Total knee arthroplasty with simultaneous triplanar osteotomy of the distal femur using patient-specific instrumentation : A case report.

Purpose: Performing a one-stage periarticular osteotomy in conjunction with total knee arthroplasty (TKA) constitutes a technically complex procedure. In such demanding cases, a personalized approach utilizing patient-specific instrumentation (PSI) may serve as an advantageous option to achieve optimal precision in bone cuts, thereby enhancing both clinical and radiological postoperative outcomes.

Methods: We present a case report of a 22-year-old man with multiple epiphyseal dysplasia (MED) resulting in knee osteoarthritis with complex femoral deformity and restricted (passive at 30-120° and active at 80-120°) range of movement (ROM). Simultaneous TKA and triplanar osteotomy with the use of PSI stabilized with the prosthesis stem was performed.

Results: The treatment resulted in correct limb and implant positioning. The functional improvement and bone union were confirmed 1 year after TKA. The patient did not report any pain in the operated joints and achieved passive 0-120° and active 10-120° ROM of the operated right knee.

Conclusion: Although the latest reports do not demonstrate improved clinical outcomes for PSI in periarticular osteotomies and TKAs separately, we highlight the benefits of PSI in complex deformities, particularly in patients requiring a combination of these two methods.