PMC7305351_01
Radiography of preoperative lower extremity.. A: Lower extremity scanogram showed more valgus anatomic axes (right: 12 , left 10 ) than normal range (6 +-3 ).. B: Osteoarthritis of both knees (Kellgren-Lawrence Grade III) are shown on lateral compartment and the tibial intercondylar eminence was absent in both knees. Both the medial and lateral condyles of the bilateral femurs as well as the femoral intercondylar notch were poorly developed.
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A lower extremity scannogram showed more valgus anatomic axes (right: 12 , left: 10 ) than normal (reference value: 6  +- 3 ) (Fig. 1A). Both knee standing radiographs showed joint space narrowing of the lateral compartment with osteoarthritis (right: Kellgren-Lawrence grade 3, left: Kellgren-Lawrence grade 3) and hypoplasia of the tibial intercondylar eminence and flat trochlea femoralis were also seen (Fig. 1B).
Physician-applied varus/valgus stress radiographs reveals lateral and medial compartment joint opening on the both knee and it indicated instability of both knees.. A: Right knee.. B: left knee.
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Physician-applied varus/valgus stress radiographs revealed lateral and medial compartment joint openings in both knees (Fig. 2).
There was no identifiable structure with the recognizable features of the anterior cruciate ligament.. A : T2 weighted sagittal MR image.. B: T2 weighted axial MR image.
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Magnetic resonance imaging (MRI) showed reduction of the cartilage thickness in the weight-bearing area of the lateral femoral condyle, a scarcely pronounced intercondylar notch and absence of the ACL (Fig. 3).
Radiography of both hips shows joint space loss, osteophyte formation, cyst formation and subchondral sclerosis.
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On both hip anteroposterior views, both hip joints showed severe osteoarthritis (right: K-L grade 4, left: K-L grade 4) (Fig. 4).
right hip and knee arthroplasty was performed, and in one year later, left hip and knee arthroplasty was implemented.. A: Pre-operative lower extremity scanogram. The pelvis is tilted to the right and osteoarthritis changes were observed on both sides of the hips and knees.. B: Post-operative lower extremity scanogram of total joint arthroplasty of the right knee and hip. After total arthroplasty of right hip and knee, the pelvis which had been tilted to the right was tilted slightly to the left then and valgus deformity was corrected when compared to the other side.. C: Post-operative lower extremity scanogram of the left total knee and hip arthroplasty. After surgery on both sides, the pelvis of both sides became balanced and the leg length was also almost no different.
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She underwent TKR and THR simultaneously (Fig. 5).