Total knee arthroplasty with concurrent femoral and tibial osteotomies in osteogenesis imperfecta.
Three total knee arthroplasties (TKA) with concurrent femoral and/or tibial osteotomies in 2 patients with osteogenesis imperfecta were performed from 2004 to 2009. The 2 patients were followed for a mean of 6 years. One patient with concurrent TKA, and femoral and tibial osteotomies developed a nonunion of the tibial site that responded to open reduction and internal fixation with iliac crest bone graft. The second patient underwent right TKA with bi-level tibial osteotomies, which healed uneventfully, allowing pain free, unassisted ambulation. The same patient then elected to undergo left TKA with bi-level tibial osteotomies. Intraoperatively he sustained a minor tibial plateau fracture requiring the use of a stemmed component and postoperatively, he developed a nonunion at the proximal site and valgus malunion of the distal site. Revision of fixation was performed at both osteotomy sites, and both healed within 3 months. Both patients are now pain free and ambulate without assistance.
The University of North Texas Health Science Center, Department of Orthopaedic Surgery, John Peter Smith Hospital, Fort Worth, TX. rwagner@jpshealth.org.
Russell
R
Wagner
Colten
C
Luedke
D000328:Adult; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D016025:Bone Transplantation; D005269:Femur / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010013:Osteogenesis Imperfecta / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D013977:Tibia / Q000601:surgery*; D016896:Treatment Outcome