Management of an Infected Nonunion of an Opening-Wedge High Tibial Osteotomy with 2-Stage Implantation of Rotating Hinge Knee Prosthesis
Introduction. High tibial osteotomy (HTO) is a frequent and effective treatment for unicompartmental gonarthritis. Only a few articles are focused on the treatment of infected nonunion. Patient and Method. A 50-year-old obese patient was operated on by medial opening-wedge HTO. She developed a painf...
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Wiley
2018-01-01
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| Series: | Case Reports in Orthopedics |
| Online Access: | http://dx.doi.org/10.1155/2018/2493095 |
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| author | Sandrine Mariaux Olivier Borens |
| author_facet | Sandrine Mariaux Olivier Borens |
| author_sort | Sandrine Mariaux |
| collection | DOAJ |
| description | Introduction. High tibial osteotomy (HTO) is a frequent and effective treatment for unicompartmental gonarthritis. Only a few articles are focused on the treatment of infected nonunion. Patient and Method. A 50-year-old obese patient was operated on by medial opening-wedge HTO. She developed a painful nonunion treated by hardware removal, allograft, and plate fixation. However, the nonunion persisted. 2 years later, cellulitis appeared with an abscess adjacent to the HTO plate. Despite surgical debridement and antibiotics, septic knee arthritis occurred. In a situation of infected nonunion and septic arthritis with chondrolysis, she was scheduled for a 2-stage total knee replacement (TKR). The infected tibial articular block was first resected and replaced by a cement spacer. After a short interval, the TKR was implanted. After 2 years, the patient walked pain-free with good knee function. Discussion. In the literature, different efficient treatments exist for infected nonunion after HTO, but comprehensive studies are missing for a consensus treatment. Current data are mostly based on case reports, since this pathology is quite rare. Conclusion. In a difficult situation of infected nonunion with septic knee arthritis, we performed a 2-stage knee prosthesis implantation. This led to an early mobilization and fast recovery. |
| format | Article |
| id | doaj-art-2d177308c173416d992c907a949bfb21 |
| institution | Kabale University |
| issn | 2090-6749 2090-6757 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
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| series | Case Reports in Orthopedics |
| spelling | doaj-art-2d177308c173416d992c907a949bfb212025-02-03T07:24:50ZengWileyCase Reports in Orthopedics2090-67492090-67572018-01-01201810.1155/2018/24930952493095Management of an Infected Nonunion of an Opening-Wedge High Tibial Osteotomy with 2-Stage Implantation of Rotating Hinge Knee ProsthesisSandrine Mariaux0Olivier Borens1Service of Orthopaedics and Traumatology, Lausanne University Hospital, Lausanne, SwitzerlandService of Orthopaedics and Traumatology, Lausanne University Hospital, Lausanne, SwitzerlandIntroduction. High tibial osteotomy (HTO) is a frequent and effective treatment for unicompartmental gonarthritis. Only a few articles are focused on the treatment of infected nonunion. Patient and Method. A 50-year-old obese patient was operated on by medial opening-wedge HTO. She developed a painful nonunion treated by hardware removal, allograft, and plate fixation. However, the nonunion persisted. 2 years later, cellulitis appeared with an abscess adjacent to the HTO plate. Despite surgical debridement and antibiotics, septic knee arthritis occurred. In a situation of infected nonunion and septic arthritis with chondrolysis, she was scheduled for a 2-stage total knee replacement (TKR). The infected tibial articular block was first resected and replaced by a cement spacer. After a short interval, the TKR was implanted. After 2 years, the patient walked pain-free with good knee function. Discussion. In the literature, different efficient treatments exist for infected nonunion after HTO, but comprehensive studies are missing for a consensus treatment. Current data are mostly based on case reports, since this pathology is quite rare. Conclusion. In a difficult situation of infected nonunion with septic knee arthritis, we performed a 2-stage knee prosthesis implantation. This led to an early mobilization and fast recovery.http://dx.doi.org/10.1155/2018/2493095 |
| spellingShingle | Sandrine Mariaux Olivier Borens Management of an Infected Nonunion of an Opening-Wedge High Tibial Osteotomy with 2-Stage Implantation of Rotating Hinge Knee Prosthesis Case Reports in Orthopedics |
| title | Management of an Infected Nonunion of an Opening-Wedge High Tibial Osteotomy with 2-Stage Implantation of Rotating Hinge Knee Prosthesis |
| title_full | Management of an Infected Nonunion of an Opening-Wedge High Tibial Osteotomy with 2-Stage Implantation of Rotating Hinge Knee Prosthesis |
| title_fullStr | Management of an Infected Nonunion of an Opening-Wedge High Tibial Osteotomy with 2-Stage Implantation of Rotating Hinge Knee Prosthesis |
| title_full_unstemmed | Management of an Infected Nonunion of an Opening-Wedge High Tibial Osteotomy with 2-Stage Implantation of Rotating Hinge Knee Prosthesis |
| title_short | Management of an Infected Nonunion of an Opening-Wedge High Tibial Osteotomy with 2-Stage Implantation of Rotating Hinge Knee Prosthesis |
| title_sort | management of an infected nonunion of an opening wedge high tibial osteotomy with 2 stage implantation of rotating hinge knee prosthesis |
| url | http://dx.doi.org/10.1155/2018/2493095 |
| work_keys_str_mv | AT sandrinemariaux managementofaninfectednonunionofanopeningwedgehightibialosteotomywith2stageimplantationofrotatinghingekneeprosthesis AT olivierborens managementofaninfectednonunionofanopeningwedgehightibialosteotomywith2stageimplantationofrotatinghingekneeprosthesis |