Bilateral Total Knee Arthroplasty for Charcot Arthropathy After Cauda Equine Syndrome: A Case Report.
Abstract: Charcot arthropathy of the knee is a relatively rare and poorly understood condition. Diagnosis requires detailed history of the patient, radiological investigation and exclusion of other causes of arthropathy. Conservative treatment is sufficient only in early stages. In late stages, either arthrodesis or total knee arthroplasty is the treatment of choice. We report a case of a 65-year-old woman who presented with Charcot arthropathy in both knees, after a spinal fracture 35 years ago, which caused cauda equine syndrome with diminished sensation of both legs. She underwent bilateral total knee arthroplasty using hinged knee prosthesis.
Copyright 2020, Karageorgos et al.
Publication Date: 2020-02-28 PubMed ID: 34434361PubMed Central: PMC8383629DOI: 10.14740/jmc3412Google Scholar: Lookup
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- Case Reports
Summary
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This study describes a case of a 65-year-old woman with Charcot arthropathy in both knees caused by a spinal fracture 35 years ago, which resulted in cauda equina syndrome. Treatment via bilateral total knee arthroplasty using hinged knee prosthesis was successfully implemented.
About Charcot Arthropathy and Cauda Equina Syndrome
- Charcot arthropathy of the knee is a rare condition that is not fully understood in the medical community. It is typically identified through a thorough patient history, radiological examination, and the exclusion of other potential causes of arthropathy.
- Cauda equina syndrome is a serious medical condition that can occur after a spinal fracture. It results in decreased sensation in both legs, among other potential symptoms. It is believed to have contributed to the development of Charcot arthropathy in the patient’s case.
Conservative Treatment and Its Limitations
- According to the study, conservatory treatment can be effective but only in the early stages of Charcot arthropathy.
- The article noted that such treatments often fail to significantly improve conditions in the later stages of the disease. This means a more aggressive approach to treatment is needed for late-stage Charcot arthropathy.
Arthrodesis and Total Knee Arthroplasty
- The researchers discussed two potential treatments for late-stage Charcot arthropathy: arthrodesis and total knee arthroplasty. Arthrodesis is a surgical technique that involves fusing the joint bones, thereby rendering the joint immobile.
- On the other hand, total knee arthroplasty involves the replacement of the knee joint with an artificial one. Both of these treatments are considered to be effective for late-stage Charcot arthropathy, although they each have their own risks and benefits.
- In this case, the treatment of choice was bilateral total knee arthroplasty using a hinged knee prosthesis. This treatment was chosen due to its relative safety and efficacy, and the fact that it would allow the patient to regain some mobility in her knees.
Cite This Article
APA
Karageorgos A, Papadopoulos AX, Gelalis ID, Matzaroglou C.
(2020).
Bilateral Total Knee Arthroplasty for Charcot Arthropathy After Cauda Equine Syndrome: A Case Report.
J Med Cases, 11(2), 49-53.
https://doi.org/10.14740/jmc3412 Publication
Researcher Affiliations
- Department of Orthopaedic Surgery, Olympion Medical Center, Patras, Greece.
- Department of Orthopaedic Surgery, Olympion Medical Center, Patras, Greece.
- Orthopaedic Department, University of Ioannina, Greece.
- Orthopaedic Surgery and Traumatology Department of Rehabilitation Sciences, University of Patras, Greece.
Conflict of Interest Statement
None to declare.
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Citations
This article has been cited 2 times.- Mei F, Li JJ, Lin J, Zhou D, Xing D. Constrained Condylar Prostheses for the Treatment of Charcot Arthropathy: A Case Report and Literature Review.. Orthop Surg 2023 May;15(5):1423-1430.
- Lu V, Zhang J, Thahir A, Zhou A, Krkovic M. Charcot knee - presentation, diagnosis, management - a scoping review.. Clin Rheumatol 2021 Nov;40(11):4445-4456.
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