Abstract

BackgroundSimultaneous osteoarthritis (OA) of the ankle joint complicates primary total knee arthroplasty (TKA). In such cases, rehabilitation of TKA is limited by debilitating ankle pain, but varus or valgus ankle arthritis may even compromise placement of knee prosthetic components.Case presentationWe present a patient with simultaneous bilateral valgus and patellofemoral OA of the knees and bilateral varus OA of the ankle joints that equally contributed to overall disability. This 63 years old, motivated and otherwise healthy patient was treated by simultaneous bilateral total knee and ankle arthroplasty (quadruple total joint arthroplasty, TJA) during the same anesthesia. Two years outcome showed excellent alignment and function of all four replaced joints. Postoperative time for rehabilitation, back to work (6th week) and hospital stay (12 days) of this special patient was markedly reduced compared to the usual course of separate TJA.ConclusionsSimultaneous quadruple TJA in equally disabling OA of bilateral deformed knees and ankles resulted in a better functional outcome and faster recovery compared to the average reported results after TKA and TAA in literature. However, careful preoperative planning, extensive patient education, and two complete surgical teams were considered essential for successful performance. To the best of our knowledge this is the first case report in literature about quadruple major total joint arthroplasty implanted during the same anesthesia in the same patient.

Highlights

  • Simultaneous osteoarthritis (OA) of the ankle joint complicates primary total knee arthroplasty (TKA)

  • Simultaneous quadruple Total joint arthroplasty (TJA) in disabling OA of bilateral deformed knees and ankles resulted in a better functional outcome and faster recovery compared to the average reported results after TKA and total ankle arthroplasty (TAA) in literature

  • To the best of our knowledge this is the first case report in literature about quadruple major total joint arthroplasty implanted during the same anesthesia in the same patient

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Summary

Conclusions

Replacements of deformed and disabled arthritic knee and ankle joints within a short period of time have beneficial influences on each other and improve overall rehabilitation and patients’ outcome. Author details 1Department of Orthopaedic Surgery, University Clinics of Basel, Spitalstr. Authors’ contributions Both authors did the surgical procedures and the follow-up examinations. GP wrote the manuscript and BH did corrections. Both authors have read and approved the revised manuscript. Competing interests BH was involved in the development of the ankle prosthesis used in the published article and receives institutional research royalties from INTEGRA Company. GP has no competing interests in relation to the published material

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