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Patellar dislocation following distal femoral replacement after extraarticular knee resection for bone sarcoma:A case report

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World Journal of Clinical Cases 2022年第11期10卷 3561-3572页

作者： Yuta Kubota Kazuhiro Tanaka Masashi hirakawa Tatsuya Iwasaki Masanori Kawano Ichiro Itonaga Hiroshi Tsumura Orthopaedic Surgery Oita UniversityYufu City 879-5593OitaJapan

BACKGROUND For the treatment of bone sarcoma in the distal femur,wide-margin resection and knee reconstruction with tumor endoprosthesis are standard therapies.Extraarticular knee resection is required in cases of tumor invasion of the knee joint;however,the incidence of complications,such as aseptic loosening,prosthesis infection,and implant failure,is higher than that following intra-articular knee resection.To the best of our knowledge,there are three reports of patellar dislocations after replacement of a tumor endoprosthesis.CASE SUMMARY A 36-year-old man with no significant past medical history was admitted to our institution with continuous pain in his left knee for 4 mo.An open biopsy was performed,and the patient was diagnosed with a left distal femoral malignant bone tumor.Extra-articular knee resection and knee reconstruction with a tumor endoprosthesis were performed.Although the alignment of the tumor prosthesis was acceptable,knee instability was noticed postoperatively.The axial radiographic view of the patellar and computed tomography showed lateral patellar dislocation at 4 wk postoperatively.The patient had to undergo a lateral release and proximal realignment.He could perform his daily activities at 9 mo postoperatively.Radiography revealed no patellar re-dislocation.CONCLUSION Proximal realignment may be considered during primary surgery if there is an imbalance in the forces controlling the patellar tracking.

关键词： Bone tumor Distal femoral replacement Lateral release Patellar dislocation Proximal realignment Case report

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