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Revision total knee arthroplasty with Charcot-Marie-Tooth disease - a case report
Jaad Mahlouly1, Julien Wegrzyn1, Olivier Guyen1
1Department of Orthopaedics and Traumatology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
International Journal of Surgery Case Reports
|July 25, 2025
Summary
Total knee arthroplasty (TKA) in Charcot-Marie-Tooth (CMT) patients can fail early due to neuromuscular dysfunction. Revision with a rotating-hinge TKA offers a durable solution for complex cases with bone loss and instability.
Area of Science:
- Orthopedic Surgery
- Neurology
- Biomedical Engineering
Background:
- Charcot-Marie-Tooth (CMT) disease is a rare hereditary neuropathy causing progressive muscle weakness and gait abnormalities.
- Total knee arthroplasty (TKA) in CMT patients presents unique challenges due to altered biomechanics and potential for early implant loosening.
Observation:
- A 72-year-old woman with advanced CMT experienced disabling pain and instability 10 years post-TKA.
- Radiographs showed severe aseptic loosening and significant metaphyseal bone loss.
Findings:
- A one-stage revision surgery using a rotating-hinge TKA with tibial augmentation resulted in excellent recovery and functional improvement.
- The patient maintained a favorable outcome at 3-year follow-up.
Implications:
- CMT patients may require specialized pre-operative planning and long-term monitoring after TKA.
- Rotating-hinge TKAs are a reliable solution for revision surgery in CMT patients with substantial bone loss and instability.
- Consideration of stemmed or constrained implants may be beneficial for primary TKA in CMT patients to enhance stability and durability.
Keywords:
Case reportCharcot-Marie-ToothMultidirectional instabilityRotating-hinged TKATKA periprosthetic bone lossTotal knee arthroplasty revision
