PDF(Pubmed)
Abstract：
BACKGROUND: Neuroarthropathy of the knee or Charcot knee, leading to chronic joint destruction, is a rare disease that is difficult to diagnose. The treatment of this condition is difficult and controversial.
METHODS: A 74-year-old Asian woman has had bilateral knee pain for 22 years and deformity for 10 years, which has been aggravating for 2 months. Physical examination showed bilateral knee varus deformity greater than 15°, and -20 to 90° range of motion. X-ray revealed bilateral varus deformity with massive free body hyperplasia. Combined with medical history as syringomyelia, the patient was diagnosed with bilateral Charcot knees and bilateral joint replacements were performed using Legacy Constrained Condylar Knee prostheses (LCCK; Zimmer, USA). The patient reported satisfactory treatment outcomes, pain relief, and improved range of motion in both knees, without postoperative complications or prosthesis loosening at 2 year after operation.
CONCLUSIONS: Total knee arthroplasty (TKA) may be considered a viable option for treating the Charcot knee. The use of constrained condylar prostheses can produce satisfactory results. Attention should be given to survival risks, complications, and other potential determining factors associated with TKA when devising a treatment strategy for the Charcot knee.
METHODS: A 74-year-old Asian woman has had bilateral knee pain for 22 years and deformity for 10 years, which has been aggravating for 2 months. Physical examination showed bilateral knee varus deformity greater than 15°, and -20 to 90° range of motion. X-ray revealed bilateral varus deformity with massive free body hyperplasia. Combined with medical history as syringomyelia, the patient was diagnosed with bilateral Charcot knees and bilateral joint replacements were performed using Legacy Constrained Condylar Knee prostheses (LCCK; Zimmer, USA). The patient reported satisfactory treatment outcomes, pain relief, and improved range of motion in both knees, without postoperative complications or prosthesis loosening at 2 year after operation.
CONCLUSIONS: Total knee arthroplasty (TKA) may be considered a viable option for treating the Charcot knee. The use of constrained condylar prostheses can produce satisfactory results. Attention should be given to survival risks, complications, and other potential determining factors associated with TKA when devising a treatment strategy for the Charcot knee.
摘要：
背景：膝关节或Charcot膝关节的神经关节病，导致慢性关节破坏，是一种难以诊断的罕见疾病。这种情况的治疗是困难和有争议的。
方法：一名74岁的亚裔女性患双侧膝关节疼痛22年，畸形10年，已经加重了两个月。体格检查显示双侧膝内翻畸形大于15°，和-20到90°的运动范围。X线示双侧内翻畸形伴大量游离体增生。结合脊髓空洞症的病史，该患者被诊断为双侧Charcot膝关节，并使用Legacy约束髁膝关节假体进行了双侧关节置换（LCCK；Zimmer，美国）。患者报告治疗结果令人满意，疼痛缓解,改善了双膝的活动范围，术后2年无并发症或假体松动。
结论：全膝关节置换术（TKA）可能被认为是治疗Charcot膝关节的可行选择。使用约束髁假体可以产生令人满意的结果。应注意生存风险，并发症,以及设计Charcot膝关节治疗策略时与TKA相关的其他潜在决定因素。
方法：一名74岁的亚裔女性患双侧膝关节疼痛22年，畸形10年，
结论：全膝关节置换术（TKA）可能被认为是治疗Charcot膝关节的可行选择。
