Computer-assisted total bilateral knee arthroplasty for a patient with severe hyperextension in residual poliomyelitis: a case report

Background. Total knee arthroplasty in patients in the residual stage of poliomyelitis is a technically difficult job. The reasons for this are anatomical features and therefore difficulties in an implant choice and conflicting results. In the present case report, we describe a unique method of a computer-navigated installation of a rotating-hinge implant in a non-standard position for a patient with residual poliomyelitis. The aim of the study is to demonstrate a method of a computer-navigated installation of rotating-hinge knee implants in a patient with severe hyperextension and valgus deformity in the residual stage of poliomyelitis. Case description. The clinical case presents a 55-year-old man with lower peripheral paraparesis as a consequence of poliomyelitis and bilateral valgus knee arthritis with severe hyperextension. The patient moved on crutches at a distance no more than 300 meters. Two-stage total knee arthroplasty was performed using a navigation system and second-generation rotating-hinge implants. At the 4-year follow-up period, we note a good clinical result, and the patient is satisfied with the total knee arthroplasty outcomes. Conclusion. The clinical case demonstrates good results of performing total knee arthroplasty in a patient with bilateral severe hyperextension and knee valgus deformity in residual poliomyelitis. Having analyzed available topic-related literature, we developed an original method of a computer-navigated installation of a second-generation rotating-hinge implant. The method can be an effective treatment solution for patients with knee arthritis deformity in the residual stage of poliomyelitis.