Bilateral Bony Fused Knees
Restoring mobility after a successful Total Knee
A 39-year old healed (burned out) Rheumatoid Arthritis patient came
to Nanavati Super Speciality Hospital, with bilateral 90 degree bony
fused knee joints. There was no movement in both the knees while her
spine, both hips and ankles were mobile. She also had associated hand
deformities. Other than this, there was no significant co-morbidities.
She was wheelchair bound for eleven years. Her X-ray showed bilateral
bony continuity of femur with tibia (knee joint).
In pre-operative planning, the blood vessels, nerves and the bony fusion
mass was dissected and safely resected at the joint line. Since there
was flexion / extension gap mismatch of more than 10 mm, Nexgen
Rotating Hinge TKR (Zimmer USA) was implanted which corrected
the deformity from 90 degree to 30 degree on the operation table.
Expertise in handling such cases led the team of doctors to wait, as
such residual deformities can be gradually corrected using a splint. In
this case, the residual 30 degree of flexion deformity was progressively
corrected to full correction in over four weeks using push knee splint.
On successfully correcting one knee, the other knee was operated after
an interval of six weeks, resulting in bilateral straight knee.
Four years post operation the patient has excellent mobility, stability
and function. She has gained 0 to 110 painless stable active movements.
Now she can walk, climb stairs, sit on chair and get up unaided
independently. After eleven years of wheelchair-bound life, she has
started to walk independently.
Dr. Pradeep B. Bhosale
Director, Arthritis & Joint
Orthopaedics & Joint
Nanavati Super Speciality