[Ortho] Болит непростой коленный сустав.

[Середа Андрей]

>
> I miss the ankle on orthoroengenogram.
>
Good day. There is equinus deformity of the foot cause she tries to
commensate legs length deficiency (around 4-5 cm) and she walks on forefoot
and toes. The dorsiflexion of foot is restricted with 10 degrees of
equinus. The foot and ankle are painless.

> Arthroscopy?
>
Knee arthroscopy? What for? To see severe osteoarthritis? No doubt on x
rays.

> Double osteotomy?
>
And wi will get more abducted extremity

> Tka later as last option. This is a difficcult one!
>
May be the first option? Or one staged osteotomy  and TKA?

> Is a neuralgia an option in presence of such a knee and hip?
>
No

> Are the limbs equal?
>
I`m not sure I can measure legs length properly in this case. When she lies
prone as she feels comfortable right heel is more proximal for 4-5 cm than
left one.

> Let us know.
>
I will.


-- 
C уважением, Середа Андрей Петрович.
Sereda Andrey, MD, PhD, orthopaedic surgeon,
I.M. Sechenov First Moscow State Medical University, Orthopaedic
department, Deputy Director for Science.
6, Bolshaya Pirogovskaya street
119991, Moscow, Russia
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