Orthopedic Research and Reviews (Jul 2021)
Treatment Approach for Knee Osteoarthritis with Ipsilateral Femoral Cartilage Tumor: A Case Series
Abstract
Aadit Shah, Eric Lepkowsky, Alexander Duke, Meghan Moriarty, Haley Riordan, Fazel Khan Stony Brook University Hospital, Department of Orthopaedics, Stony Brook, NY, 11794, USACorrespondence: Aadit ShahStony Brook University Hospital, Department of Orthopaedics, 101 Nicolls Road, HSC T-18 – 089, Stony Brook, NY, 11794, USATel +1-631-786-9484Email [email protected]: Osteoarthritis (OA) is a common pathology affecting the knee joint. Twenty percent of the cartilaginous tumors of bone are in the distal femur. This presents a challenge for treating patients with knee OA who also have ipsilateral distal femur cartilage tumors. We propose a classification system for knee OA with ipsilateral cartilaginous tumor and a treatment approach to address this issue. Intramedullary guides are avoided when performing total knee arthroplasty (TKA) in these patients so as not to further contaminate the femur with tumor cells. A non-image-based stereotactic surgical system is favored at our institution to achieve this goal. Seven patients underwent classification and treatment with TKA utilizing this approach. Average final follow-up was 15.3 months. Component alignment averaged 89.2° and all patients had 0° of extension with an average flexion to 107.5°. There were no postoperative complications and no radiographic evidence of component complication, tumor recurrence, or tumor expansion. Few studies have reported on the treatment of knee OA with concurrent cartilaginous tumor of the distal femur. All patients treated with the proposed approach had their OA successfully treated without complication related to their cartilaginous tumor or TKA components. This case series presents a novel classification and treatment algorithm to potentially guide arthroplasty surgeons in approaching these often-concurrent occurring pathologies.Keywords: total knee arthroplasty, osteoarthritis, cartilage tumor, enchondroma, chondrosarcoma