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Case Reports
. 2021 Jul 8;14(7):e242909.
doi: 10.1136/bcr-2021-242909.

Total knee arthroplasty in a young patient with achondroplasia

Hassan Zmerly  1   2 , Marco Russo  3 , Manuela Moscato  3 , Ibrahim Akkawi  4
Affiliations
Case Reports

Total knee arthroplasty in a young patient with achondroplasia

Hassan Zmerly et al. BMJ Case Rep. .

Abstract

Achondroplasia is a genetic skeletal dysplasia, characterised by dwarfism, with upper and lower limb deformities, that can lead to knee osteoarthritis; the surgical treatment is a challenge due to the particular joint anatomy variances. We present a 40-year-old woman, affected by achondroplasia with severe left knee osteoarthritis; the patient was treated conservatively with poor results. Between the ages of 12 and 17 years, she underwent multiple operative procedures for lower limb lengthening and a partial correction of the valgus deformity, by applying an external fixator. The patient was successfully treated with cemented posterior stabilised, fixed-bearing, total knee arthroplasty. The patient affected by achondroplasia, with severe knee osteoarthritis, should be considered for total joint replacement, which can be carried out with or without additional extra-articular osteotomy for alignment correction. Due to skeletal dysplasia in joint deformities, knee replacement requires careful preoperative planning and special technical considerations.

Keywords: degenerative joint disease; orthopaedic and trauma surgery; osteoarthritis.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
(A, B) Preoperative X-ray images showing valgus knee osteoarthritis, with epiphysial deformities and metaphyseal angulation.
Figure 2
Figure 2
Surgical procedure; intraoperative view of articular degenerative change (A) and the definitive implant (B).
Figure 3
Figure 3
(A, B) Postoperative X-ray showing accurate placement of definitive implant.
See this image and copyright information in PMC

References

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