IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v18y2021i23p12473-d688998.html
   My bibliography  Save this article

Staged Joint Arthrodesis in the Treatment of Severe Septic Ankle Arthritis Sequelae: A Case Report

Author

Listed:
  • Yong-Cheol Hong

    (Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Cheonan 31151, Korea
    These authors contributed equally to this work and are co-first authors.)

  • Ki-Jin Jung

    (Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Cheonan 31151, Korea
    These authors contributed equally to this work and are co-first authors.)

  • Hee-Jun Chang

    (Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Cheonan 31151, Korea)

  • Eui-Dong Yeo

    (Department of Orthopaedic Surgery, Veterans Health Service Medical Center, Seoul 05368, Korea)

  • Hong-Seop Lee

    (Department of Foot and Ankle Surgery, Nowon Eulji Medical Center, Eulji University, Seoul 01830, Korea)

  • Sung-Hun Won

    (Department of Orthopaedic Surgery, Soonchunhyang University Hospital Seoul, Seoul 04401, Korea)

  • Jae-Young Ji

    (Department of Anesthesiology and Pain Medicine, Soonchunhyang University Hospital Cheonan, Cheonan 31151, Korea)

  • Dhong-Won Lee

    (Department of Orthopaedic Surgery, Konkuk University Medical Center, Seoul 05030, Korea)

  • Ik-Dong Yoo

    (Department of Nuclear Medicine, Soonchunhyang University Hospital Cheonan, Cheonan 31151, Korea)

  • Sung-Joon Yoon

    (Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Cheonan 31151, Korea)

  • Woo-Jong Kim

    (Department of Orthopaedic Surgery, Soonchunhyang University Hospital Cheonan, Cheonan 31151, Korea)

Abstract

Septic ankle arthritis is a devastating clinical entity with high risks of morbidity and mortality. Prompt treatment is necessary because delayed or inadequate treatment can lead to irreversible damage that may occur on the articular surface, resulting in cartilage erosion, infective synovitis, osteomyelitis, joint deformity, and pain and joint dysfunction. An aggressive surgical approach is required when a joint infection causes severe limb-threatening arthritis. A 58-year-old woman visited our clinic with increasing pain in the right ankle, which had been present for the previous 2 months. She complained of discomfort in daily life due to deformity of the ankle; limping; and severe pain in the ankle even after walking a little. The patient reported a history of right-ankle injury while exiting a bus in her early 20s. Plain radiographs of the right ankle joint revealed that the medial malleolus was nearly absent in the right ankle joint on the anteroposterior view, and severe varus deformity was observed with osteoarthritic changes because of joint space destruction. Magnetic resonance imaging revealed diffuse synovial thickening of the destroyed tibiotalar joint with joint effusion. Hybrid 99mTc white blood cell single-photon emission computed tomography/computed tomography showed increased uptake along the soft tissue around the ankle joint; uptake was generally low in the talocrural and subtalar joints. A two-stage operation was performed to remove the infected lesions and correct the deformity, thus enabling limb salvage. The patient was nearly asymptomatic at the 6-month follow-up, with no discomfort in her daily life and nearly normal ability to carry out full functional activities. She had no complications or recurrent symptoms at the 1-year follow-up. We have described a rare case of a staged limb salvage procedure in a patient with chronic septic arthritis sequelae. For patients with severe joint deformity because of septic ankle sequelae, staged arthrodesis is a reliable method to remove infected lesions, solve soft tissue problems, correct deformities, and maintain leg length.

Suggested Citation

  • Yong-Cheol Hong & Ki-Jin Jung & Hee-Jun Chang & Eui-Dong Yeo & Hong-Seop Lee & Sung-Hun Won & Jae-Young Ji & Dhong-Won Lee & Ik-Dong Yoo & Sung-Joon Yoon & Woo-Jong Kim, 2021. "Staged Joint Arthrodesis in the Treatment of Severe Septic Ankle Arthritis Sequelae: A Case Report," IJERPH, MDPI, vol. 18(23), pages 1-9, November.
  • Handle: RePEc:gam:jijerp:v:18:y:2021:i:23:p:12473-:d:688998
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/18/23/12473/pdf
    Download Restriction: no

    File URL: https://www.mdpi.com/1660-4601/18/23/12473/
    Download Restriction: no
    ---><---

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:18:y:2021:i:23:p:12473-:d:688998. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.