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Bilateral Total Knee Arthroplasties in a Patient with Bilateral Below-Knee Amputations and Osseointegration Limb
Hamid Al Badi1, Michael Tanzer, Robert Turcotte
1Jo Miller Orthopaedic Research Laboratory Division of Orthopaedic Surgery, Montreal General Hospital, McGill University, Montreal, QC, Canada.
Case:
A 38-year-old man with congenital pain insensitivity underwent bilateral below-knee amputations. After his subsequent bilateral osseointegration (OI) limb replacements, he rapidly developed severe bilateral knee arthritis and varus deformity. In lieu of performing bilateral above-knee amputations, he underwent bilateral staged total knee arthroplasties (TKA) with excellent clinical and radiographic evaluation at 1-year follow-up.
Conclusion:
To address both the limited bone stock and OI implant stem location, TKA after OI limb replacement in congenital pain insensitivity patients can be successfully achieved with a nonkeeled cementless tibial component and augmentation with a tibial cone.
