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Total knee arthroplasty in a young patient with achondroplasia
  1. Hassan Zmerly1,2,
  2. Marco Russo1,
  3. Manuela Moscato1 and
  4. Ibrahim Akkawi3
  1. 1San Pier Damiano Hospital, Faenza, Italy
  2. 2UCM Malta, LUDES, Lugano, Switzerland
  3. 3Villa Erbosa Hospital, Bologna, Italy
  1. Correspondence to Professor Hassan Zmerly, 3 Villa Erbosa Hospital, Bologna, Italy; zmerly{at}


Achondroplasia is a genetic skeletal dysplasia, characterised by dwarfism, with upper and lower limb deformities, that can lead to knee osteoarthritis; the surgical treatment is a challenge due to the particular joint anatomy variances. We present a 40-year-old woman, affected by achondroplasia with severe left knee osteoarthritis; the patient was treated conservatively with poor results. Between the ages of 12 and 17 years, she underwent multiple operative procedures for lower limb lengthening and a partial correction of the valgus deformity, by applying an external fixator. The patient was successfully treated with cemented posterior stabilised, fixed-bearing, total knee arthroplasty. The patient affected by achondroplasia, with severe knee osteoarthritis, should be considered for total joint replacement, which can be carried out with or without additional extra-articular osteotomy for alignment correction. Due to skeletal dysplasia in joint deformities, knee replacement requires careful preoperative planning and special technical considerations.

  • osteoarthritis
  • degenerative joint disease
  • orthopaedic and trauma surgery

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  • Contributors HZ—writing the manuscript, analysis and interpretation of data, and technical and material support. MR—conception and design, data collection and critical revision of the manuscript. MM—analysis and interpretation of data, supervision and critical revision of the manuscript. IA—writing the manuscript, and technical and material support.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.