An Unsuccessful Case of Hemireplacement of the Medial Knee with Tibial Sliding Osteotomy. A Large Defect-filling Method and the Possibility of a New Tibial Component.
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A 72-year-old female patient with severe OA in her left knee was treated by a hemireplacement procedure. A medial defect, over 2cm in size, was filled up thereby elevating the medial proximal half of the tibia. Moved tibial bone was fixed by a plate and cancellous bones were plugged to fill any gap.In the second month postoperatively, partial weight-bearing was initiated, and in the 3rd month the patient was permitted to fully weight-bear. Seven months postoperatively tibial bone between the tibial component and the plate was crushed, with the patient showing signs of severe instability but with no pain. However, she has recently developed gonalgia while walking, the most probable cause of which might be a fatigue fracture of the interposed tibial bone. At the stage when the patient did not feel any pain, while at the same time lowing crushed bone, we believe the tibial component was then on the tip of the plate.This suggested to us a new tibial component with the plate connected to the metal back. This could be used at revision surgery for the large tibial deficit.
- 西日本整形・災害外科学会の論文
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