Detaillierte Beitrags-Information
| Beitragstitel | Revision total knee arthroplasty in a patient with Charcot-Marie-Tooth disease. |
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| Beitragscode | P069 |
| Autoren | |
| Präsentationsform | Poster |
| Themengebiete |
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| Abstract |
Introduction Charcot-Marie-Tooth (CMT) disease is a rare hereditary neurodegenerative sensory-motor disorder affecting the peripheral nervous system. Total knee arthroplasty (TKA) in this particular patient cohort can be challenging. Furthermore, little is known about the long-term results and survivorship of TKA in these particular patients. Case report We hereby present a case of a seventy-two year old woman with Charcot-Marie-Tooth disease and bilateral distal muscle weakness with unstable and massively loose TKA with major tibial bone loss. The primary TKA surgery was twelve years ago. Postoperatively the radiographs showed a well-positioned and aligned TKA and the short-term evolution showed good functional improvement. However, the patient was referred with symptoms of invalidating pain and instability 12 years after primary surgery while the first symptoms gradually began 8 years after. The radiographic exams showed a massive prosthetic loosening with major bone loss on the femoral and tibial side. During revision surgery, significant metallosis, loosening of the femoral and tibial component and severe osteolysis of the tibial plateau was present. A one-stage revision was performed with a cemented semi-constrained TKA (Zimmer, LCCK), including augmentation of the proximal tibial metaphysis with tantalum support and additional bone graft. The patient recovered well and was able to discharge hospital 5 days after surgery. No complications were reported. At one year post-operatively, the patient showed a favorable course with an excellent functional outcome. Conclusion CMT disease is a rare condition that can mimic diabetic neuropathy and can cause secondary atrophy of the gastro-soleus complex, lower leg muscular imbalance and therefore be a major risk factor for TKA loosening. It is important to be aware of the increased complication risk performing TKA in patients with CMT disease. Revision surgery in such situation can be complex due to massive bone loss and instability due to muscle weakness. Even more, it is crucial to follow up these patients closely in order to detect potential complications early. In our case, the revision to a semi-constrained TKA showed an excellent functional result at 1 year after surgery. |