case_images: PMC8570898_01
case_images: Radiography of the pelvis shows arthrodesis of the right hip joint and posterior lumbar interbody fusion.
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case_images: PMC8570898_01_CRIOR2021-6443618.001.jpg
case_images: fig1
case_images: Using radiography, we observed the fusion of the right hip joint at an abduction of 10  (Figure 1) and determined that the extent of OA on the healthy side (left side) was slight.
case_images: Radiography shows grade 4 osteoarthritis of the right knee joint, according to the Kellgren-Lawrence scoring system, with a pagoda-type tibial plateau. (Right (a) and left (b) anterolateral view and right (c) and left (d) lateral view).
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case_images: PMC8570898_01_CRIOR2021-6443618.002.jpg
case_images: fig2
case_images: The shape of the tibial plateau was a pagoda-type, and the medial tibial plateau depression (MTPD) was -40  (Figure 2).
case_images: Full-length radiography of the lower limbs shows pelvic tilt and right genu varum.
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case_images: PMC8570898_01_CRIOR2021-6443618.003.jpg
case_images: fig3
case_images: Full-length radiography of the lower limbs showed pelvic tilt and genu varum, with a femorotibial angle of 182  (Figure 3).
case_images: Stress radiography shows remarkable instability of the right knee. (Varus (a) and valgus (b)).
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case_images: PMC8570898_01_CRIOR2021-6443618.004.jpg
case_images: fig4
case_images: Significant instability of the knee was also observed using stress imaging, with valgus and varus instabilities of 9  and 7 , respectively (Figure 4).
case_images: Computed tomography of the hip joint shows marked atrophy of the right gluteus medius muscle.
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case_images: PMC8570898_01_CRIOR2021-6443618.005.jpg
case_images: fig5
case_images: Computed tomography (CT) of the hip joint demonstrated marked atrophy of the right gluteus medius muscle (Figure 5).
case_images: Postoperative radiography shows that tibial condyle valgus osteotomy with an open distance of 11 mm was performed and fixed with a metal plate. (Anteroposterior view (a) and lateral view (b)).
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case_images: PMC8570898_01_CRIOR2021-6443618.006.jpg
case_images: fig6
case_images: Tokyo, Japan). The open distance was determined by opening the osteotomy site until contacting the femoral and tibial medial condyle. The postoperative outcome was positive. The patient's MTPD improved to -30  (Figure 6), and she attained full range of motion in her right knee immediately after surgery. The patient began with partial weight bearing immediately after surgery, and full weight bearing was achieved 4 weeks subsequently.
case_images: Knee instability improved after the removal of the metal implants (varus (a) and valgus (b)), and a double-legged stance view shows no correction loss at 2 years and 9 months postoperatively (c).
case_images: CRIOR2021-6443618.007.jpg
case_images: PMC8570898_01_CRIOR2021-6443618.007.jpg
case_images: fig7
case_images: The right knee joint displayed a flexion of 70  and an extension of -5 , and stress radiography showed a valgus instability of 5  and a varus instability of 3 , demonstrating improved stability in the right knee and better walking ability (Figure 7).