# Simultaneous bilateral total knee replacement in a patient with achondroplasia and severe varus deformity: a case report

## TL;DR

A 61-year-old woman with achondroplasia and severe knee deformities successfully underwent a single-stage bilateral knee replacement, achieving pain-free movement and proper alignment.

## Contribution

This is one of the first reports of simultaneous bilateral TKA in a patient with achondroplasia and extreme varus deformity.

## Key findings

- The patient achieved neutral limb alignment and pain-free ambulation at 5-year follow-up.
- Stable implants were confirmed on radiographs after the procedure.
- The case demonstrates the feasibility of one-stage bilateral TKA in this rare condition.

## Abstract

We present a unique case of a 61-year-old female with achondroplasia and end-stage osteoarthritis of both knees who presented with severe pain and bilateral varus deformities of over 40 degrees. The patient underwent single-stage bilateral total knee arthroplasty (TKA) using cemented rotating-hinge implants with long stems. At 5-year follow-up, the patient has neutral limb alignment, pain-free ambulation without assistive devices, and stable implants on radiographs. This is one of the first reported cases of simultaneous bilateral TKA in a patient with achondroplasia and extreme bilateral varus deformity, highlighting how successful correction can be achieved using hinged implants and careful surgical planning, underscoring the feasibility of one-stage bilateral intervention in this rare and challenging scenario.