PMC4673322_01
Preoperative condition. (a, b) Anteroposterior and lateral X-P (plain X-ray or roentgenography) of the knee showing partial pseudarthrosis of the knee and varus deformity of the joint. (c) Clinical photo of the patient shows marked bowing.
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fig1
X-rays were taken and revealed marked arthritic changes in an almost pseudoarthrotic knee joint (Figure 1).
Preoperative planning. (a, b) Examination under anesthesia showing ROM 0-25 . (c) Anteromedial approach.
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fig2
In 2005, the surgery was performed under general anesthesia and excision of the arthrodesis via an anteromedial approach was carried out (Figure 2).
Intraoperative photos. (a) Pseudarthrosis of the arthrodesed knee joint. (b) Soft tissue closure, that is, repair of the medial patellofemoral ligament and release of the lateral retinaculum. (c) Skin closure after desarthrodesis, with a separate lateral incision for release.
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fig3
Skin closure was feasible without tension (Figures 3(b) and 3(c)).
Last follow-up X-P. (a, b) X-P of the knee joint after arthroplasty, 10 years after surgery. (c, d) Whole leg standing X-P showing improvement of the mechanical axis and LLD.
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fig4
His flexion ROM has improved to 90-100 , he has no pain, and he walks independently with no brace or contractures (Figures 4 and 5).
Last follow-up clinical photo. (a) Clinical photo in maximum flexion of the knee joint (about 100 ). (b) Clinical photo in maximum extension of the knee joint (about 0 ).
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fig5
His flexion ROM has improved to 90-100 , he has no pain, and he walks independently with no brace or contractures (Figures 4 and 5).