2016 Volume 35 Issue 2 Pages 169-173
Multiple exostoses often produce joint disorders resulting from limb deformities, which may sometimes require operations such as osteotomy or arthroplasty. We report a case of bilateral total hip arthroplasty (THA) for hip osteoarthritis (OA) and distal femoral varus osteotomy for knee osteoarthritis with valgus limb deformity in a 71-year-old woman, who complained of difficulty walking due to bilateral knee and hip pain. The left knee pain had appeared along with multiple exostoses at about 50 years of age. The symptoms progressed with the left knee pain increasing and left hip pain then appearing, along with instability due to the left leg valgus deformity. Both hip joints developed severe OA with exostoses and coxa valga, and a pronounced contracture. The left knee developed lateral OA due to the valgus deformity of the distal femur and the proximal tibia. We initially performed a left THA, followed by the same procedure on the right hip. The hip pain subsequently subsided, and the range of motion was markedly improved. However, the pain and instability of the left knee persisted. As a result, a left distal femoral varus osteotomy (closed wedge) was performed for improvement of lower limb alignment. Two years postoperatively, the bilateral hip and left knee pains have remitted, walking ability has improved, and the left knee OA has not progressed any further. In summary, bilateral THAs and distal femoral varus osteotomy enabled stabilization of this patient’s gait through the improvement of lower-limb alignment, pain relief, and the recovery of joint function.
