Affiliation:
1. Department of Orthopaedic Surgery, Faculty of Medicine, Saga University , Saga, Japan
2. Department of Orthopaedic Surgery, Saga Central Hospital , Saga, Japan
Abstract
ABSTRACT
Patients with leprosy are known to tend to develop neuropathic arthropathy, known as Charcot joint. There are no case reports of total knee arthroplasty (TKA) in patients with leprosy with polyarticular neuropathic arthropathy, and the results are unknown. In this study, we report a case of TKA in a patient with leprosy with polyarticular neuropathic arthropathy and discuss its outcomes and indications. Right TKA using the NexGen Legacy Constrained Condylar Knee implant was performed in a 62-year-old man with neuropathic arthropathy in multiple joints with clinical symptoms, particularly in the right knee. Seven years post-operation, the American Knee Society Score-knee and -function, which represent knee function and activities of daily living on a scale of 100 points, were significantly improved compared with preoperative values, from 30 to 99 points and 0 to 60 points, respectively. Indications for arthroplasty for neuropathic arthropathy should be carefully considered in each individual case. In this case, the patient had neuropathic arthropathy in multiple joints; however, TKA was performed because recovery of function in the right knee was expected to significantly improve the patient’s activities of daily living, and a good mid-term clinical outcome was achieved. Therefore, indications for arthroplasty should be considered in patients with systemic neuropathic arthropathy such as leprosy, and with accurate assessment and appropriate implant selection, good long-term outcomes may be expected.
Publisher
Oxford University Press (OUP)
Reference39 articles.
1. Leprosy;World Health Organization,2023
2. Orthopaedic complications of leprosy;Moonot;J Bone Joint Surg Br,2005
3. Clinical aspects of leprosy;Talhari;Clin Dermatol,2015
4. The operation of the century: total hip replacement;Learmonth;Lancet,2007
5. Two-part total knee arthroplasty: evolution and present status;Coventry;Clin Orthop Relat Res,1979