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Case Reports
. 2024 May;14(5):78-82.
doi: 10.13107/jocr.2024.v14.i05.4440.

Bilateral Knee Arthrodesis and Total Hip Arthroplasty for Knee and Hip Dysplasia Secondary to Spina Bifida: A Case Report

Colin Neitzke  1   2 , Charles Gusho  3 , Austin Yu  4 , Joel Williams  4
Affiliations
Case Reports

Bilateral Knee Arthrodesis and Total Hip Arthroplasty for Knee and Hip Dysplasia Secondary to Spina Bifida: A Case Report

Colin Neitzke et al. J Orthop Case Rep. 2024 May.

Abstract

Introduction: Spina bifida is a rare neurological condition that, if uncorrected, may cause chronic valgus knee stress difficulty with independent ambulation and significant pain. Current literature lacks comprehensive guidance on surgically correcting progressive hip and knee deformities in spina bifida patients, which include osteotomy and primary. When these options are contraindicated, alternative approaches such as arthrodesis may be indicated, although they remain understudied in this population.

Case report: A 47-year-old man presented with bilateral hip and knee pain. Radiographs demonstrated valgus knee deformities with severe arthrosis and bilateral femoral head subluxation. The patient had a history of spina bifida with chronic lower extremity weakness and neurogenic bladder. He underwent staged bilateral instrumented knee arthrodesis and staged bilateral total hip arthroplasty (THA).

Conclusion: This is the first reported case of bilateral instrumented knee arthrodesis in a patient with spina bifida. Orthopedic care of these patients is complex. Surgical correction of symptomatic knee and hip deformities through instrumented arthrodesis and THA may permit an improved functional outcome.

Keywords: Spina bifida; instrumented knee arthrodesis; total hip arthroplasty.

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Conflict of interest statement

Conflict of Interest: Nil

Figures

Figure 1
Figure 1
Bilateral AP (A) radiograph of the knees with left lateral (B) and right lateral (C) knee radiographs demonstrating severe degenerative changes and arthrosis from spina bifida.
Figure 2
Figure 2
AP radiograph of the pelvis demonstrating severe dysplastic changes of the hips of a 44-year-old patient with spina bifida, which often arises in the setting of severe lumbosacral lesions.
Figure 3
Figure 3
Bilateral AP radiographs of the right (A) and left (B) knees demonstrating arthrodesis hardware in appropriate positions with appropriately healed surgical incisions.
Figure 4
Figure 4
AP radiograph of the pelvis demonstrating uncemented bilateral total hip arthroplasty with a single Dall-Miles cable transfixing a fracture of the left medial proximal femur.
See this image and copyright information in PMC

References

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