TJA in Rare Conditions
Gunshot Wound to the Hip Resulting in a Femoral Head and Acetabulum Fracture Treated With Open Reduction and Internal Fixation and Bipolar Hemiarthroplasty
Combined fractures of the femoral head and acetabulum due to ballistic injuries are rare injuries, especially in the elderly. We present a case of a 70-year-old female who sustained a gunshot wound to the left hip, resulting in a comminuted femoral head fracture and posterior wall acetabular fracture. She was treated with open reduction and internal fixation of the acetabulum, as well as bipolar hemiarthroplasty for treatment of her femoral head fracture. At her 18-month follow-up visit, the patient was doing well and had no complaints.Total Knee Arthroplasty With Patient-Specific Instrumentation to Correct Severe Valgus Deformity in a Patient With Hereditary Multiple Exostoses
Patients with hereditary multiple exostosis develop several benign osseocartilaginous bulge lesions throughout the body. A 62-year-old woman presented for evaluation of worsening left knee valgus deformity, and left knee pain. She had been diagnosed with hereditary multiple exostosis at the age of 12 years. Radiographic evaluation of the left knee revealed exostoses that caused continuous bulges from cortical bone at the metaphyseal regions of the femur and tibia as well as extra-articular deformity.Outcomes of Total Knee Arthroplasty in Patients With a Prior Contralateral Above-Knee Amputation: A Retrospective Review of a Nationwide Database
Total knee arthroplasty (TKA) in patients with a prior contralateral above-knee amputation (AKA) is uncommon, with limited literature describing the outcomes. We used a national database to compare the outcomes of primary TKA in above-knee amputees and nonamputees.Parsonage-Turner Syndrome and Closed-Incision Negative-Pressure Wound Therapy After Total Hip Arthroplasty in a Case of Marfan Syndrome
Negative pressure wound therapy (NPWT) is a postoperative wound care method, which has recently become an ongoing field of research in hip and knee arthroplasty. We report the successful management of wound dehiscence and infection after THA in a case of Marfan syndrome by closed-incision negative-pressure wound therapy (ciNPWT). Our patient also developed a rare postoperative neurologic complication, that is, Parsonage-Turner syndrome (PTS). To our knowledge, this is the first report of PTS and ciNPWT use for SSI after THA in a Marfan patient.Staged Bilateral Total Knee Arthroplasty for Neglected Blount Disease Using a Gap Balancing Technique
Blount disease is an acquired, asymmetrical disorder of proximal tibial growth that results in a complex three-dimensional proximal tibial deformity, with tibial varus being the dominating feature. Although the exact pathophysiology is unknown, Blount disease is separated into 2 clinical variants, infantile and adolescent, based on the onset of symptoms occurring before or after the age of 10 years. If recognized and treated early, affected patients generally have a favorable prognosis; however, if neglected, it can lead to progressive malalignment and premature osteoarthritis.Segmental Fractures of the Neck of Femur: Fix or Replace?
Combined intracapsular and extracapsular fractures of the proximal femur—segmental fractures of neck of femur (SFNOF)—are rare and complex injuries. Literature regarding SFNOF is very limited; only one small retrospective study and 19 unique case reports have been described. We report the case of a 42-year-old man who suffered a compound subcapital femur fracture type Garden IV and an ipsilateral multifragmentary greater trochanter fracture from severe crush trauma. Neither the precise fracture constellation nor our management strategy, primary cemented total hip arthroplasty combined with tension band cerclage and triple K-wire trochanteric fixation, has been described in contemporary literature.
