Popliteal Artery Pseudoaneurysm after Closing Wedge High Tibial Osteotomy.

INTRODUCTION: High tibial osteotomy (HTO) is an adequate procedure for the treatment of medial unicompartmental knee arthritis in the varus knee. It is technically demanding and has a significant complication rate. Although rare, vascular injury is potentially the most serious complication. CASE REPORT: We present the case of a 50-year-old male who developed a popliteal artery pseudoaneurysm needing surgical intervention following closing wedge (CWHTO). The patient presented with worsening pain and progressive neurological symptoms. The osteotomy healed normally but the neurological symptoms showed only minor improvement over the 2-year follow-up period. CONCLUSIONS: Even with proper surgical technique, CWHTO presents a small inherent risk of injury to the popliteal neurovascular structures. Prompt recognition and treatment of this injury are of paramount importance for a good long-term outcome. Further studies are necessary to determine if open wedge HTO would be a safer surgical option.

Knee osteoarthrosis secondary to ochronosis - clinical case.

Alkaptonuria is a rare metabolic disease in which a deficiency of the enzyme homogentisate dioxygenase causes an accumulation of homogentisic acid. Ochronosis consists of excessive deposition of homogentisic acid in the connective tissue and presents as a chestnut brown or black pigmentation. With aging, the accumulation of pigments from homogentisic acid in the joints causes osteoarthrosis. There is no specific treatment for the disease and the approach is symptomatic. Arthroplasty is the solution for severe cases of osteoarthrosis caused by this pathological condition and presents results comparable to those from patients with primary osteoarthrosis. Here, the case of a 67-year-old patient who underwent several arthroplasty procedures because of osteoarthrosis caused by this rare pathological condition is presented. The last surgical intervention consisted of total right knee arthroplasty.

A alcaptonúria é uma doença metabólica rara em que a deficiência da enzima ácido homogentísico-oxidase provoca uma acumulação de ácido homogentísico. A ocronose consiste na deposição excessiva de ácido homogentísico no tecido conjuntivo e apresenta-se como uma pigmentação acastanhada ou preta. Com o envelhecimento, a acumulação de pigmentos de ácido homogentísico nas articulações provoca osteoartrose. Não existe um tratamento específico para a doença e a abordagem é sintomática. A artroplastia é a solução para casos graves de osteoartrose causada por essa patologia e apresenta resultados comparáveis aos doentes com osteoartrose primária. Os autores apresentam o caso de um doente de 67 anos submetido a várias artroplastias, em virtude da osteoartrose causada por essa rara patologia. A última intervenção cirúrgica foi uma artroplastia total do joelho direito.