Total knee Arthroplasty as therapeutic measure for primary Ostheoarthrosis
INTRODUCTION: Knee ostheoarthrosis is a cartilage degeneration caused mostly by aging, overweight or trauma that leads to ligament injury. Besides it is an orthopedic problem, it is also a matter of well-being and functionality. This disease manly affects middle-age-women, due to their greater transversal diameter of the hip and a knee valgus angle. Its signals and symptoms are pain, movement limitation and morning joint stiffness. The Total knee arthroplasty (TKA) is classified as total when all of the three articular compartments (medial femorotibial, lateral femorotibial and femoropatellar) are replaced or unicompartmental if only one of the first two of compartments mentioned is replaced. AIM: Analyze, study and understand a left knee primary ostheoarthrosis that required a TKA as therapeutic measure. MATERIAL AND METHODS: Comparison of previous information about TKA and a case of a patient diagnosed with left knee primary arthrosis. CASE STUDY: 59-years-old woman, overweighed, who was underwent a right knee TKA one year ago. Clinic exam: painful condition during left knee flexo-extension; geno varus and 70° - 180° of the left knee joint. There were no inflammatory signals or other injuries. Complementary exams: grade III on the Alhback scale. The patient was submitted to a total primary TKA and, according to the standard surgical approaches, a longitudinal incision was made in the midline over the patella through the medial parapatellar pathway (originally described by Von Langenbeck). In addition, a cut was made on the femur perpendicular to its mechanical axis, according to the angle proposed by the literature, and another one was made on the tibia perpendicular to the long axis (parallel to the ground). The femoral rotation component was defined from the posterior, biepicondylar and Whiteside condylar lines. The tibial component was positioned in a slight external rotation of 3° in relation to the anterior tibial tuberosity. RESULTS: About the patient’s prognosis: the left lower limb had a good alignment, good distal perfusion and the patella centered on the trochanea. CONCLUSION: Based on previously studies, satisfactory results were observed in patients who had ostheoarthrosis and were submitted to TKA. According to Perse et al, TKA is a good option in elderly patients because longevity is growing and the elderly population has become more active, therefore needing a quick recovering. Therefore, the TKA has presented itself as an effective therapeutic measure for this population and for more advanced cases of ostheoarthrosis.
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