description. The clinical case presents a 55-year-old man with lower peripheral paraparesis as a consequence of poliomyelitis and bilateral valgus knee arthritis with severe hyperextension. The patient moved on crutches at a distance no more than 300 meters. Two-stage total knee arthroplasty was performed using a navigation system and second-generation rotating-hinge implants. At the 4-year follow-up period, we note a good clinical result, and the patient is satisfied with the total knee arthroplasty outcomes.

Conclusion. The clinical case demonstrates good results of performing total knee arthroplasty in a patient with bilateral severe hyperextension and knee valgus deformity in residual poliomyelitis. Having analyzed available topic-related literature, we developed an original method of a computer-navigated installation of a second-generation rotating-hinge implant. The method can be an effective treatment solution for patients with knee arthritis deformity in the residual stage of poliomyelitis.

Keywords

total knee arthroplasty / poliomyelitis / hyperextension / valgus deformity / computer navigation

References

[1] Дроздов С.Г., Иванова О.Е. Полиомиелит. Вопросы вирусологии. 2013;(1):76-90. Drozdov S.G., Ivanova O.E. Poliomyelitis. Problems of Virology. 2013;(1):76-90. (In Russian).

[2] Prasad A., Donovan R., Ramachandran M., Dawson-Bowling S., Millington S., Bhumbra R. et al. Outcome of total knee arthroplasty in patients with poliomyelitis: A systematic review. EFORT Open Rev. 2018 (6):358-362. doi: 10.1302/2058-5241.3.170028.

[3] Compston A. Aids to the investigation of peripheral nerve injuries. Medical Research Council: Nerve Injuries Research Committee. His Majesty’s Stationery Office: 1942; pp. 48 (iii) and 74 figures and 7 diagrams; with aids to the examination of the peripheral nervous system. By Michael O’Brien for the Guarantors of Brain. Saunders Elsevier: 2010; pp. [8] 64 and 94 Figures. Brain. 2010;133(10):2838-2844. doi: 10.1093/brain/awq270.

[4] Иржанский А.А., Куляба Т.А., Корнилов Н.Н. Валидация и культурная адаптация шкал оценки исходов заболеваний, повреждений и результатов лечения коленного сустава WOMAC, KSS и FJS-12. Травматология и ортопедия России. 2018;24(2):70-79. doi: 10.21823/2311-2905-2018-24-2-70-79. Irzhanski A.A., Kulyaba T.A., Kornilov N.N. Validation and cross-cultural adaptation of Rating Systems WOMAC, KSS and FJS-12 in patients with knee disorders and Injuries. Traumatology and Orthopedics of Russia. 2018;24(2):70-79. (In Russian). doi: 10.21823/2311-2905-2018-24-2-70-79.

[5] Patterson B.M., Insall J.N. Surgical management of gonarthrosis in patients with poliomyelitis. J Arthroplasty. 1992; (7) Suppl:419-426. doi: 10.1016/s0883-5403(07)80034-9.

[6] Moran M.C. Functional loss after total knee arthroplasty for poliomyelitis. Clin Orthop Relat Res. 1996;(323): 243-246. doi: 10.1097/00003086-199602000-00033.

[7] Jordan L., Kligman M., Sculco T.P. Total knee arthroplasty in patients with poliomyelitis. J Arthroplasty. 2007;22(4):543-548. doi: 10.1016/j.arth.2006.03.013.

[8] Tigani D., Fosco M., Amendola L., Boriani L. Total knee arthroplasty in patients with poliomyelitis. Knee. 2009;16(6):501-506. doi: 10.1016/j.knee.2009.04.004.

[9] Rahman J., Hanna S.A., Kayani B., Miles J., Pollock R.C., Skinner J.A. et al. Custom rotating hinge total knee arthroplasty in patients with poliomyelitis affected limbs. Int Orthop. 2015;39(5):833-838. doi: 10.1007/s00264-014-2572-y.

[10] Mullaji A., Lingaraju A.P., Shetty G.M. Computer-assisted total knee replacement in patients with arthritis and a recurvatum deformity. J Bone Joint Surg Br. 2012; 94(5):642-647. doi: 10.1302/0301-620X.94B5.27211.

[11] Krackow K.A., Weiss A.P. Recurvatum deformity complicating performance of total knee arthroplasty. A brief note. J Bone Joint Surg Am. 1990;72(2):268-271.

[12] Barrack R.L. Evolution of the rotating hinge for complex total knee arthroplasty. Clin Orthop Relat Res. 2001;(392):292-299. doi: 10.1097/00003086-200111000-00038.

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