Lateral Unicompartmental knee arthroplasty for a secondary osteonecrosis of the lateral femoral condyle. A case report
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(2020) 21:585
CASE REPORT
Open Access
Lateral Unicompartmental knee arthroplasty for a secondary osteonecrosis of the lateral femoral condyle. A case report Tao Yang, Huaming Xue, Tong Ma, Tao Wen, Long Xue, Mengyin Guan and Yihui Tu*
Abstract Background: Secondary osteonecrosis of the knee is a rare event. There are few reports regarding management of this condition. The aim of the present study is to report treatment outcomes for secondary osteonecrosis of the lateral condyle treated with unicompartmental knee arthroplasty (UKA). Case presentation: A 54-year-old woman with idiopathic thrombocytopenic purpura, who received low-dosage corticosteroids, complained of knee pain for 5 years and difficulty walking in the last 5 months. Fixed-bearing lateral UKA was performed under general anesthesia combined with midthigh saphenous nerve block. The patient could walk without ambulation aid shortly after the operation and achieved satisfactory knee joint function at the 6-week follow-up. The knee society score (KSS) increased from 68 to 91. The follow-up period was up to 1 year. There was no pain, loosening, or fracture of the prosthesis at the latest follow-up. Conclusions: This case study demonstrates successful management of secondary osteonecrosis of the lateral femoral condyle is possible with a fixed bearing lateral UKA. Early diagnosis, rigorous indication, and appropriate surgical techniques were critical to maximizing prosthesis stability in lateral UKA. Keywords: Lateral unicompartmental knee arthroplasty, Secondary osteonecrosis of the knee, Surgical methods, Case report
Background Osteonecrosis of the knee was firstly described by Ahlbäck in 1968 and had been delineated into three categories: spontaneous osteonecrosis of the knee, secondary and post-arthroscopic [1, 2]. The incidence of secondary osteonecrosis of the knee is approximately 10% that of hip osteonecrosis [3]. Dissimilar to spontaneous osteonecrosis that is mainly affecting the medial femoral condyle, secondary osteonecrosis may involve both femoral condyles, as well as the epiphysis, diaphysis, and * Correspondence: [email protected] Department of Orthopedic Surgery, Yangpu Hospital, Tongji University School of Medicine, Shanghai 200090, China
metaphysis of the involved femur and/or tibia. Often, these patients have osteonecrosis of other large joints. Recent studies reported that the femur was affected in ≤90% of cases, and > 80% of patients have bilateral disease and/or other joint involvement [2, 4]. It is more prevalent in younger patients and approximately 90% of all occurrences of secondary osteonecrosis of the knee are associated with alcohol abuse and the use of corticosteroids [3]. Unicompartmental knee arthroplasty (UKA) is considered one of the most effective treatments for knee osteonecrosis relive pain and maintain native knee kinematics [4–7]. Advantages of UKA include faster recovery, better
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits
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