Meniscal injuries lead to changes in pressure distribution in the knee joint. The risk of developing gonarthrosis increases by the amount of resected meniscal tissue. Based on 4 MRI examinations conducted over an 8‑year time period, the present case report shows the progress of cartilage degeneration after a traumatic medial meniscus lesion and subsequent partial meniscus resection in a 46-year-old male patient. Congenital or accident-independent risk factors, such as a varus limb deformity must be considered during a medical report.
UNASSIGNED: Meniskusverletzungen führen zur Veränderung der Belastungsverteilung im Kniegelenk. Das Risiko, eine Gonarthrose zu entwickeln, steigt mit Zunahme der resezierten Meniskusfläche. Der Fallbericht zeigt, basierend auf 4 MRT-Untersuchungen, die über einen Zeitraum von 8 Jahren stattfanden, die fortschreitende Knorpeldegeneration nach traumatischer Innenmeniskusläsion und resultierender Teilresektion eines zum Unfallzeitpunkt 46-jährigen Patienten. Angeborene oder unfallunabhängige Risikofaktoren wie eine varische Beinachse müssen bei einer möglichen Begutachtung Berücksichtigung finden.

BACKGROUND: When a conservative management of gonarthrosis yields unsatisfactory results, a total knee arthroplasty (TKA) is recommended as an alternative approach. The implant survival is crucial for the long-term success of the procedure. However, in case of patients with retained hardware after past orthopedic procedures, providing correct alignment of the implant, which contributes to its longevity, is especially challenging. Here we present the use of an intra-operative ultrasonography for implant positioning in a 83-year-old male, undergoing TKA, without hardware removal, which was contraindicated due to his advanced age and comorbidities. Other imaging modalities taken into consideration are also described.
METHODS: The right knee joint was approached with anterior incision. A femoral guide was introduced extramedullary. Ultrasonography was used to pinpoint the center of the femur\'s head. Tibial\'s guide was introduced intramedullary followed by a standard cut of the proximal part. Cemented ZIMMER NEXGEN prosthesis was used. Layered closure was applied. The placement of implant in neutral axis was confirmed on radiographs.
CONCLUSIONS: Our case demonstrates that ultrasonography might be helpful during TKA-procedure for implant positioning. However, more studies are needed to evaluate accuracy and application of ultrasound in the intraoperative settings.