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Primary knee arthrodesis for severe crystalline arthropathy
Bryan G Vopat1, Scott A Ritterman, Stephen Kayiaros
1Department of Orthopaedic Surgery, Warren Alpert Medical School, Brown University/Rhode Island Hospital, Providence, Rhode Island. bvopat@gmail.com.
American Journal of Orthopedics (Belle Mead, N.J.)
|November 27, 2013
Summary
Gout is a painful inflammatory arthritis. Knee fusion surgery successfully treated a severe case, providing a stable, pain-free knee for a patient with significant joint damage and instability.
Area of Science:
- Orthopedic surgery
- Rheumatology
- Crystal-induced arthritis
Background:
- Gout commonly affects joints, causing inflammatory arthritis due to monosodium urate crystal deposition.
- Severe, uncontrolled gout can lead to significant joint damage and chronic pain.
Observation:
- A 54-year-old man presented with a decade of severe knee pain from uncontrolled gout.
- The patient exhibited substantial bone loss, soft-tissue masses, and ligamentous instability.
Findings:
- Knee arthrodesis (fusion) was selected due to the patient's complex factors, including age, functional goals, and joint pathology.
- Surgical knee fusion effectively addressed the severe gouty arthritis, resulting in a stable and pain-free outcome.
Implications:
- Knee arthrodesis is a viable surgical option for managing severe, refractory gouty arthritis with significant joint destruction.
- This case highlights the importance of considering patient-specific factors in surgical decision-making for complex orthopedic conditions.
