Lateral Closing Wedge High Tibial Osteotomy and Non-customized Total Knee Arthroplasty in a Patient with Achondroplasia. Single-stage Surgical Planning

Francisco Antonio Miralles-Muñoz*, Carlos Ferragut-Bria and Julia Amparo Zofío-Bellod

Patients with achondroplasia often experience knee osteoarthritis, which is marked by varus deviation of the tibia, as well as recurvatum, internal tibial torsion, and mediolateral instability of the knee. This presents a challenge for surgeons, as it necessitates meticulous planning of intricate procedures that may need to be carried out in one or multiple surgical stages.

There are few descriptions in the literature of a single-stage complex knee treatment for patients with achondroplasia. Additionally, there is a lack of information on the method used for precisely calculating the dimensions of the bone wedge to be resected during the lateral tibial closure osteotomy procedure.

We present the case of a 52-year-old man with achondroplasia (height 122 cm) and deforming osteoarthritis of the knees. The right knee showed severe malalignment with a 36.4° extra-articular varus deformity and multidirectional instability. A single-stage surgery was necessary, involving meticulous planning for a tibial osteotomy and a total knee arthroplasty with a rotating hinge. The clinical and radiological outcomes at 2 years postoperative follow-up were satisfactory.

This study outlines the methodology used for single-stage surgical planning with a lateral closing wedge technique, followed by a non-customized total knee arthroplasty in a case of deforming osteoarthritis of the knee with very small anatomical dimensions in a young patient with achondroplasia.

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Published on: Oct 17, 2025 Pages: 17-21

Full Text PDF Full Text HTML DOI: 10.17352/amm.000037
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