Knee disarticulation following oncologic total knee arthroplasty: A 5-year follow-up case report.
Amputation
Biomechanics
Ewing sarcoma
Knee disarticulation
Total knee arthroplasty
Journal
Clinical biomechanics (Bristol, Avon)
ISSN: 1879-1271
Titre abrégé: Clin Biomech (Bristol, Avon)
Pays: England
ID NLM: 8611877
Informations de publication
Date de publication:
04 2022
04 2022
Historique:
received:
16
09
2021
revised:
21
02
2022
accepted:
23
02
2022
pubmed:
7
3
2022
medline:
28
4
2022
entrez:
6
3
2022
Statut:
ppublish
Résumé
The present case report describes the 5-year follow-up results of an atypical knee disarticulation of a man previously treated with an oncologic total knee arthroplasty due to an Ewing sarcoma. The patient presented an aseptic loosened tibial component of a tumor prosthesis system and requested final amputation, as he had previously suffered from five revision surgeries. To encourage the most functional outcome regarding an exoskeletal prosthesis, we decided to disarticulate the knee joint while retaining the currently fixed femoral component to create a full end-bearing stump. The patient could be mobilized as a functional knee disarticulated amputee. Seven months after amputation, he showed a slightly less symmetrical gait compared to the preoperative status (preoperative mean Symmetry Index: 0.984 for kinematics and 0.940 for kinetics, 7-month postoperative Symmetry Index: 0.858 and 0.915). At the 5-year follow-up, the femoral component is still stably fixated and shows no loosening signs. In addition, the Symmetry Index increased to 0.908 and 0.949. Even after 5 years, the presented amputation appears to be consistent with "conventional" knee disarticulation. The femoral component still withstands the altered loads and the patient shows a further improved gait pattern.
Sections du résumé
BACKGROUND
The present case report describes the 5-year follow-up results of an atypical knee disarticulation of a man previously treated with an oncologic total knee arthroplasty due to an Ewing sarcoma.
METHODS
The patient presented an aseptic loosened tibial component of a tumor prosthesis system and requested final amputation, as he had previously suffered from five revision surgeries. To encourage the most functional outcome regarding an exoskeletal prosthesis, we decided to disarticulate the knee joint while retaining the currently fixed femoral component to create a full end-bearing stump.
FINDINGS
The patient could be mobilized as a functional knee disarticulated amputee. Seven months after amputation, he showed a slightly less symmetrical gait compared to the preoperative status (preoperative mean Symmetry Index: 0.984 for kinematics and 0.940 for kinetics, 7-month postoperative Symmetry Index: 0.858 and 0.915). At the 5-year follow-up, the femoral component is still stably fixated and shows no loosening signs. In addition, the Symmetry Index increased to 0.908 and 0.949.
INTERPRETATION
Even after 5 years, the presented amputation appears to be consistent with "conventional" knee disarticulation. The femoral component still withstands the altered loads and the patient shows a further improved gait pattern.
Identifiants
pubmed: 35248833
pii: S0268-0033(22)00038-9
doi: 10.1016/j.clinbiomech.2022.105608
pii:
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
105608Informations de copyright
Copyright © 2021. Published by Elsevier Ltd.