Abstract
Coxitis knee refers to knee osteoarthritis caused by ipsilateral or contralateral hip joint disease, while long leg arthropathy (LLA) occurs contralateral to the affected hip joint and requires treatment that takes into consideration the alignment of both lower limbs. Here we report a case of rheumatoid arthritis with valgus deformity and severe knee flexion contracture caused by LLA.
A 68-year-old woman consulted us in 2011 because of right gonalgia accompanied by impaired motor function. On examination, severe pelvic inclination due to terminal-stage coxarthrosis on the left was observed. Consequently, valgus knee deformity with a femorotibial angle of 162 degrees, and flexion contracture of 50 degrees were observed.
In order to achieve support in the lower limbs, the patient was informed that total knee arthroplasty (TKA) followed by total hip arthroplasty (THA) would compensate for the limb length discrepancy. Left THA was performed two months after completing posterior-stabilized type TKA on the right knee. As a result, the patient had good limb function. With regard to the treatment of LLA, even when the chief complaint indicates a knee joint disorder, the need for simultaneous treatment of the hip joint disease for correction of the bilateral lower limb alignment should be considered and explained to the patient.
