PMC7301637_01
Pre-operative plain radiographs: (A) standing both lower limbs, (B) anteroposterior (AP), (C) lateral view, right knee.
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F1
Plain knee radiographs and magnetic resonance imaging (MRI) revealed severe arthritis of both lateral compartments and hypoplasia of the dislocated patellae (Figure 1).
Intra-operative clinical photographs, right knee: (A) anterior view, lateral condyle implant in situ (on lateral condyle), (B) anterior view, "medial condyle implant in situ (on lateral condyle)".
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F2
Intra-operatively, the lateral femoral implant did not conform to the morphology of the patient's lateral femoral condyle given the gross deformity present (Figure 2A). The implant sat well in the middle of the lateral femoral condyle, leading to appropriate bone coverage and an acceptable mechanical axis (Figure 2B).
Post-operative plain radiographs, right knee: (A) anterior view, (B) lateral view.
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F3
PMC7301637_02
Pre-operative plain radiographs: (A) standing bilateral, (B) AP view, right knee, (C) lateral view, right knee.
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F4
He had sustained trauma to both lower limbs several years earlier with fractures of both tibiae, his left femoral diaphysis, distal right femur and right patella (which was treated six years prior to his first presentation to the current authors' institution, with cerclage wiring) (Figure 4). Additionally, the right distal femur had a recurvatum deformity with lateral translation of the distal fracture fragment and there was evidence of patella baja (Figure 4).
Intra-operative clinical photographs, right knee with right-sided femoral implant in situ: (A) anterior view (knee in extension), (B) lateral view (knee in flexion), (C) view from above (knee in flexion) and "right knee with LEFT-sided femoral implant in situ": (D) anterior view (knee in extension), (E) anterior view (knee in flexion), (F) view from above (knee in flexion).
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F5
Intra-operatively, the right femoral implant trial was grossly mismatched relative to the distal femur due to the underlying post-traumatic deformity and lateral translation of the native distal femur due to fracture mal-union (Figures 5A-5C).
Post-operative plain radiographs: (A) standing both lower limbs, (B) AP, right knee, (C) lateral view, right knee, (D) merchant view, right knee.
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F6
Radiographs were satisfactory (Figure 6).