Joint surgery in severe XXXX .

@entity1 @entity924 @entity1691 @entity572 @entity85
Twenty-three @entity1 with @entity1691 with severe @entity85 of @entity572 , knees, and ankles were treated by a variety of surgical procedures followed by a comprehensive rehabilitation program. The surgery included 35 total hip replacements, six knee arthroplasties, and seven femoral osteotomies. @entity924 (eight procedures) was done on 6 @entity1 . Shortening of the femur was performed in @entity1 with long-standing flexion contractures when straightening of the limb during the operation caused traction on the vessels and the nerves. When there was both hip and knee involvement, hip arthroplasty was performed first. Preoperative planning aimed at obtaining plantigrade position of the feet and lower limb-length equality. Availability of custom-made and miniaturized components was essential. Positioning of @entity1 on the operating table necessitated special supports. Six @entity1 were completely bedridden before surgery and 17 were severely disabled or deformed. All the @entity1 but 2 improved markedly, became mobile, independent, and self-supporting. Revision arthroplasty was performed in 4 @entity1 ; 3 others deteriorated functionally, but refused further treatment. Heterotopic bone formation was observed after operation in 6 @entity1 . Surgery for severe @entity1691 requires highly specialized and well-equipped centers.
