Artroplastia primaria con prótesis tipo bisagra en rodilla compleja

Abstract

Knee arthroplasty with hinge-type prosthesis allows joint replacement in cases of severe loss of bone stock, ligament instability, varus or valgus deformities, oncological surgery, revision of primary knee arthroplasty in complex post-traumatic cases for primary surgery. Clinical and functional scores improved significantly. Rotating hinge devices present a risk of mechanical failure and risk of infection in up to 25 to 28% of cases with survival rates that vary from excellent to poor results according to the ideal patient. We present the case of a male patient 55 years old, with a history of traffic accident 4 years ago with fracture of the femur and left tibial plateau with surgical resolution with osteosynthesis, presents pain in the left knee of 2 years of evolution VAS 8/10 plus deformity, and functional limitation for walking on physical examination: left knee with 8 cm anterior surgical scar on femur and 8 cm lateral part of tibia arches of mobility flexion 50 °, extension 0 °, valgus deformity 25 °, click (+), brushing (+), Zohlen (+) ligament signs (+), Western Ontario and McMaster Universities Arthritis Index (Womac) presurgical 77; With Ranawat II post-traumatic Genu valgus arthrosic diagnosis, primary knee arthroplasty was performed with a hinge-type prosthesis, obtaining good clinical and functional results, which was determined with improvement of the Womac scale 30, VAS 1/10 mobility arches flexion 80 °, extension 0 ° and internal and external rotation 20 ° at post-surgical control with return to daily activities and remission of pain.