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Total knee arthroplasty in vascular malformation.

Harish Bhende1, Nanadkishore Laud1, Sandeep Deore1

  • 1Center for Joint Replacement Surgery, Laud Clinic, Saraswati Nilayam, Dadar East, Mumbai, Maharashtra, India.

Indian Journal of Orthopaedics
|November 6, 2015
PubMed
Summary

Klippel-Trenaunay syndrome patients with deep vascular malformations can develop joint pain. Navigated total knee arthroplasty offers a successful surgical solution, avoiding intra-medullary alignment complications.

Keywords:
ArthroplastyKnee arthroplastycomputer assistedkneenavigation surgeryreplacementsurgeryvascular malformationvascular neoplasms

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Area of Science:

  • Orthopedic Surgery
  • Vascular Malformations
  • Genetics and Syndromes

Background:

  • Klippel-Trenaunay syndrome (KTS) is characterized by extensive vascular malformations affecting superficial and deep tissues, including muscles, bones, and joints.
  • Recurrent intra-articular bleeds in KTS patients can lead to premature arthritis and significant joint pain, complicating management.
  • Traditional arthroplasty in KTS patients presents challenges due to the high risk of complications, particularly with intra-medullary alignment techniques.

Purpose of the Study:

  • To describe a successful case of navigated total knee arthroplasty in a Klippel-Trenaunay syndrome patient.
  • To highlight the advantages of navigated arthroplasty in avoiding intra-medullary complications associated with vascular malformations.
  • To propose recommendations for knee arthroplasty consideration in patients with KTS.

Main Methods:

  • A case study detailing the surgical approach for a Klippel-Trenaunay syndrome patient undergoing total knee arthroplasty.
  • Utilized computer navigation for precise joint alignment, bypassing the need for intra-medullary instrumentation.
  • Documented pre-operative, intra-operative, and post-operative findings, focusing on surgical technique and patient outcomes.

Main Results:

  • Successful implementation of navigated total knee arthroplasty in a patient with Klippel-Trenaunay syndrome.
  • Avoidance of intra-medullary complications, demonstrating the efficacy of navigation in complex cases.
  • Positive functional outcome and pain relief post-surgery.

Conclusions:

  • Navigated total knee arthroplasty is a viable and safe alternative for Klippel-Trenaunay syndrome patients with intra-articular vascular malformations.
  • This technique mitigates risks associated with conventional intra-medullary alignment, improving surgical safety and efficacy.
  • Careful pre-operative planning and consideration of specific measures are crucial for successful arthroplasty in this patient population.