Non-union after correction of femoral deformity combined with total knee arthroplasty

Non-union after correction of femoral deformity combined with total knee arthroplasty

Takatomo Mine, M.D., Ryutaro Kozuma, M.D., Koichiro Ihara, M.D., Hiroyuki Kawamura, M.D., Ryutaro Kuriyama, M.D., Yasunari Tominaga, M.D.

Department of Orthopaedic Surgery, National Hospital Organization Kanmon Medical Center, Shimonoseki Japan.

International-Journal-of-Case-Reports-2d code

In knee arthritis with extra-articular deformity of the femur, total knee arthroplasty becomes more challenging. Simultaneous femoral deformity correction and TKA can be a complex procedure. We present a case in which TKA and femoral osteotomy for varus femoral deformity were performed simultaneously. Non-union in the osteotomy portion occurred after the operation. Teriparatide therapy and low intensity pulsed ultrasound therapy was administered after a diagnosis of non-union. Bony union was partially obtained at 29 months after surgery.

Keywords: Total Knee Arthroplasty, extra-articular deformity, osteotomy, nonunion

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How to cite this article:
Takatomo Mine, Ryutaro Kozuma, Koichiro Ihara, Hiroyuki Kawamura, Ryutaro Kuriyama, Yasunari Tominaga. Non-union after correction of femoral deformity combined with total knee arthroplasty. International Journal of Case Reports, 2019 4:57. DOI: 10.28933/ijcr-2018-12-2805


1. Lonner JH, Siliski JM. Lotke PA. Simultaneous femoral osteotomy and total knee arthroplasty for treatment of osteoarthritis associated with severe extra-articular deformity. J Bone Joint Surg Am 2000;82:342-348
2. Papadopoulos EC, Parvizi J, Lai CH, Lewallen DG. Total knee arthroplasty following prior femoral fracture. Knee 2002;9:267-274
3. Y.-K. Lee, Y.-C. Ha, K.-H. Koo. Teriparatide, a nonsurgical solution for femoral nonunion? A report of three cases. Osteoporos Int 2012;23:2897-2900
4. Stephen J. Incavo, Carl Kapadia, Robert Torney. Use of an intramedullary Nail for Correction of Femoral Deformities Combined with Total Knee Arthroplasty A Technical Tip. J Arthroplasty 2007;22:133-135
5. Naruse K, Uchino M, Hirakawa N, Toyama M, et al. The Low-intensity Pulsed Ultrasound (LIPUS) Mechanism and the Effect of Teriparatide on Fracture healing. J Orthop Trauma 2016;30 S3
6. Wang JW, Wang CL. Total knee arthroplasty for arthritis of the knee with extra-articular deformity. J Bone Joint Surg2002;84:1769-1774.
7. Mann JW 3rd, Insall JN, Scuderi GR. Total knee arthroplasty in patients with associated extra-articular deformity. Orthop Trans 1997;21:59
8. Wolff AM, Hungerford DS, et al.The effect of extraarticular varus and valgus deformity on total knee arthroplasty.Clin Orthop 1991;272:35
9. Nozaka K, Shimada K,Miyakoshi N, Yamada S, et al. Can combined therapy with teriparatide and low-intensity pulsed ultrasound (LIPUS) accelerate fracture healing? J Orthop Trauma. 2016;30:S2
10. Bottros J, Klika AK, Lee HH,et al. The use of navigation in total knee arthroplasty for patients with extra-articular deformity. J Arthroplasty 2008;23:74

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