Combined Proximal Tibial Osteotomy for Adult Kashin–Beck Disease with Severe Varus Knee Osteoarthritis: Case Report and Literature Review
Background Kashin–Beck disease (KBD) is an endemic, chronic osteoarthropathy that seriously affects joint function and can lead to severe knee deformity. Osteotomy is considered to be one of the effective methods for the treatment of this disease. Therefore, we designed a novel type of osteotomy nam...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-12-01
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| Series: | Orthopaedic Surgery |
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| Online Access: | https://doi.org/10.1111/os.13520 |
| _version_ | 1811299603223412736 |
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| author | Yunfei Liu Ruiyang Li Yu Zhan Xuetao Xie Congfeng Luo |
| author_facet | Yunfei Liu Ruiyang Li Yu Zhan Xuetao Xie Congfeng Luo |
| author_sort | Yunfei Liu |
| collection | DOAJ |
| description | Background Kashin–Beck disease (KBD) is an endemic, chronic osteoarthropathy that seriously affects joint function and can lead to severe knee deformity. Osteotomy is considered to be one of the effective methods for the treatment of this disease. Therefore, we designed a novel type of osteotomy named combined proximal tibial osteotomy (CPTO), which combines the characteristics of opening‐wedge high tibial osteotomy and tibial condylar valgus osteotomy. Case presentation We report the case of a 48‐year‐old male with knee pain and varus deformity who was diagnosed with KBD and varus knee osteoarthritis (Kellgren–Lawrence stage IV). Considering the patient's relatively young age, a varus deformity of the right knee of 16.79°, and an intra‐articular instability, we performed a CPTO treatment. In this procedure, we performed an L‐shaped osteotomy from the medial edge of the proximal tibia to the intercondylar eminence and an osteotomy from the medial side of the proximal tibia to the lateral side through the same incision, to adjust the leg alignment and the congruity of the joint by valgus correction. At 29 months follow‐up, this patient achieved satisfactory results, with a varus right knee of 2.87°. There was significant improvement in his right knee function, pain, and joint stability. Conclusions CPTO may be an acceptable treatment for KBD patients with severe knee varus deformity and intra‐articular instability. It can be considered as an alternative treatment, especially for patients with advanced osteoarthritis needing knee preservation. |
| first_indexed | 2024-04-13T06:37:16Z |
| format | Article |
| id | doaj.art-2f823c05696a458eb98734457aec070b |
| institution | Directory Open Access Journal |
| issn | 1757-7853 1757-7861 |
| language | English |
| last_indexed | 2024-04-13T06:37:16Z |
| publishDate | 2022-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Orthopaedic Surgery |
| spelling | doaj.art-2f823c05696a458eb98734457aec070b2022-12-22T02:57:50ZengWileyOrthopaedic Surgery1757-78531757-78612022-12-0114123441344710.1111/os.13520Combined Proximal Tibial Osteotomy for Adult Kashin–Beck Disease with Severe Varus Knee Osteoarthritis: Case Report and Literature ReviewYunfei Liu0Ruiyang Li1Yu Zhan2Xuetao Xie3Congfeng Luo4Department of Orthopaedics The Affiliated Suzhou Science & Technology Town Hospital of Nanjing Medical University Suzhou ChinaDepartment of Orthopaedic Surgery Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai ChinaDepartment of Orthopaedic Surgery Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai ChinaDepartment of Orthopaedic Surgery Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai ChinaDepartment of Orthopaedic Surgery Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai ChinaBackground Kashin–Beck disease (KBD) is an endemic, chronic osteoarthropathy that seriously affects joint function and can lead to severe knee deformity. Osteotomy is considered to be one of the effective methods for the treatment of this disease. Therefore, we designed a novel type of osteotomy named combined proximal tibial osteotomy (CPTO), which combines the characteristics of opening‐wedge high tibial osteotomy and tibial condylar valgus osteotomy. Case presentation We report the case of a 48‐year‐old male with knee pain and varus deformity who was diagnosed with KBD and varus knee osteoarthritis (Kellgren–Lawrence stage IV). Considering the patient's relatively young age, a varus deformity of the right knee of 16.79°, and an intra‐articular instability, we performed a CPTO treatment. In this procedure, we performed an L‐shaped osteotomy from the medial edge of the proximal tibia to the intercondylar eminence and an osteotomy from the medial side of the proximal tibia to the lateral side through the same incision, to adjust the leg alignment and the congruity of the joint by valgus correction. At 29 months follow‐up, this patient achieved satisfactory results, with a varus right knee of 2.87°. There was significant improvement in his right knee function, pain, and joint stability. Conclusions CPTO may be an acceptable treatment for KBD patients with severe knee varus deformity and intra‐articular instability. It can be considered as an alternative treatment, especially for patients with advanced osteoarthritis needing knee preservation.https://doi.org/10.1111/os.13520Kashin–Beck diseaseosteoarthritisosteotomyvarus |
| spellingShingle | Yunfei Liu Ruiyang Li Yu Zhan Xuetao Xie Congfeng Luo Combined Proximal Tibial Osteotomy for Adult Kashin–Beck Disease with Severe Varus Knee Osteoarthritis: Case Report and Literature Review Orthopaedic Surgery Kashin–Beck disease osteoarthritis osteotomy varus |
| title | Combined Proximal Tibial Osteotomy for Adult Kashin–Beck Disease with Severe Varus Knee Osteoarthritis: Case Report and Literature Review |
| title_full | Combined Proximal Tibial Osteotomy for Adult Kashin–Beck Disease with Severe Varus Knee Osteoarthritis: Case Report and Literature Review |
| title_fullStr | Combined Proximal Tibial Osteotomy for Adult Kashin–Beck Disease with Severe Varus Knee Osteoarthritis: Case Report and Literature Review |
| title_full_unstemmed | Combined Proximal Tibial Osteotomy for Adult Kashin–Beck Disease with Severe Varus Knee Osteoarthritis: Case Report and Literature Review |
| title_short | Combined Proximal Tibial Osteotomy for Adult Kashin–Beck Disease with Severe Varus Knee Osteoarthritis: Case Report and Literature Review |
| title_sort | combined proximal tibial osteotomy for adult kashin beck disease with severe varus knee osteoarthritis case report and literature review |
| topic | Kashin–Beck disease osteoarthritis osteotomy varus |
| url | https://doi.org/10.1111/os.13520 |
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